Over the past three decades, extensive health, economic, and social costs have been associated with obesity. Children from disadvantaged backgrounds are more likely to be obese, with weight gain in childhood continuing into adulthood and resulting in the early onset of cardiovascular disease. Such adverse effects are pronounced among women than men. Gender differences are also evident in socioeconomic opportunities, psychosocial resources, and emotional/behavioral coping strategies, suggesting that there may be gender- driven psychosocial, behavioral, and biological, e.g., genetic and reproductive, mechanisms linking early life adversities (ELAs) to obesity and cardiovascular risk. Nonetheless, some individuals who have experienced ELAs do not succumb to cardiovascular risk; they may leverage individual psychosocial resources to halt or reverse accumulated disadvantages from childhood, although the availability of such resources may also vary by gender. Few studies have employed an integrative approach to understanding the broader set of influences on gender differences in obesity and cardiovascular risk. The overall goal of this Pathway to Independence Award is to provide the PI with the interdisciplinary training and research experience needed to investigate how ELAs affect body weight and cardiovascular risk, via the interplay of psychosocial, behavioral, and biological mechanisms, while characterizing gender differences throughout the analysis. Having previously worked as a nurse in South Korea, the PI brings front-line experience to the task of understanding health disparities. During her subsequent training and research in sociology and population health science, she applied theories of social determinants of health to multiple nationally representative data sets. The PI is well along the path to becoming a leading researcher on gender, life adversities, and health. During the K99 phase, the PI seeks training and mentoring to broaden her focus beyond social perspectives to include epidemiological and psychological knowledge of (1) causal inferences in behavioral obesity research (including co-twin control analyses), (2) cardiovascular disease, (3) reproductive health, and (4) resilience. During the R00 phase the PI will develop an integrative life-course approach to study the gender-specific pathways through which ELAs affect risk of adult obesity and cardiovascular disease by combining her primary expertise in sociology with additional epidemiological and psychological knowledge. The proposed research will be based on a nationally representative longitudinal data set, known as MIDUS (Midlife in the United States), which began with 7,108 adults, including 998 twin dyads. Findings from the PI's research should be relevant for development of gender-specific interventions to reduce the risk of obesity and cardiovascular disease, particularly for individuals who have experienced adversities in early life.

Public Health Relevance

Reducing the prevalence of obesity and obesity-related chronic conditions has been a top priority of U.S. public health officials for the past three decades, yet obesity rates remain high and more than two in three adults are currently classified as overweight or obese. By incorporating multidisciplinary knowledge, the proposed research will provide novel insights into (1) the social determinants of adult obesity and cardiovascular risk with a focus on early life adversities, and along to the way illuminate (2) gender-specific psychosocial, behavioral, and biological mechanisms to explain the associations between early life adversities, adult obesity, and cardiovascular risk. Research findings have the potential to inform prevention and intervention strategies, which may substantially reduce the costs obesity poses to public health.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Transition Award (R00)
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Special Emphasis Panel (NSS)
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Nielsen, Lisbeth
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University of California Riverside
Social Sciences
Schools of Arts and Sciences
United States
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Lee, Chioun; Tsenkova, Vera K; Boylan, Jennifer M et al. (2018) Gender differences in the pathways from childhood disadvantage to metabolic syndrome in adulthood: An examination of health lifestyles. SSM Popul Health 4:216-224
Lee, Chioun; Coe, Christopher L; Ryff, Carol D (2017) Social Disadvantage, Severe Child Abuse, and Biological Profiles in Adulthood. J Health Soc Behav 58:371-386