Tag: cardiovascular disease

Rationing sugar in the first three years of a baby’s life reduces long term cardiovascular outcomes

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Adapted from BMJ 25 Oct 2025

Between October 1951 and March 1956, sugar rationing was still going on in some areas of the UK, but not in others.

In the British Biobank Study, sugar rationing, demographic information, socioeconomic status, lifestyle, genetic factors and birthweight were analysed. These were compared against the later development in adulthood of cardiovascular disease, myocardial infarction, heart failure, atrial fibrillation, stroke, cardiovascular mortality, diabetes and hypertension.

Sugar rationing was associated with lower risks of several cardiovascular risk factors in adulthood. Those who experienced rationing got ( hazard ratio 0.80) less heart disease, 0.75 less myocardial infarction, 0.74 less heart failure, 0.76 less atrial fibrillation, 0.69 less stroke, and 0.73 less cardiovascular mortality. Diabetes and hypertension were jointly responsible for 31.1% of the excess cardiovascular disease association.

My comment: These results strongly support Dr Robert Lustig’s efforts to reduce the sugar consumption of babies and toddlers. Unfortunately I was born after the era of sugar rationing and my mum was sugar mad. Both parents and every relative I ever encountered added two heaped spoonfuls of sugar to a small cup of tea. I stopped sugar in my tea aged 14 but by then it was too late to save my teeth from widespread fillings. It isn’t too late to improve the diet of the babies that are being born now, and I hope this information is widely disseminated. Setting up a lifetime of sugar dependence for babies and children is a very bad idea and can be avoided by taking care of the diet in the pre-kindergarten years.

Some benefits persist even if you do regain weight after a diet

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Adapted from BMJ 2 March 2024

One in four UK adults has obesity and one in three is overweight. These factors increase the rate of diabetes and cardiovascular disease. Although many people lose weight after starting various types of dietary intervention, they are often dismayed that weight is usually regained.

A systematic review and meta-analysis of 249 weight management programmes for adults worldwide was conducted. Intense weight management programmes were compared to less intense or no intervention at all. Intensive programmes included diet and exercise but not medications or surgery.

All trials ran for at least a year after the interventions were completed and some as far as four years afterwards. The average follow up period was 28 months.

Those who had little or no support had lost 2.1kg and those who had had intensive support lost 4.9kg. Those who lost the most weight gained it back the most quickly.

The researchers found that five years after the end of a weight management programme, people who had been offered support still weighed less than those who got little or no support. They also had lower blood pressure, cholesterol, and blood sugar levels despite the weight regain.

Cardiovascular outcomes are improving for type two diabetics

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There have been large reductions in myocardial infarction, cardiac death, and all cause mortality over the last fifteen years in Denmark for type two diabetics. For instance, the cumulative seven year risk of myocardial infarction reduced from6.9% to 28%. These reductions occurred over a period of time when there has been a lot more emphasis on using drugs to reduce cardiovascular risk. (Diabetes Care 2021)

In Sweden blood was tested to see how much dairy products were being consumed. Those who consumed the most dairy fat had 25% less risk of myocardial infarction compared to the lowest risk.

As many dietary guidelines recommend limiting dairy products in order to limit saturated fat intake, perhaps they should take note.

An article in the American Journal of Clinical Nutrition suggests that if the carbohydrate – insulin model of obesity is correct, then instead of calorie control diets and exercise to reduce obesity, focus should be put on low carbohydrate diets.

Gender differences in cardiovascular disease patterns

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Whatever our gender, two out of three of us will get a cardiovascular event of some kind, and many of these will be fatal.

Do men and women respond differently? This was the question that Dutch researchers led by Maarten Leening from Rotterdam asked of almost 3 thousand, mainly white, men and women over the age of 55 who lived in the Netherlands. He followed them up for 20 years.

He found that men started accumulating and dying of cardiovascular disease from the age of 55 onwards, but that women’s risk did not rise appreciably till they were aged 70. Furthermore, the pattern of illness differed.

Men tended to have a heart attack, but women were more likely to get a stroke or heart failure as the first event.

The authors point out that hyperlipidaemia is not a risk factor for heart failure but high blood pressure and other lifestyle factors are.

As a GP I welcome knowing about the differences in gender patterns. Both men and women who hope to optimise their cardiac health need to pay attention to staying smoke free, keeping slim, taking exercise, sleeping well and reducing stress. Both will need blood pressure checks.  A low carb diet, such as described in our book, can greatly improve glycaemia, lipid patterns, weight and blood pressure. Currently I usually only order echocardiograms when people have murmurs or are breathless on exertion. Maybe this is too late? A lot of attention is paid to lipid checks and prescribing statins in primary care, but there is not the same emphasis on seeking cardiac failure. Diabetics are at higher risk of cardiac failure but even in this group screening is not done for this condition. Heart failure is often hard to spot till it is very severe. It seems “normal” for people to do hardly any physical activity or planned exercise.  In many older people arthritis limits mobility and the breathlessness that would be apparent at a fast pace never becomes obvious.

(BMJ 2014;349:g5992)