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.

项目摘要 今天每日免费的糖摄入量 同样：平均儿童 不仅对于青少年和成年人，而且在婴儿和幼儿中被认为太高了 超过成人每日限制，到两岁。然而，对长期的严格证据 这种幼儿暴露的期限健康影响是有限的，并且早期的因果途径 儿童营养的持久作用知之甚少。一种可能性是生理变化 对疾病风险的持久影响。另一个是习惯形成，因为对甜度的偏爱是通过暴露而形成的 在生命的早期饮食及其过度消费量可能会持续到成年。稀缺 经验证据并不令人惊讶。从经验上评估这些关系在很大程度上具有挑战性 由于缺乏跨越足够长的时期的高质量数据，但也是由于选择 关注。因为富含糖的饮食的随机分配通常是不可行的，所以自然实验的证据 需要。 这项研究的目的是利用独特的自然实验，可提供合理的外源性 生命早期接触糖和糖果的变化，以评估长期因果饮食的影响 和成年后的健康。自然的实验是1月之间在英国的糖和糖果的配给 1940年和1953年2月，这可能会引起当今老年人饮食和健康的差异。使用 回归不连续性设计，我们假设1953年2月之前和之后出生 配给结局是相似的，除了它们早期接触糖和糖果。我们的具体目的是： 目标1：检查糖果在生命早期的摄入量如何影响成年后的饮食和健康。 AIM 1A：评估总卡路里每日摄入量的队列差异，食物组（例如咸味和甜食， 水果，蔬菜，肉类，甜点），糖和其他营养素（例如游离和内在的糖，蛋白质，脂肪）。 AIM 1B：评估与饮食有关 疾病，例如肥胖，糖尿病，残疾，高血压，中风，心脏病发作，关节炎和癌症。 目标2：检查职业，退休年龄，收入，资产和财富的队列差异，目标 了解当今老年人的健康差异在多大程度上促进了这些结果。 目标3：检查长期效果是否因配给而有所不同 目标4：检查儿童时期的性和社会经济特征是否适应早期暴露的影响 致糖果，健康饮食，健康和经济健康。 这些发现至少将为下面的儿童免费糖摄入指南提供新的参考 两岁及其长期影响，并为早期的肥胖预防工作提供信息。自英国都是因为两者 而且美国具有可比的，世界上最高的免费糖摄入量，几乎相同的电流和预计 肥胖症和相关慢性疾病的患病率将对美国具有令人难以置信的相关性和有价值。