The Sweet Life: The Long-Term Effects of a Sugar-Rich Early Childhood

Paul Gertler & Tadeja Gracner (2022) NBER DOI 10.3386/w30799

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Abstract:

We show that sugar-rich diet early in life has large adverse effects on the health and economic well-being of adults more than fifty years later.

Excessive sugar intake early in life led to higher prevalence of chronic inflammation, diabetes, elevated cholesterol and arthritis. It also decreased post-secondary schooling, having a skilled occupation, and accumulating above median wealth.

We identified elevated sugar consumption across lifespan as a likely pathway of impact.

Exploiting the end of the post-WWII rationing of sugar and sweets in 1953 in the United Kingdom, we used a regression discontinuity design to identify these effects.

FAB RESEARCH COMMENT:

This remarkable study involves a detailed comparison of both health and economic outcomes for older adults who were born in the UK during the years just before, and just after, the post-war rationing of sugar came to an end in 1953.

As potential 'nutritional programming' effects of prenatal and early life diet were the question being addressed, the researchers took care to include only those adults for whom their birth timing made it clear that their conception, pregnancy and early infancy fell entirely either before sugar rationing was lifted, or afterwards.

The data show that during the postwar rationing period, the typical diet of the UK population met official nutritional guidelines, despite relative shortages of many major food groups. (Notably, it has never met these since).

However, when the rationing of sugar was lifted, sugar consumption rapidly doubled within a very short period of time. No other food group showed anything like the increase in consumption that was seen for sugar when restrictions were lifted (which happened at different times for different foods).*

Careful analyses, controlling for numerous other relevant variables, show that 50 years later, adults who were born after sugar rationing was lifted had strikingly higher rates of degenerative disease, and significantly poorer educational and economic outcomes, than those whose pregnancy and early infancy fell within the period of low sugar intakes.

As the researchers explain, powerful long-term effects such as these are more than plausible given that:

early life nutrition not only shapes the initial formation and development of all brain and body systems, but also has permanent (i.e. lifelong) effects on metabolism, health and wellbeing.

Nutrition during the critical period from conception to around 2 years of age ('the first 1000 days') has irreversible effects gene expression and regulation. These lasting 'epigenetic' effects are collectively known as 'nutritional programming'

high sugar intakes in early life also predicted higher sugar intakes throughout life (22% more than controls) - again consistent with other evidence for prenatal and early life influences on food and taste preferences.

*Intakes of sugar have risen even further since then - with the next most rapid increase occurring after the late 1970s, when dietary guidelines first advised against 'high-fat' foods, and consumption of sugary soft drinks, snack foods and the addition of sugar to ultra-processed 'ready-meals' really took off from the 1980s onwards (closely followed by the modern-day 'epidemics' of obesity, Type 2 diabetes, Non-Alcoholic Fatty Liver Disease and other Non-Communicable Diseases....)

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