The Sweet Life: The Long-Term Effects of Excess Sugar Consumption in Early Childhood

项目摘要 每日游离糖摄入量 平均而言，儿童 不仅对青少年和成年人来说， 超过成人每天的限制，由两岁。然而，长期以来的严格证据- 这种早期儿童接触的长期健康影响是有限的，早期儿童接触的因果途径是有限的。 对儿童营养的长期影响知之甚少。一种可能是生理变化， 对疾病风险的持久影响。另一个是习惯的形成，因为对甜味的偏好是通过接触形成的 早期高糖饮食及其过量消费可能会持续到成年。稀缺 并不令人惊讶。从经验上评估这些关系在很大程度上具有挑战性 这是因为缺乏足够长时间的高质量数据， 性问题由于随机分配高糖饮食往往是不可行的，从自然实验的证据 是必要的。 这项研究的目的是利用一种独特的自然实验， 在生命早期暴露于糖和甜食的变化，以评估对饮食的长期因果影响 健康在成年。一个自然的实验是在英国从一月到二月对糖和糖果实行定量配给。 1940年和1953年2月，这可能导致今天老年人的饮食和健康发生变化。使用 回归不连续设计，我们假设1953年2月前后出生的队列， 配给结束的情况相似，除了他们在生命早期接触糖和糖果的情况。我们的具体目标是： 目的1：研究生命早期摄入甜食如何影响成年后的饮食和健康。 目的1a：评估每日总热量摄入、食物组（例如，咸甜小吃， 水果、蔬菜、肉类、甜点），糖和其它营养物（例如，游离和内在糖、蛋白质、脂肪）。 目的1b：评估死亡率、发病率和饮食相关的住院/门诊医疗保健访视的队列差异 疾病，如肥胖、糖尿病、残疾、高血压、中风、心脏病发作、关节炎和癌症。 目标2：研究职业、退休年龄、收入、资产和财富方面的群体差异， 了解当今老年人的健康差异在多大程度上促成了这些结果。 目标3：检查长期影响是否因定量配给而异 目标4：研究儿童期的性别和社会经济特征是否会减轻早期接触的影响 甜食对成人饮食、健康和经济福祉的影响。 研究结果将至少为以下儿童的游离糖摄入量指南提供新的参考 2岁及其长期影响，以及为早期肥胖预防工作提供信息。由于英国 和美国有可比的，世界上最高的游离糖摄入量和几乎相同的当前和预测 肥胖症和相关慢性病的患病率，我们的研究结果将是令人难以置信的相关和有价值的美国。

PROJECT SUMMARY Daily free sugar intake today as well: on average, children is considered too high not only for teens and adults, but among infants and toddlers exceed the adult daily limit by two years of age. Yet, rigorous evidence on the long- term health impacts of this early childhood exposure is limited and the causal pathways through which early- childhood nutrition has long-lasting effects are poorly understood. One possibility is physiological changes with lasting effects on disease risks. Another is habit formation, as the preference for sweetness is shaped by exposure to a sugar-rich diet early in life and its excessive consumption that may then persist into adulthood. The scarcity of empirical evidence is not that surprising. Evaluating these relationships empirically is challenging in large part due to the lack of high-quality data that span a period that is sufficiently long, but also because of selection concerns. Because random assignment of sugar-rich diet is often infeasible, evidence from natural experiments is needed. The goal of this study is to exploit a unique natural experiment that provides plausibly exogenous variation in exposure to sugar and sweets early in life in order to evaluate the long-term causal effects on diet and health in adulthood. The natural experiment is the rationing of sugar and sweets in the UK between January 1940 and February 1953, which likely induced variation in the diet and health of today's older adults. Using a regression discontinuity design, we assume that cohorts born right before and after February 1953 when the rationing ended are similar, except in their exposure to sugar and sweets early in life. Our specific aims are to: Aim 1: Examine how intake of sweets early in life influences diet and health in adulthood. Aim 1a: Assess cohort differences in daily intake of total calories, food groups (e.g., savory and sweet snacks, fruits, vegetables, meats, desserts), sugar and other nutrients (e.g., free and intrinsic sugars, proteins, fats). Aim 1b: Assess cohort differences in mortality, morbidity, and in/outpatient health care visits for diet-related disease, such as obesity, diabetes, disability, hypertension, stroke, heart attack, arthritis, and cancer. Aim 2: Examine cohort differences in occupation, retirement age, 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 rationing Aim 4: Examine if sex and socio-economic characteristics in childhood moderate the impact of early exposure to sweets on adult diet, health and economic well-being. The findings will, at a minimum, provide a new reference for guidelines on free sugar intake for children below two years of age and their long-term impact, as well as inform early obesity prevention efforts. Since both UK and the US have comparable, world's highest intake of free sugar and almost identical current and projected prevalence in obesity and related chronic disease, our findings will be incredibly relevant and valuable to the US.