Obesity and its related cardiovascular diseases have been known to be largely preventable. Understanding of modifiable risk factors for obesity in early life will be helpful in establishing effective prevention programs and policies to reduce the obesity epidemic. Among the early determinants of obesity that have been suggested in numerous studies, research indicates that cardiometabolic health in adulthood may be partly associated with early disadvantaged conditions such as socioeconomic status and adversity.
Recent epidemiologic studies have suggested that socioeconomic groups with greater access to high-energy density foods are at greater risk of being obese than the opposite conditions
1) and socioeconomic factors in childhood and adolescence have significant association with coronary heart disease risk, all-cause mortality, or cardiovascular mortality in mid-life.
2,
3) Data from one Swedish prospective cohort study have suggested two life course pathways for metabolic syndrome: one through body mass index in adolescence and early childhood for both men and women and the other through adolescent socioeconomic disadvantage for women.
4,
5)
In terms of adversity in early life, there are several studies that report a correlation between early adverse experience and cardiovascular disease as well as obesity in adult life.
6,
7) Possible mechanisms that may link early adverse experience and cardiovascular disease may include a mediating effect caused by behavioral changes in lifestyle factors and adipomyokines or inflammatory markers.
8,
9)
Interestingly, in this issue of Korean Journal of Family Practice, Choi et al.
10) propose a positive association between maternal education and occupational status in childhood and metabolic syndrome in adulthood among Korean females from the Korean National Health and Nutrition Examination, 2007-2009. Although this study has some limitations, this finding is intriguing and, if confirmed from well-designed longitudinal cohort studies in the future, will hopefully be helpful in establishing public health strategies for preventing obesity and its related cardiovascular disease at the population level.
Considering the increasing prevalence of obesity and its associated chronic diseases in Korea and the few numbers of published studies on early risk factors for obesity, much more research is thus needed in order to elucidate the association between the two in the foreseeable future.
Notes
References
- 1. Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev Psychiatry 2012;24:176-188. PMID: 22724639.
- 2. Wamala SP, Lynch J, Kaplan GA. Women's exposure to early and later life socioeconomic disadvantage and coronary heart disease risk: the Stockholm Female Coronary Risk Study. Int J Epidemiol 2001;30:275-284. PMID: 11369727.
- 3. Hemmingsson T, Lundberg I. How far are socioeconomic differences in coronary heart disease hospitalization, all-cause mortality and cardiovascular mortality among adult Swedish males attributable to negative childhood circumstances and behaviour in adolescence? Int J Epidemiol 2005;34:260-267. PMID: 15333622.
- 4. Gustafsson PE, Persson M, Hammarstrom A. Life course origins of the metabolic syndrome in middle-aged women and men: the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood. Ann Epidemiol 2011;21:103-110. PMID: 21184951.
- 5. Gustafsson PE, Hammarstrom A. Socioeconomic disadvantage in adolescent women and metabolic syndrome in mid-adulthood: an examination of pathways of embodiment in the Northern Swedish Cohort. Soc Sci Med 2012;74:1630-1638. PMID: 22464906.
- 6. Dong M, Giles WH, Felitti VJ, Dube SR, Williams JE, Chapman DP, et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 2004;110:1761-1766. PMID: 15381652.
- 7. Gunstad J, Paul RH, Spitznagel MB, Cohen RA, Williams LM, Kohn M, et al. Exposure to early life trauma is associated with adult obesity. Psychiatry Res 2006;142:31-37. PMID: 16713630.
- 8. Bertone-Johnson ER, Whitcomb BW, Missmer SA, Karlson EW, Rich-Edwards JW. Inflammation and early-life abuse in women. Am J Prev Med 2012;43:611-620. PMID: 23159256.
- 9. Joung KE, Park KH, Zaichenko L, Sahin-Efe A, Thakkar B, Brinkoetter M, et al. Early life adversity is associated with elevated levels of circulating leptin, irisin, and decreased levels of adiponectin in midlife adults. J Clin Endocrinol Metab 2014;99:E1055-E1060. PMID: 24650014.
- 10. Choi BY, Lee DC, Chun EH, Lee JY. The relationship between metabolic syndrome and childhood maternal education level, job status findings from the Korean National Health and Nutrition Examination, 2007-2009. Korean J Fam Med 2014;35:207-215.
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