The Long-Term Effects of Excess Sugar Consumption in Early Childhood.
Approved Research ID: 58599
Approval date: April 30th 2020
The average daily intake of sugars added to foods during processing and preparation is too high; exceeding triple the recommended daily amount. This is concerning because excess intake of added sugars is a key risk factor for unhealthy weight-gain, cardiovascular disease, diabetes, and cancer; diseases that account for nearly 70 percent of all deaths and a global economic burden of more than $2 trillion per year. More troubling is that infants and toddlers consume too much added sugar as well. While nutritional guidelines recommend zero added sugars for children up to age 2, American infants and toddlers consume an average of 4.2 tsp of added sugars per day, and their consumption vastly exceeds the recommended limit for adults by age 24 months. Though debated for years, rigorous evidence on the long-term health impacts of such early exposure is limited and the pathways through which early nutrition may have lasting effects are poorly understood. We will exploit a unique natural experiment - the end of sugar and sweets rationing in 1953 in the United Kingdom (UK) - that provides variation in exposure to sugar and sweets in early childhood to evaluate the long-term causal effects on diet, health and economic outcomes measured more than five decades later in older adulthood. In our analyses, we will assume that cohorts born soon before and after the rationing ended are similar, except in their exposure to sugar and sweets early in life and aim to assess the extent to which habits, epigenetics and perinatal conditions play a role in differences in adult health outcomes. The anticipated project duration is three years. The findings will, at a minimum, provide a new reference for dietary guidelines on added sugar intake for children below two years of age, their long-term impact, and inform early obesity and related disease prevention efforts.
Aim 1: Examine how exposure to sugar-rich diet early in life influences diet and health in older adulthood.
Aim 1a: Analyze adult dietary behaviors, including daily intake of total calories, food groups (e.g., savory and sweet snacks, fruits, vegetables, meats, desserts), added sugar and other nutrients (e.g., proteins, fats, carbohydrates), and compare them across individuals who were exposed to a more or less sugar-rich diet early in life.
Aim 1b: Compare mortality, morbidity, and health outcomes, including but not limited to obesity, diabetes, disability, hypertension, stroke, heart attack, arthritis, cognition, and cancer types across individuals who were exposed to a more or less sugar-rich diet early in life.
Aim 2: Examine how early diet correlates with occupation, retirement status, earnings, assets and wealth; with the goal of understanding the extent to which health differences among today's older adults contribute to these outcomes.
Aim 3: Examine whether the long-term effects vary by exposure to different diets during specific developmental periods and to assess critical exposure window for habit formation and the extent to which it explains variation in adult diet, health and economic well-being relative to the role of epigenetics and perinatal conditions.
Additional aims/new scope:
Aim 4: Assess cohort differences in age trajectory of cognitive function among older adults.
Aim 5: Examine how cohort differences in cognitive function vary by sex and genetic pre-disposition for Alzheimer's disease and related dementia (ADRD) and systemic inflammation.
Aim 6: Examine the extent to which diet, metabolic health and education among today's older adults mediate the total effect of sugar-rich diet, as obtained in Aims 1 and 2, on cognitive health