Britain’s postwar sugar craze confirms harms of sweet diets in early life
A study utilising the end of sugar rationing in the UK as a natural experiment reveals that early-life exposure to high sugar intake may increase the risk of type 2 diabetes and hypertension later in life.
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31/10/2024 - Science
In 1953, the United Kingdom got its sweet tooth back, ending the rationing of candies and sugar that had begun during World War II. Hordes of people descended on candy stores and started to sweeten more of their foods at home. Within the year, the nation’s sugar consumption doubled.
Now, a team of researchers has turned this sharp shift in the British diet into a vivid demonstration of how sugary diets in early life undermine long-term health. Combining food surveys and sugar sales from the 1950s with medical records of adults from the UK Biobank database, the team found that people conceived or born after 1953 had higher risks of type 2 diabetes and hypertension decades later than those born during rationing. The findings, published online today in Science, underscore the sweet stuff’s negative effects in early infancy, say researchers.
“It’s a fascinating study,” says Edward Gregg, an epidemiologist at the Royal College of Surgeons in Ireland. “Although we know … sugar influences diabetes risk, to have a natural experiment like this wherein you have a whole population under a [dietary] restriction, followed by a dramatic change and in turn a big impact on diabetes and hypertension, I think is pretty profound.”
Public health authorities recommend no added sugar for infants during the first 1000 days from conception, a critical window for development. But the pervasiveness of sweetened foods in many countries means babies are exposed to unnaturally large amounts of sugar in utero and after birth. By some estimates, the average pregnant person in the United States consumes more than 80 grams of added sugar daily—about triple the recommended limit for adults—while more than 80% of babies and toddlers have foods with added sugar on any given day.
Numerous animal studies have linked sugar to type 2 diabetes and other health problems. But clear-cut human evidence is hard to come by because of the challenges of studying people from womb to old age and disentangling the effect of sugar versus other diet or lifestyle factors, says Tadeja Gracner, an economist at the University of Southern California and the RAND Corporation, a policy think tank. Sugar rationing offered a rare opportunity: Babies conceived on either side of 1953 would have had very different early-life sugar exposure, but were similar in all other respects. Although other products such as butter were also derationed in the mid-1950s, none saw such a leap in consumption.
Gracner and her colleagues sifted through U.K. dietary surveys from the 1950s, as well as annual sugar and sweet sales. Through the UK Biobank, which has been collecting data from participants since 2006, they also gathered medical information for more than 60,000 people born between 1951 and 1956. Nearly 4000 of them had developed diabetes and almost 20,000 had hypertension.
Among the 60,000, a person’s likelihood of having either condition depended on how many of their first 1000 days fell during rationing, the team found. Someone conceived before but born after sugar rations ended in September 1953 had about a 15% lower risk of diabetes than someone conceived after that, and a 5% lower risk of hypertension. Infants who reached age 1.5 before rationing ended fared even better, with a 40% lower risk of diabetes and a 20% lower risk of hypertension compared with the never-rationed group. The reduction in diabetes risk was more pronounced in women than in men.
Early-life sugar could drive later-life disease in various ways, Gracner says. Exposure in the womb might affect fetal development in a way that predisposes someone to metabolic diseases. Infants eating a sugary diet might also develop a taste for sweet foods, causing them to eat more sugar as adults—an outcome for which her team has some preliminary evidence. The researchers didn’t see an effect of derationing on conditions without obvious links to sugar, such as shortsightedness or type 1 diabetes (which is rarer and mainly genetically determined), suggesting the results weren’t an effect of people born after 1953 being in poorer health or more likely to be diagnosed.
“It’s a really exciting analysis,” says Jack Bowden, a biostatistician at the University of Exeter. Particularly convincing was finding a “dose-response relationship”—as time under sugar rationing increased, later-life disease risk decreased. He cautions there may still be confounding differences between UK Biobank participants born before 1953 and those born after.
Tannaz Moin, an endocrinologist at the University of California, Los Angeles’s David Geffen School of Medicine, says the study highlights the power of natural experiments, which “provide critical information from real-world settings where randomized controlled trials may not be feasible or ethical.” Although UK Biobank data have limitations—participants skew white and wealthy, for example—the results could spur policy changes to improve maternal and infant health and avoid chronic disease, she adds.
Awareness campaigns, taxing sugar, and tighter regulations on food formulation and labeling all might help, Gracner says. She stresses that parents shouldn’t be blamed. “It’s very difficult to eat within recommended guidelines in our current environment—and that difficulty starts very early in life.”
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