# NIH grant: First taste, lasting impact: Early-life exposure to added sugars from infant formula and complementary foods on glucose variability and obesity risk. (1R01DK149491-01) — retained record

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NIH grant 1R01DK149491-01: First taste, lasting impact: Early-life exposure to added sugars from infant formula and complementary foods on glucose variability and obesity risk.
Institute: {'code': 'DK', 'abbreviation': 'NIDDK', 'name': 'National Institute of Diabetes and Digestive and Kidney Diseases', 'admin_org_id': '12500020', 'admin_funding_url': ''}. PI: Kai Ling  Kong. Award: $532087.
Start: 2026-08-28T00:00:00.
ABSTRACT:
 Obesity and type 2 diabetes are global public health crises with origins rooted in early-life nutrition.
While breastfeeding confers long-term metabolic protection, most U.S. infants are introduced to formula within
the first 6 months of life. Our recent work shows that infants consuming formula with higher added sugar
content gain weight more rapidly and later consume more added sugars from complementary foods. However,
no study has directly linked early added sugar exposure to real-time glycemic patterns—a critical gap given
that glucose variability (GV) is a well-established early marker of metabolic dysfunction. Emerging evidence
links early sugar exposure with increased risk of metabolic syndrome, insulin resistance, and type 2 diabetes,
findings consistent with historical data showing reduced adult diabetes risk among populations with early-life
sugar restriction (e.g., during wartime rationing). The overall goal of this proposal is to evaluate whether
exposure to added sugars in infant formula and complementary foods is associated with greater GV and
whether GV predicts excessive weight gain during the first two years of life. We will recruit 200 infants at 3
months of age and follow them, with glucose monitoring conducted at 3, 6, and 12 months using the Dexcom
G7 continuous glucose monitoring (CGM) system. GV will be assessed using mean glucose concentration,
mean amplitude of glycemic excursions (MAGE), and percent coefficient of variation (CV). At each timepoint,
infant anthropometrics (weight and length) and dietary intake (3-day caregiver-reported dietary records) will
also be collected. A follow-up visit at 24 months will assess obesity risk. We propose to examine the
association between added sugar intake from infant formula and complementary foods and GV during infancy.
We hypothesize that higher percentage of daily energy from added sugars in formula and complementary
foods will be associated with increased GV, reflecting poorer glucose control (Specific Aim 1). We also
propose to examine the longitudinal association between GV and rapid weight gain through 24 months
(Specific Aim 2). Rapid weight gain will be operationalized as upward weight-for-age percentile crossing. We
hypothesize that increased GV will predict greater weight gain and higher weight-for-length z-scores at 12 and
24 months of age. This study is the first to link real-time glycemic responses with early added sugar exposure
from infant formula and complementary foods. It directly aligns with the recent U.S. Department of Health and
Human Services (HHS) and Food and Drug Administration (FDA) initiative to review nutrients in infant formula,
underscoring the urgent need for stronger oversight and transparency in infant nutrition. By identifying the role
of added sugars—a currently underregulated component—this research will generate critical evidence to
inform regulatory updates and improve formula standards.
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