Obesity and type 2 diabetes risk in midadult life: the role of childhood adversity.
OBJECTIVE
Child abuse has been associated with poorer physical health in adulthood, but less is known about childhood adversity more broadly, including neglect and family problems, or the pathways from adversity to adult disease. We have examined how different stressful emotional or neglectful childhood adversities are related to adiposity and glucose control in midadulthood, taking into account childhood factors, and whether the relationships are mediated by adult health behaviors and socioeconomic position.


METHODS
This was a prospective longitudinal study of 9310 members of the 1958 British birth cohort who participated in a biomedical interview at 45 years of age. Primary outcomes consisted of continuous measures of BMI, waist circumference, and glycosylated hemoglobin at 45 years and categorical indicators: total obesity (BMI > or = 30), central obesity (waist circumference: > or = 102 cm for men and > or = 88 cm for women), and glycosylated hemoglobin level of > or = 6.


RESULTS
The risk of obesity increased by 20% to 50% for several adversities (physical abuse, verbal abuse, witnessed abuse, humiliation, neglect, strict upbringing, physical punishment, conflict or tension, low parental aspirations or interest in education, hardly takes outings with parents, and father hardly reads to child). Adversities with the strongest associations with adiposity (eg, physical abuse) tended to be associated with glycosylated hemoglobin levels of > or = 6, but in most cases associations were explained by adjustment for adulthood mediators such as adiposity. Effects of other adversities reflecting less severe emotional neglect and family environment were largely explained by childhood socioeconomic factors.


CONCLUSIONS
Some childhood adversities increase the risk of obesity in adulthood and thereby increase the risk for type 2 diabetes. Research is needed to understand the interrelatedness of adversities, the social context of their occurrence, and trajectories from adversity to adult disease.
Thomas
Claudia
C
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, 30 Guilford St, London WC1N 1EH, United Kingdom. c.thomas@ich.ucl.ac.uk
Hyppönen
Elina
E
Power
Chris
C
D000293:Adolescent; D054523:Adult Survivors of Child Abuse; D015992:Body Mass Index; D002648:Child; D002649:Child Abuse; D016241:Child of Impaired Parents; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000523:psychology; D005195:Family Relations; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology* / Q000523:psychology; D016487:Parenting
D006442:Glycated Hemoglobin