Gender differences in cardiovascular disease risk: Adolescence to young adulthood.

BACKGROUND AND AIMS: Gender differences in cardiovascular disease (CVD) have been well documented but rarely for young adults and the extent to which gender related lifestyle differences may contribute to gender differences in CVD risk experienced by young adults have not been reported. METHODS AND RESULTS: Data are from a long-running cohort study, the Mater-University of Queensland Study of Pregnancy (MUSP). We track gender differences in CVD related behaviours at 21 and 30 years (consumption of a Western Diet/Health-Oriented Diet, cigarette smoking, vigorous physical exercise, heavy alcohol consumption). At 30 years we compare males and females for CVD risk, and the extent to which lifestyle behaviours at 21 and 30 years contribute to CVD risk. At both 21 and 30 years of age, males more frequently consume a Western Diet and less often a Health Oriented Diet. By contrast, males are also much more likely to report engaging in vigorous physical activity. On most CVD markers, males exhibit much higher levels of risk than do females at both 21 and 30 years. At 30 years of age males have about five times the odds of being at high risk of CVD. Some lifestyle behaviours contribute to this additional risk. CONCLUSION: Young adult males much more frequently engage in most CVD related risk behaviours and males have a higher level of CVD risk. Gender differences in CVD risk remain high even after adjustment for CVD lifestyles, though dietary factors independently contribute to CVD risk at 30 years.

Do tobacco and cannabis use and co-use predict lung function: A longitudinal study.

BACKGROUND: Use of tobacco and cannabis is common and has been reported to predict lung function. Less is known about co-use of tobacco and cannabis and their impact on changes in lung function to early adulthood. RESEARCH QUESTION: The study examines whether cigarette smoking or cannabis use and co-use are each associated with lung function in a population sample of young adults. STUDY DESIGN AND METHODS: Data are from a prospective cohort study of cigarette smoking, cannabis use and co-use at 21 and 30 years of age and lung function (FVC, FEV1, FEV1/FVC) measured at 30 years. Lung function results are transformed using Global Lung Function Formulae. Subjects are the children of pregnant women who were recruited into the cohort study over the period 1981-3. Respondents were administered a spirometry assessment at 21 and 30 years of age. These respondents completed a smoking and cannabis use questionnaire at 21- and 30-year follow-ups. RESULTS: Cigarette smoking (with or without cannabis use) is associated with reduced airflow. There is no consistent association between cannabis use and measures of lung function. The co-use of tobacco and cannabis appears to entail no additional risk to lung function beyond the risks associated with tobacco use alone. INTERPRETATION: Persistent cigarette smoking is associated with reduced airflow even in young adults. Cannabis use does not appear to be related to lung function even after years of use.

Does Childhood Maltreatment Lead to Low Life Success? Comparing Agency and Self-Reports.

BACKGROUND: The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. OBJECTIVES: To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. PARTICIPANTS AND SETTING: Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. METHODS: Details of childhood maltreatment are from two sources; child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. RESULTS: Childhood maltreatment whether measured by agency report or self-report predicts overall low life success; agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28); sexual abuse, OR = 2.85(2.05,3.96); emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. CONCLUSIONS: Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life.

Do adversities experienced over the early life course predict mental illness and substance use behaviour in adulthood: A birth cohort study.

A range of adult health outcomes have been linked to early childhood adversities. These early adversities include parental marital breakdown and family economic disadvantage. Childhood experiences of maltreatment have also been linked to a variety of adult health outcomes. As both childhood adversities and child maltreatment often co-occur, we examine whether childhood adversities at 3 stages of the child's early life course predict any of nine adult mental health outcomes controlling for past experiences of child trauma (maltreatment). Data are from a long running birth cohort study, the Mater-University of Queensland Study of Pregnancy (MUSP). We use bivariate and multinomial logistic regression with adjustment for confounding, to predict adult outcomes. Experiences of recent life events in pregnancy appear to be unrelated to adult mental health. Recent life events experienced at the 5-year follow-up independently predicts lifetime ever depression and cannabis use disorder. Experiences of recent life events at 14-years of age predict lifetime ever depression, cannabis and amphetamine use in adulthood. Our findings support early childhood interventions which should be supplemented with a focus on later childhood and the adolescent period of development. Interventions should also focus on the broader social and demographic context within which children are born. Efforts to reduce the occurrence and consequences of childhood maltreatment should be given primary attention in order to reduce the childhood factors contributing to adult mental illness.

Parental imprisonment as a risk factor for cardiovascular and metabolic disease in adolescent and adult offspring: A prospective Australian birth cohort study.

