Evidence map›Paper›PMID 41125420›Full record

ArticleBMJ (Clinical research ed.)2025

Exposure to sugar rationing in first 1000 days after conception and long term cardiovascular outcomes: natural experiment study.

Jiazhen Zheng, Zhen Zhou, Jinghan Huang, Qiang Tu, Haisheng Wu, Quan Yang, Peng Qiu, Wenbo Huang, Junchun Shen, Chuang Yang and 1 more

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Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Jiazhen ZhengBioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China.
Zhen ZhouSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Jinghan HuangBiomedical Genetics Section, School of Medicine, Boston University, Boston, MA, USA.
Qiang TuFaculty of Medicine and Health, University of Sydney, Australia.
Haisheng WuSchool of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region.
Quan YangCardiac and Vascular Center, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Peng QiuDepartment of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Wenbo HuangDepartment of Clinical Epidemiology and Health Economics, University of Tokyo, Tokyo, Japan.
Junchun ShenBioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China.
Chuang YangDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.ORCID 0000-0002-1405-0960
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine whether exposure to sugar rationing during early life is associated with a reduction in the risk of cardiovascular outcomes in adulthood.

designNatural experiment study.

settingUK population based cohort.

participants63 433 UK Biobank participants born between October 1951 and March 1956 without prevalent cardiovascular disease, multiple births, adoption, or birth outside the UK. Exposure was quasi-experimentally assigned on the basis of birth date relative to the end of sugar rationing in 1953. External validation cohorts from the Health and Retirement Study and the English Longitudinal Study of Ageing were used.

main outcome measuresPrimary outcomes were incident cardiovascular disease, myocardial infarction, heart failure, atrial fibrillation, stroke, and cardiovascular disease mortality, ascertained through linked health records. Hazard ratios were estimated using Cox and parametric hazard models adjusted for demographic, socioeconomic, lifestyle, parental health, and genetic factors and geographical controls. Multiple cardiac parameters were measured in a subset undergoing cardiac magnetic resonance imaging.

resultsLonger exposure to sugar rationing was associated with progressively lower cardiovascular risks in adulthood. Compared with people never exposed to rationing, those exposed in utero plus 1-2 years had hazard ratios of 0.80 (95% confidence interval (CI) 0.73 to 0.90) for cardiovascular disease, 0.75 (0.63 to 0.90) for myocardial infarction, 0.74 (0.59 to 0.95) for heart failure, 0.76 (0.66 to 0.92) for atrial fibrillation, 0.69 (0.53 to 0.89) for stroke, and 0.73 (0.54 to 0.98) for cardiovascular disease mortality. Incident diabetes and hypertension jointly mediated 31.1% of the sugar rationing-cardiovascular disease association, whereas birth weight contributed only 2.2%. Sugar rationing was also associated with a modest increase in left ventricular stroke volume index (0.73 (95% CI 0.05 to 1.41) mL/m

conclusionExposure to sugar rationing during the first 1000 days of life was associated with lower cardiovascular risks in adulthood and slightly more favourable cardiac indices, suggesting long term cardiovascular benefits of early life sugar restriction.

Indexed as

Cardiovascular DiseasesDietary SugarsPrenatal Exposure Delayed EffectsDiet SurveysFemaleFood InsecurityHumansIncidenceMaleMiddle AgedUK BiobankUnited KingdomDietary Sugars

Identifiers

PMID41125420
PMCPMC12542096

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.