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Rationing in early life lowered the risk of diabetes and hypertension by approximately 35 per cent and 20 per cent, respectively, while also delaying the onset of these diseases by four and two years, the study revealed
Doctors said the findings are important in today’s context, considering continuous debates on the ill effects of sugar. (Getty Image for Representation)
From conception to age two, reducing sugar intake during the first 1,000 days of a baby’s life may lower the risk of major health problems in adulthood, a new study has found.
Rationing in early life lowered the risk of diabetes and hypertension by approximately 35 per cent and 20 per cent, respectively, while also delaying the onset of these diseases by four and two years.
The researchers, in the study titled “Exposure to Sugar Rationing in the First 1000 Days of Life Protected against Chronic Disease”, investigated the effect of sugar exposure during the first 1,000 days from conception on the risk of diabetes and hypertension.
The study published in the medical journal Science used quasi-experimental variation from the end of sugar rationing in the United Kingdom in September 1953.
“Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-rationing.”
However, not many people recognised that this period of rationing had an impact on the health of children in the coming years.
Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, the authors found that “early-life rationing reduced diabetes and hypertension risk by about 35 per cent and 20 per cent, respectively, and delayed disease onset by 4 and 2 years”.
“Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began. In-utero sugar rationing alone accounted for about one-third of the risk reduction,” the study said.
Study Useful But Caution Needed: Experts
While Indian experts regard the study as a significant piece of research, they also advise caution in interpreting its findings.
According to Dr Anoop Misra, this natural experiment arising from the UK’s sugar rationing period offers valuable insights into early-life sugar exposure.
“The findings, including a 35 per cent reduction in diabetes risk and a 20 per cent reduction in hypertension among those exposed to rationing, are important in today’s context, considering continuous debates on the ill effects of sugar.”
However, Misra said caution is needed in interpretation, as the 1950s dietary environment — including various nutrients beyond sugar — differs markedly from the present. “Despite this, replicating such a study in the future may prove challenging, underlying the importance of incorporating these findings into all dietary guidelines,” he said.
Dr Rajeev Jayadevan, convener, scientific committee and past president, India Medical Association (IMA), Cochin, raised an important point that the researchers’ findings could be because of lower rates of obesity found in this group.
“Earlier studies done on children born during the Dutch famine showed that adult obesity rates were higher among children born at that time. Thus, the effects of early nutrition cast a long shadow.”
It is important to put these findings in context, he said. “Poor nutrition before and during pregnancy is a major problem in developing countries. On the one hand, there is a problem of inadequate food intake, and now the study adds that taking excessive sugar is also not good.”
From India’s perspective, women need to build their health and correct common problems like anaemia and vitamin deficiencies even before planning pregnancy. During pregnancy, they must receive a balanced nutritious diet, but with no added sugar. This also includes avoiding sweets and sweetened soft drinks. Poor diet during pregnancy is linked with worse health outcomes for the baby, including preterm delivery, low birth weight and cognitive deficits (defective brain development) later on.
“Therefore, dietary counselling for women of childbearing age is vital. In addition to maintaining a healthy diet while pregnant, the mother will thus be able to make sure that the diet given to the baby after the first six months of exclusive breastfeeding is also nutritionally balanced.”
Dr Pooja Jagannath, a diabetologist at Bengaluru-based Sparsh Hospital, told News18 that the study’s findings indicate that introducing policies focused on sugar management — through public health initiatives and awareness campaigns — could play a pivotal role in addressing the diabetes epidemic in India.
“The study is particularly relevant for India — a country now considered the diabetes capital of the world. The study’s insights offer a valuable lesson: managing sugar exposure in early life could significantly curb the alarming rise of diabetes and related chronic conditions in India.”
She suggested that governmental and healthcare frameworks could explore guidelines that restrict excessive sugar in children’s diets, particularly in processed foods. “Such measures, alongside public awareness, could not only prevent early onset but also lessen the health and economic burden of diabetes in India.”
Dr Ambrish Mithal, chairman and head, endocrinology and diabetes at Max Healthcare calls the study “remarkable”.
“The study indicates the need for public health intervention and stricter norms on intake of added sugar during pregnancy and post birth. This includes the mother’s diet during pregnancy and diet of infant including use of formula milk post birth.”
While Mithal appreciates the follow-up and work done by researchers to prove the concept, he said that foetal programming of adult disease is not a new but well recognised concept called Barker Hypothesis. “It is not just genes but how the genes are programmed.”
India’s rapidly growing diabetes burden, affecting millions across urban and rural populations, is driven by both genetic predisposition and lifestyle shifts, including increased sugar intake in diets, especially among young and developing children.