Objectives: Parental imprisonment is linked with child health in later life. The present study provides the first prospective cohort analysis and non-U.S. based study examining parental imprisonment and cardiometabolic risk factors in adolescence and adulthood. Methods: The study followed 7,223 children born from live, singleton births from 1981 to 1984 in Brisbane, Australia. Data on parental imprisonment was collected at mother interview when the children were ages 5 and 14. Our sample analyzes offspring with biometric data collected by health professionals, including 3,794 at age 14, 2,136 at age 21, and 1,712 at age 30. Analyses used multivariate linear and logistic regression, and time-varying growth curve models. Results: Among female respondents, parental imprisonment at ages ≤5 was associated with higher body-mass index (BMI) at ages 14, 21, and 30; higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) at age 30; and increased sedentary hours, larger waist circumference, and odds of a high-risk waist circumference at age 30. Parental imprisonment when the child was aged ≤14 was associated with increased BMI and SBP at age 30 for females. In growth-curve models, parental imprisonment when the child was aged ≤5 and ≤ 14 among females was linked with increased BMI; parental imprisonment when the child was aged ≤5 was associated with increased SBP and DBP. No significant associations were observed for males. Conclusions: Using prospective cohort data, our results support research showing that parental imprisonment, particularly in early childhood, is associated with increased BMI, blood pressure, sedentary hours, and waist circumference in females in early adulthood. These findings implicate parental imprisonment as a risk factor for cardiometabolic health issues in later life among females.

Predicting Child Maltreatment over the Early Life Course: A Prospective Study.

A large number of early life exposures predict child maltreatment. Using data from a 30-year birth cohort study we examine 12 early life course risk factors of four types of self-reported childhood maltreatment recalled at the 30-year follow-up. Of the 7223 children in the sample at birth, 2425 responded to the Child Trauma Questionnaire at the 30-year follow-up. On adjusted analysis being a teenage mother predicts childhood physical and sexual abuse, as well as child neglect. More numerous maternal marital partner changes in the 5 years after the birth predict offspring experiences of emotional abuse, sexual abuse and childhood neglect. Policy responses should focus on the broad social context in which children are reared as the most effective approach to reducing the high level of childhood abuse and neglect.

Timing and chronicity of family poverty and development of unhealthy behaviors in children: a longitudinal study.

PURPOSE: To examine the impact of the timing and duration of family experiences of poverty over the child/adolescent early life course on child aggressive/delinquent behavior and tobacco and alcohol consumption. METHODS: Data were taken from a large scale population based birth cohort study with repeated follow-ups until 21 years after the birth. Poverty was measured during the pregnancy, 6 months, 5 years, and 14 years after the birth. Aggressive/delinquent behavior was measured at 14- and 21-year follow-ups. Tobacco and alcohol consumption were measured at the 21-year follow-up. RESULTS: In multivariate analysis, family poverty experienced at the 14-year follow-up predicted persistent aggressive/delinquent behavior as well as smoking and higher levels of alcohol consumption at the 21-year follow-up. However, the strongest associations were for recurrent experiences of family poverty, with the group that experienced repeated poverty (3-4 times) being more than twice more likely to be aggressive/delinquent at both 14 and 21 years, and to drink more than one glass of alcohol per day at 21 years. CONCLUSIONS: Repeated experiences of poverty in early childhood and adolescence are strongly associated with a number of negative health-related behavior outcomes. Experience of poverty in the early adolescence seems to be the most sensitive period for such exposure.

Early pubertal maturation in the prediction of early adult substance use: a prospective study.

AIMS: To examine whether self-reporting a later stage of pubertal development in early adolescence predicts young adults' use of illicit drugs. DESIGN: Population-based prospective birth cohort study. SETTING: Follow-up of a cohort of mothers and their children, recruited between 1981 and 1983. PARTICIPANTS: Cohort of 2710 young adults who completed a self-report questionnaire about their use of cannabis and amphetamines at the 21-year follow-up. MEASUREMENTS: Young adults' use of cannabis and amphetamines were measured at the 21-year follow-up. Stage of pubertal development was assessed at the 14-year follow-up. Potential confounding and mediating variables were assessed between birth and when the child was 14 years. FINDINGS: Of 2,710 young adults, 49.9% (47.3 females and 52.7% males) reported that they had used cannabis and 21.0% (18.9% females and 23.3% males) reported that they had used amphetamines and cannabis by 21 years. In multivariate analyses, adolescents with a later stage of puberty were more likely to use cannabis or amphetamines in young adulthood. This association was not confounded by mother's education or child's gender and age. Part of the relationship was explained by the higher frequency of child externalizing behaviour at 14 years. CONCLUSIONS: The findings warrant further attention to puberty as a sensitive period in an individual's development. With regard to prevention, there is a need to understand more about the pathways between pubertal development, child behaviour problems and substance use.

Child and adolescent externalizing behavior and cannabis use disorders in early adulthood: an Australian prospective birth cohort study.

This study examined the association between age of onset and persistence of externalizing behavior and young adults' cannabis use disorders (CUDs). Data were from a 21 year follow-up of a birth cohort study in Brisbane, Australia. The present cohort consisted of 2225 young adults who had data available about CUDs at 21 years and externalizing behavior at 5 and 14 years. Young adults' CUDs were assessed using the CIDI-Auto. Child and adolescent externalizing behavior were assessed at the 5- and 14-year phases of the study. After controlling for confounding variables, children who had externalizing behavior at both 5 and 14 years (child-onset-persistent) (COP) had a substantial increase in risk of CUD at age 21 years (Odds ratio (OR)=2.5; 95% CI: 1.5, 4.2). This association was similar for those who had 'adolescent onset' (AO) externalizing behavior. However, there was no association between 'childhood limited' (CL) externalizing behavior and CUD. Externalizing behavior in adolescence is a strong predictor of subsequent CUD. Smoking and drinking at 14 years partially mediated the link between externalizing behavior and CUD.