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

项目总结 今天每天的游离糖摄入量 同样：平均而言，孩子们 不仅对青少年和成年人，而且对婴儿和蹒跚学步的孩子来说，都被认为太高了 超过成人每日限额两岁。然而，严格的证据表明- 这种儿童早期接触对足月健康的影响是有限的，早期- 儿童时期的营养具有长期的影响，但人们对此知之甚少。一种可能性是生理上的变化 对疾病风险的持久影响。另一种是习惯的形成，因为对甜味的偏好是通过接触而形成的 早年的高糖饮食，以及随后可能会持续到成年的过度消费。稀缺性 经验证据的出现并不令人意外。从经验上评估这些关系在很大程度上是具有挑战性的。 由于缺乏跨越足够长时间的高质量数据，但也是因为选择 担忧。因为随机分配富含糖分的饮食通常是不可行的，来自自然实验的证据 是必要的。 这项研究的目标是开发一种独特的自然实验，它提供了看似合理的外源 生命早期接触糖和甜食的变化，以评估饮食的长期因果影响 以及成年后的健康。自然的实验是在英国的糖和糖果配给在一月份 1940年和1953年2月，这可能会导致当今老年人的饮食和健康发生变化。使用 回归不连续设计，我们假设在1953年2月之前和之后出生的队列 配给结束的情况是相似的，除了他们在生命早期接触到糖和糖果。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。 目标1a：评估每日总卡路里摄入量、食物类别(例如，可口和甜食、 水果、蔬菜、肉类、甜点)、糖和其他营养素(例如，游离和固有的糖、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/门诊保健就诊的队列差异 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：审查在职业、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不同 目标4：检查儿童期的性和社会经济特征是否缓和了早期暴露的影响 对成人饮食、健康和经济福祉的甜食。 这些发现至少将为以下儿童的游离糖摄入量指南提供新的参考 两岁的儿童及其长期影响，以及早期预防肥胖的努力。因为英国和英国 与美国相比，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 在肥胖和相关慢性疾病的患病率方面，我们的发现将对美国具有令人难以置信的相关性和价值。

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.