Haoxian Tang, Xuan Zhang, Jingtao Huang, Xiaojing Chen, Jianan Hong, Hanyuan Lin, Cuihong Tian, Luo Nan, Mi Lin, Qinglong Yang, Shiwan Wu, Pan Chen, Jiasheng Wen, Liwen Jiang, Youti Zhang, Yali Wang, Xuerui Tan, Yequn Chen
Elevated sugar intake has been linked to poor cardiovascular health, but the effects of early-life sugar restriction on the lifelong risk of heart failure remain unclear. Using the end of sugar rationing in the United Kingdom in 1953 as a natural experiment, we classify participants in the UK Biobank by birth timing to define early-life exposure to sugar rationing. Here we show that individuals exposed to early-life sugar rationing exhibit an approximately 14% lower risk of heart failure and develop the condition about 2.6 years later than those unexposed. Longer exposure is associated with stronger effects, and population-level estimates suggest that around 4–5% of heart failure cases may be attributable to the absence of early-life sugar restriction. Genetic susceptibility does not modify these associations but acts additively. These findings underscore the long-term importance of early-life sugar exposure for heart failure, and further studies are warranted. High sugar intake is a potential risk factor for heart failure, but there is insufficient evidence for the benefit of restricting sugar intake during pregnancy or early life. Using the end of UK sugar rationing as a natural experiment, this study shows that lower sugar intake early in life is linked to lower risk of heart failure and later disease onset.