Cardiovascular risk factors (CVR)-including obesity, elevated lipids, altered glucose metabolism, hypertension, and elevated low-grade inflammation-are detectable, common, and increasing during adolescence. However, the developmental origins of adolescent CVR and its increases are poorly understood. Research on adults suggests that CVR is concentrated among those who had poor self-regulation in childhood, including difficulties in regulating their behaviors (e.g., impulsivity), emotions (e.g. negative emotion), and/or physiology (e.g., heart rate variability) during situations of challenge. Here we propose to test whether trajectories of self-regulation extending from ages to 2 to 10 predict trajectories of CVR during adolescence (ages 16, 17, 18). We also propose to test whether childhood self-regulation ?adolescent CVR pathways are mediated by health behaviors (e.g., substance use, exercise, nutrition, and sleep). By testing these linkages, the proposed research will be the first to conduct a fine-grained developmental analysis of childhood self-regulation ?health behaviors ?CVR pathways spanning 16 years. We have assembled an interdisciplinary team of scientists from Developmental, Clinical, and Quantitative Psychology, Pediatrics, Exercise Physiology, and Nutrition and draw on resources from two neighboring academic institutions. Furthermore, we propose to leverage a valuable extant scientific resource: an ongoing 15-year longitudinal study that has already collected extensive data on self-regulation and psychosocial adversity at ages 2, 4, 5, 7, and 10 and will collect these data again at ages 15 and 17. The proposed project adds the measurement of indicators of CVR, including serum markers, and also in-depth measurements of health behaviors, specifically substance use, physical activity, dietary habits and intake, and sleep at ages 16, 17, and 18. Thus, funding requested in this proposal would expand and enhance the ongoing longitudinal study through the examination of past and current measures plus additional metabolic (e.g., blood lipids, fasting glucose, insulin) and inflammatory markers (e.g., IL-1, IL-6 TNF-?, hs-CRP) and health behavior assessments for approximately 200 adolescents. Results will provide a foundation for informing the early prevention of CVR, and for building a larger program of research on early self-regulation and its implications for disease risk during the early life course.
The proposed research is the first to provide a fine-grained analysis of whether poor emotional, behavioral, and physiological self-regulation in childhood predicts cardiovascular risk trajectories during adolescence. The project also proposes to test whether health behaviors, including substance use, exercise, nutrition, and sleep explain these associations. Understanding how poor childhood self-regulation gives rise to adolescent disease risk is essential for understanding how to prevent chronic disease beginning early in life, when such preventions and interventions are generally most cost-effective.