Testing cortisol dysregulation as a mediator between early stress and adolescent cardiovascular health

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PROJECT SUMMARY/ABSTRACT Cardiovascular disease is the leading cause of death in the United States. Psychosocial stress in early childhood has been linked to poorer cardiovascular health, with behavioral and biological alterations as potential mechanisms. One proposed mechanism between early stress and poorer cardiovascular health later in life is dysregulation in cortisol, a hormone that mediates stress responses and regulates metabolism. Cortisol dysregulation can include heightened or blunted cortisol levels, as both have been associated with chronic stress and poor health. A second proposed mechanism is alterations in diet and eating behaviors following early psychosocial stress as acute and chronic stress have been associated with obesogenic diet and eating behaviors. It is currently unknown whether cortisol dysregulation and altered diet and eating behaviors mediate the association between early psychosocial stress and poorer cardiovascular health in adolescence. The goal of this project is to understand whether cortisol dysregulation and altered diet and eating behaviors are pathways between early childhood stress and poorer cardiovascular health in adolescence. This work will identify targets for interventions to promote ideal cardiovascular health in populations who have experienced early stress. This goal will be accomplished using two complementary cohorts: new data collected on 100 diverse adolescents oversampled for high psychosocial risk and existing data from the Avon Longitudinal Study of Parents and Children (ALSPAC; N=9,600). These cohorts will be used to address two aims. Aim 1: To test the hypothesis that cortisol dysregulation mediates the association between psychosocial stress in early childhood and 1a) adolescent obesity, blood pressure, and serum markers of inflammation and poor cardiovascular health, and 1b) adolescent obesogenic dietary patterns and eating behaviors. Aim 2: To test the hypothesis that childhood obesogenic dietary patterns and eating behaviors mediates the association between psychosocial stress in early childhood and 2a) adolescent obesity, blood pressure, and serum markers of inflammation and poor cardiovascular health, and 2b) adolescent obesogenic dietary patterns and eating behaviors. I am a developmental psychologist with expertise in childhood psychosocial stress and cortisol regulation. This award will enable me to extend my expertise to assessing and improving cardiovascular health in adolescents. To conduct this research, I will complete a training plan based at the University of Denver under the primary mentorship of Dr. Elysia Davis. I will obtain training and content knowledge in the following areas: 1) cardiovascular health and gold-standard approaches for measurement of obesity, blood pressure, and serum markers of cardiovascular health; 2) diet and eating behavior assessment; 3) advanced statistics; and 4) conducting interventions. The research and training in this proposal will help me launch an independent career investigating pathways from early stress to cardiovascular health.