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Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender,race, adult psychosocial risk and health behaviors
Authors:Cynthia R Davis  Eric Dearing  Nicole Usher  Sarah Trifiletti  Lesya Zaichenko  Elizabeth Ollen  Mary T Brinkoetter  Cindy Crowell-Doom  Kyoung Joung  Kyung Hee Park  Christos S Mantzoros  Judith A Crowell
Institution:1. Judge Baker Children''s Center, 53 Parker Hill Avenue, Boston, MA 02120, USA;2. Boston College, Boston, MA;3. Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA;4. Division of Newborn Medicine, Boston Children''s Hospital, Boston, MA;5. Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Gyeonggi-do, Korea;6. Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA;g Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, NY
Abstract:

Objective

This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of “modifiable” risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity.

Materials/Methods

210 Black/African Americans and White/European Americans, mean age = 45.8; ± 3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist–hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise).

Results

Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI.

Conclusions

Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning.
Keywords:MetS  Metabolic Syndrome  HPA  hypothalamic&ndash  pituitary&ndash  adrenal  GC  Glucocorticoids  SES  Socioeconomic Status  ECG  electrocardiogram  BMI  body mass index  WHR  waist&ndash  hip ratio  DSM  diagnostic and statistical manual  FFQ  food frequency questionnaire  AHEI  alternative healthy eating index
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