Major New Study: Sugar Is More Dangerous for Babies Than We Thought

When I was a fetus in my mother's uterus, she had a constant craving for mac and cheese and root beer. That sounds delicious, right? And who am I to food monitor what a pregnant woman eats, other than being the consequence of one of those pregnancies? Well, I'm not gonna sugarcoat it, she might have screwed me. Now, new research in Science is suggesting that early life exposure to sugar, including in utero, and in the first years of life can seriously and causally impact a child's risk of developing diabetes, high blood pressure, and obesity later in life. Now, to many of you, this might not sound surprising, so let me unpack what's really special about this study in particular. Because usually, to demonstrate causality for effects that take decades in humans, you can't really do a randomized trial. So you need to rely on animal data or standard observational epidemiological studies, which are riddled with confounders. However, now and again, real-world circumstances impose a natural experiment, and in the United Kingdom, rationing of sugar continued after World War II until 1953, in particular September 1953. And after sugar rationing ended, sugar intake almost doubled immediately and selectively, with intake of other foodstuffs like fats, produce, and protein remaining rather constant. And this presented— presents a natural quasi-experiment, because what you can do is follow cohorts of children, in this case 60,183 children, through their life course. Comparing those conceived and born just before rationing ended—these are the sugar ration babies—to those conceived and born just after rationing ended. These are the sugar unration babies, or the sugar babies, because they were exposed to more sugar during development. And that's exactly what they did in this study. And it's a really cool design because it takes advantage of a historical event to control for variables through a sort of randomization in time in a way that would be impossible to do otherwise. So what did they find in this cool new study? The researchers found a dose-dependent effect whereby less exposure to sugar during early life led to lower risk of type 2 diabetes, lower risk of hypertension, high blood pressure, and lower risk of obesity later in life, particularly starting about age 50. Half a century after the exposure. And when I say dose-dependent, in this case I mean in time, whereby there was a protective effect of not being exposed to sugar in utero for kids born just before the end of rationing, and an even stronger effect if the sugar rationing included the first year of life, because kids were conceived one year earlier, and an even stronger effect still if the rationing included the first two years of life, So protective effect in utero, but even more protective effect if the rationing included years 1 and 2 of life. Now, for fully rationed kids, the risk of type 2 diabetes was reduced by 35%, the risk of high blood pressure was reduced by 20%, and the risk of obesity was reduced by about 30% as compared to the unrationed sugar babies. Or, to put it the other way, the sugar babies were were at much higher risk of diabetes, high blood pressure, and obesity than the sugar-free babies, or the low-sugar babies. And I'll reinforce this really important point. For the vast majority of these humans' lifespans, they've had similar access to sugar. So the effect appears to be caused, yes, caused, by early life exposure to sugar, including in utero. Now, what this paper does not do is define the causal mechanisms. How does early life sugar exposure increase risk of diabetes, hypertension, and obesity? It could be through increasing lifelong sugar cravings, through rewiring of the brain during development. It could also be through changes cemented in the microbiome, or changes in epigenetics, It's not yet clear, but something is clearly going on. Now, I want to transition to size up the problem given modern statistics on sugar, some of which will blow your mind. Okay, according to the CDC, it's important to note children under 2 years should not be given any foods or beverages with added sugar. Any, according to the CDC. Nevertheless, most young children do consume added sugar, starting before birth vis-à-vis their mothers. In fact, pregnant and lactating women consume more than triple the recommended amount of added sugar per day, over 80 grams of added sugar per day on average, and that's not including natural sugars like fruits, and is equivalent to more than 5 chocolate frosted donuts with sprinkles from Dunkin' Donuts. How crazy is that? That's a daily average of just added sugar. And these new data on the serious harms of early life exposure to sugar, they build upon a mountain of prior evidence, and they make the case that this is a major problem that needs to be addressed if we are to give our kids and grandkids and grand-grandkids the best possible chance of a healthy life. So now I want to talk about solutions, because there's a lot on the table. Except for sugar. Solutions include increasing education and awareness, that's what we're doing here, or legislation to limit sugar exposure in public settings like schools, hospitals, and vending machines. There's also options like sugar taxes and so on. And in addition, I'm an advocate of carefully selected sugar substitutes as a tool, but I do emphasize carefully selected because certain artificial sweeteners may have similarly detrimental heritable effects. For example, the artificial sweetener aspartame, which is found in Diet Coke and hundreds of other products, has been shown to cause increased anxiety and anxiety-like behavior in animal models that can be inherited for up to 2 generations, even at low to moderate doses. So not any sweet or sugar substitute will do, which brings me to the question, in the universe of sweeteners, What are the best options? Currently, my opinion, based on my reading of the literature, is that stevia, monk fruit, and allulose are all reasonable. But overall, I actually have to give the edge to the rare sugar and C3 epimer of fructose, allulose, given its impact on fat cell physiology and hormones. Allulose is super interesting. It doesn't spike insulin or glucose, and it can actually reduce glucose and insulin responses to added sugar, including in human randomized trials. And it appears particularly potent at increasing natural levels of the hormone GLP-1. Not to the same extent as injectable weight loss medications, however, it can still have potential therapeutic benefit. And it's been shown in animal models at least to have anti-obesogenic, anti-sugar properties, which is pretty cool. And as a disclosure, in case you're not already aware, the interesting research on allulose is actually why I'm on the scientific advisory board of RX Sugar, which produces allulose-based products, along with fellow scientists Dr. Dabeneck D'Agostino, Dr. Andrew Kutnick, Dr. Ben Bikman, and Dr. Richard Johnson, which are some names you might know. And especially for this video, just for kicks and giggles, and to promote education around this message and the cautionary tale around sugaring children, my friend and new low-sugar mom with twins helped us generate some really cool kid-friendly sugar-free recipes using RXSugar products, including some amazing RXSugar brownie truffles and low-carb allulose flan, which you can access totally free via the links below. They are delicious. I've already tried them out. But free recipes aside, the core message here is plain and simple: sugar is not benign. You can have it, and I'm not advocating no children ever eat sugar. I'm a pragmatist. However, the normalization of our current sugar-laden food ecosystem is a big, big problem. A problem that impacts children even before they're born and have the informed right to choose what they put into their own bodies. Okay, I was gonna close here, but one last important message. Among the exciting initiatives I have planned to make metabolic health mainstream, which I know you know is our mission here on my channel, I'm partnering with Exam Crackers, a medical school exam MCAT prep company to help put the metabolism back in medicine. We are offering free MCAT prep questions based on the papers covered in my videos for anyone to access if they want to learn and test their knowledge. And if you also know someone preparing for medical school, or that's you, and you want them or you want to become metabolically literate and metabolically mindful, I suggest you guys check out the links below and potentially sign up for Exam Crackers courses for their MCAT prep course. It really is top in class. And it's gonna help us put the metabolism back in medicine and make future doctors aware of the importance of metabolic health, including starting in utero.