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

甜蜜的生活：幼儿期过量摄入糖分的长期影响

• 批准号: 10618017
• 负责人: Tadeja Gracner
• 金额: $ 24.42万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-15 至 2023-10-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10618017
• 关键词: 2 year old; Accounting; Address; Adult; Age; Aging; Arthritis; Behavior; Blood Pressure; Calories; Carbohydrates; Cardiovascular Diseases; Cause of Death; Cessation of life; Characteristics; Child; Childhood; Cholesterol; Chronic Disease; Clinic; Clinical; Cohort Studies; Consumption; Data; Data Set; Diabetes Mellitus; Diet; Diet Habits; Diet Surveys; Disease; Economic Burden; Elderly; England; Exposure to; Fatty acid glycerol esters; Fiber; Food; Fruit; Funding; Goals; Guidelines; Habits; Health; Health Care Visit; Health Surveys; Hemoglobin; Hypertension; Infant; Intake; Juice; Life; Life Style; Link; Long-Term Effects; Longitudinal Surveys; Malignant Neoplasms; Measures; Meat; Morbidity - disease rate; Myocardial Infarction; Natural experiment; Nutrient; Nutrition Surveys; Obesity; Obesity associated disease; Occupations; Outcome; Outcome Measure; Outpatients; Participant; Pathway interactions; Patient Self-Report; Patients; Personal Satisfaction; Physiological; Preparation; Prevalence; Primary Health Care; Proteins; Public Hospitals; Records; Reporting; Research Design; Retirement; Risk Factors; Role; Savory; Socioeconomic Factors; Stroke; Surveys; Teenagers; Toddler; United Kingdom; Variant; Visit; Weight Gain; aged; cohort; demographics; design; dietary; disability; disorder risk; early childhood; economic outcome; fruits and vegetables; health difference; health economics; improved; innovation; mortality; nutrition; obesity prevention; preference; sex; socioeconomics; sugar; waist circumference

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.

项目概要 今天每日游离糖摄入量 还有：平均而言，儿童 不仅对青少年和成人来说，而且对婴儿和幼儿来说也被认为太高 超过成人每日限量两岁。然而，长期的严格证据表明 这种早期儿童接触的长期健康影响是有限的，并且早期接触的因果途径 儿童营养的长期影响尚不清楚。一种可能性是生理变化 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由接触形成的 生命早期的高糖饮食及其过量摄入可能会持续到成年。稀缺性 经验证据的出现并不令人惊讶。凭经验评估这些关系在很大程度上具有挑战性 由于缺乏跨越足够长时期的高质量数据，而且还因为选择 的担忧。由于随机分配富含糖的饮食通常是不可行的，来自自然实验的证据 是需要的。 这项研究的目的是利用一种独特的自然实验，提供合理的外源性 生命早期接触糖和甜食的变化，以评估对饮食的长期因果影响 和成年后的健康。自然的实验是英国在一月份之间实行糖和糖果的配给 1940 年和 1953 年 2 月，这可能导致当今老年人的饮食和健康状况发生变化。使用 在断点回归设计中，我们假设出生于 1953 年 2 月前后的队列 配给结束的情况相似，除了他们在生命早期接触糖和糖果。我们的具体目标是： 目标 1：研究生命早期摄入甜食如何影响成年后的饮食和健康。 目标 1a：评估每日摄入总热量、食物类别（例如咸味和甜味零食、 水果、蔬菜、肉类、甜点）、糖和其他营养素（例如游离糖和内在糖、蛋白质、脂肪）。 目标 1b：评估与饮食相关的死亡率、发病率和住院/门诊医疗保健就诊的队列差异 疾病，例如肥胖、糖尿病、残疾、高血压、中风、心脏病、关节炎和癌症。 目标 2：检查职业、退休年龄、收入、资产和财富方面的队列差异，目标是 了解当今老年人之间的健康差异对这些结果的影响程度。 目标 3：检查长期影响是否因配给而变化 目标 4：检查儿童时期的性别和社会经济特征是否会减轻早期暴露的影响 甜食对成人饮食、健康和经济福祉的影响。 研究结果至少将为以下儿童游离糖摄入指南提供新的参考 两岁及其长期影响，并为早期肥胖预防工作提供信息。由于英国 美国的游离糖摄入量是世界上最高的，目前和预计的摄入量几乎相同 肥胖和相关慢性疾病的患病率，我们的研究结果将对美国具有极大的相关性和价值。