Sex-Specific Associations of Added Sugars and Fructose Exposure Across the First 1,000 Days With Body Composition at 24 Months

Background

Added sugars during early development may influence adiposity, but whether associations vary by developmental timing and child sex is unclear.

Objectives

To determine whether child sex modifies associations of added sugars and fructose exposure from pregnancy through 24 months with body composition at 24 months.

Methods

This secondary longitudinal analysis included 130 mother-child dyads. Maternal diet was assessed during mid-pregnancy and child diet at 2wk and 6mo (infancy), and 12mo and 24mo (toddlerhood). Multivariable regression tested sex-by-exposure interactions for anthropometric outcomes; 42 children had usable dual-energy X-ray absorptiometry (DXA) data.

Results

Prenatal added sugars were more positively associated with percentage body fat and total and regional fat mass in girls than in boys. Prenatal fructose was more positively associated with waist circumference in boys. During infancy, added sugars were more positively associated with percentage body fat and total and regional fat mass in boys, whereas fructose was more positively associated with fat-free mass in girls.

Conclusions

Associations of early-life sugars exposure with body composition varied by developmental timing and child sex. Findings from the smaller DXA subset are exploratory and require replication but suggest that susceptibility to early dietary sugars may differ across developmental windows.

Practitioner Points

• Repeated dietary assessment from pregnancy through toddlerhood suggested that the relation of early sugars exposure to body composition may differ by both developmental timing and child sex.

• Exploratory DXA findings showed more positive associations of prenatal added sugars with adiposity in girls and of infancy added sugars with adiposity in boys.

• The findings do not support sex-specific dietary recommendations; they reinforce the importance of limiting added sugars in early life and of replicating sex- and timing-specific patterns in larger cohorts.