Early-Life Sugar Restriction Linked to Lower Adult Heart Disease Risk: BMJ
UK: A study examining World War II–era sugar rationing in the United Kingdom found that individuals exposed to limited sugar intake from conception through early childhood had significantly lower cardiovascular risks later in life. Those who spent their first 1,000 days under sugar rationing showed a 20% lower risk of cardiovascular disease and a 25% lower risk of heart attack after age 40.
The research, published in the BMJ, analyzed data from 63,433 participants in the UK Biobank born between October 1951 and March 1956. Participants were free from cardiovascular disease at baseline, and the study excluded multiple births, adoption cases, and individuals born outside the UK. Exposure to sugar rationing was determined by birth date relative to the end of rationing in 1953, creating a natural quasi-experiment. External validation was performed using the Health and Retirement Study and the English Longitudinal Study of Ageing.
Jiazhen Zheng, a doctoral student at the Hong Kong University of Science and Technology, and colleagues investigated a range of cardiovascular outcomes, including incident cardiovascular disease, myocardial infarction, heart failure, atrial fibrillation, stroke, and cardiovascular mortality.
They applied Cox and parametric hazard models, adjusting for demographic, socioeconomic, lifestyle, parental health, genetic factors, and geographic location. A subset of participants underwent cardiac magnetic resonance imaging to assess cardiac structure and function.
Key Findings:
- Longer exposure to sugar rationing in early life was associated with lower cardiovascular risk in adulthood.
- Participants exposed in utero and during their first one to two years had a hazard ratio of 0.80 for cardiovascular disease.
- Hazard ratio for myocardial infarction in the same group was 0.75.
- Hazard ratio for heart failure was 0.74.
- The hazard ratio for atrial fibrillation was 0.76.
- Hazard ratio for stroke was 0.69.
- Hazard ratio for cardiovascular mortality was 0.73.
- Diabetes and hypertension mediated approximately 31% of the association between early sugar restriction and cardiovascular risk.
- Birth weight contributed only 2% to the observed association.
- Cardiac imaging revealed modest improvements, including higher left ventricular stroke volume index and ejection fraction among those exposed to early sugar restriction.
“Our results indicate that limited sugar exposure during the critical first 1,000 days of life confers lasting cardiovascular benefits,” the researchers noted. They emphasized that the protective effects were more pronounced with longer durations of sugar restriction, highlighting the importance of early-life nutrition in shaping lifelong heart health.
The study emphasizes the potential of population-level interventions during early development, such as dietary guidelines and sugar reduction policies, to reduce long-term cardiovascular risk. The authors recommend further research to explore individual-level dietary exposures, the interaction of genetic and environmental factors, and the mechanisms through which early sugar restriction influences cardiometabolic outcomes.
This research contributes to growing evidence that early nutrition plays a critical role in lifelong heart health. By showing that early-life sugar limitation can reduce the risk of heart disease and improve cardiac function decades later, the study provides compelling support for policies and interventions targeting nutrition in pregnancy and early childhood.
"Overall, these findings offer important insights for public health strategies, suggesting that careful management of sugar intake during the first 1,000 days after conception could be a practical approach to preventing cardiovascular disease in later life," the authors concluded.
Reference: BMJ 2025;391:e083890
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