Rafael Urrialde de Andrés
Professor at the Faculty of Biological Sciences of the Complutense University of Madrid and at the Faculty of Pharmacy of the San Pablo-CEU University, and member of the Board of Directors of the Spanish Society of Nutrition
This is an observational study with a very large sample size, concluding aspects regarding the restriction of added sugar intake during the first 1,000 days of life and its long-term effects on preventing the occurrence and prevalence of diabetes and hypertension.
As an observational study, it has all the limitations and restrictions implicit in this methodology, compared to clinical trials. The correlation it demonstrates is not causation, but it supports what other studies have also shown: the importance of avoiding added sugar and preventing an excess of free sugars from any food source during the first 1,000 days of life. It also benefits from a very large and representative sample size.
Although there is no direct causality demonstrated between sugar restriction during the first 1,000 days and the reduction in diabetes and hypertension prevalence, what has been observed is that this restriction—not only of added sugars but also of free sugars—has a positive effect on reducing childhood overweight and obesity, and later, on the occurrence of certain conditions associated with both overweight and obesity. Today, recommendations are to minimize added sugar and free sugar intake in infants and young children (zero to three years old).
The limitation, as with all observational studies, is the same as those of other studies using this type of analysis compared to clinical trials. Additionally, it should be clear that correlation in this type of study does not mean causation. However, it helps lay the foundation for other studies, which could lead to stronger conclusions through systematic reviews or meta-analyses, as observational studies may be influenced by other variables that can distort results or conclusions.
It adds more data on the importance of reducing sugar in the child population, especially from zero to three years old. Reducing the intake of any type of free sugar during this period of life is essential to reduce the occurrence of certain physiological or pathological conditions. It is important to consider not only the sugar added to food products but also free sugars. For example, with fruits and juices, it is better to consume whole fruits, as their digestion and absorption are slower, leading to a lower glycemic index.