The ACE study, conducted by the CDC and Kaiser Permanente, found that adverse childhood experiences (ACEs) significantly increase our risk for multiple chronic health concerns. These chronic health concerns include metabolic syndrome-related concerns, such as insulin resistance, type-2 diabetes, high cholesterol, overweight and obesity, hypertension, heart attack, stroke, and other cardiovascular concerns. But how could this be? How exactly does something that we experience in early childhood impact our risk for chronic disease twenty or more years later? Let’s find out.
First of All, What are Adverse Childhood Experience or ACEs Anyway?
Throughout this article, I’ll use the terms “early life stress,” “childhood trauma,” and “adverse childhood experiences” interchangeably. Before we get into the details of how this type of trauma increases our risk for metabolic syndrome-related health concerns, I want you to understand exactly what I mean when I use these terms.
When I use these terms, I’m referring to any experience that chronically activates the stress response during childhood. This could be a stressful condition that recurs multiple times or it could be a stressful event that occurred once but led to activation of your stress response every time you thought about or remembered it.
Here is a list of the most commonly studied adverse childhood experiences:
- your parents being separated or divorced;
- living with someone who is experiencing depression or another mental health concern;
- living with someone who struggles with addiction;
- seeing your mother or another household member treated violently;
- having someone in your household go to jail or prison;
- experiencing sexual, physical, or emotional abuse;
- feeling like you’re not loved or protected at home;
- and not having enough clothing, food, shelter, or means to obtain necessities during childhood.
I’ve listed the most commonly studied forms of adverse childhood experiences above, but there has also been research done that looked at connections between chronic health concerns and other forms of trauma, such as:
- having a parent or sibling die,
- being in foster care,
- being chronically ill during childhood,
- and more.
How Do Adverse Childhood Experiences Affect Our Risk For Insulin Resistance, High Blood Sugar, & Type 2 Diabetes?
If you’ve experienced early life stress, also referred to as adverse childhood experiences or ACEs, and you’ve been diagnosed with diabetes, the two could very well be related. Research suggests that when we experience trauma during childhood, it changes our brains and bodies in such a way that it negatively impacts our diabetes risk. Trauma during childhood increases our diabetes risk by its effects on our stress responses and our lifestyle habits.
So how exactly does trauma impact our stress responses and increase our risk for high blood sugar, insulin resistance, and diabetes? When we experience ACEs, the chronic arm of our stress response (which is controlled by what’s known as the hypothalamus-pituitary-adrenal axis or HPA axis) becomes hyperactive. In other words, our bodies become so used to releasing stress hormones in response to stressful situations that they begin to overreact to things that are only slightly stressful. Hyperactivity of the stress response explains why levels of stress-related hormones like corticotropin-releasing hormone and cortisol tend to be higher in ACE survivors than in non-ACE survivors.
When the stress response becomes hyperactive, the high blood levels of cortisol and other stress hormones lead to disruption of our endocrine, immune, and autonomic nervous systems. These physiological changes and the unhealthy lifestyle behaviors that can come about as a result work together to increase our risk for insulin resistance, high blood sugar, and diabetes. These unhealthy lifestyle behaviors include overweight and obesity, living a sedentary lifestyle, and using alcohol and/or recreational drugs, all of which we as ACE survivors are at increased risk for as a result of our trauma.
How Do Adverse Childhood Experiences Affect Our Risk For Heart Attack, Stroke, Heart Failure, and Other Cardiovascular Concerns?
Adverse childhood experiences also lead to increased risk of being diagnosed with high blood pressure, heart disease, atherosclerosis, peripheral artery disease, heart attack, stroke, and other cardiovascular concerns. For example, research demonstrates that, compared to those who were raised in more favorable family environments, people who were exposed to less favorable family environments (e.g. experiences of abuse, neglect) were 129% to 153% more likely to experience a cardiovascular event. This includes heart attack, stroke, heart failure, coronary artery disease, peripheral artery disease, and other cardiovascular disease events. But how exactly do adverse childhood experiences increase our risk for cardiovascular disease?
As we’ve seen excessive exposure to early life stress leads to our bodies over-producing cortisol both at baseline and when we are exposed to anything remotely stressful. Whenever your stress response is activated, your body also activates your immune response. Because of the immune system changes that take place when we are exposed to childhood stressors, an inflammatory process begins. This inflammatory process damages the integrity of our arteries and plaque begins to build up in our blood vessels. We refer to this as atherosclerosis.
The interesting thing is that this plaque build-up actually begins in the teens and twenties for most people. It then takes place for years before we begin to see changes on our blood cholesterol tests. This means even if you have perfect cholesterol levels, there could be an underlying inflammatory process taking place in your cardiovascular system. And this process could be setting the stage for cardiovascular concerns. This includes hypertension, heart attack, stroke, heart failure, and other cardiovascular concerns. AND… as I’ve explained, all of this could have begun with the trauma you experienced during childhood.
What Can I Do to Decrease My Risk of Developing Metabolic Syndrome-Related Concerns as a Survivor of Adverse Childhood Experiences?
Understanding the link between ACEs and metabolic syndrome-related concerns like insulin resistance, high blood sugar, diabetes, heart attack, stroke, heart failure, coronary artery disease, peripheral artery disease, and other cardiovascular disease events is a crucial first step to reducing your risk and being proactive about your health. Because we see a dose-response relationship between ACEs and chronic disease, meaning that the higher your ACE score, the higher your risk tends to be, I recommend that ACE survivors know their ACE score and understand what it means for them personally. This is critical because if you’ve experienced at least one type of adverse childhood experience, you carry an increased risk for not only metabolic syndrome-related concerns, but a host of other health concerns, such as mental health concerns like anxiety, depression, bipolar disorder, schizophrenia, and PTSD; autoimmune diseases like rheumatoid arthritis, lupus, Hashimoto’s, Grave’s, ulcerative colitis and Crohn’s; reproductive concerns like PMS, PCOS, fibroids, infertility, and endometriosis; and more.
The good news, however, is that experiencing ACEs does not mean you’ll definitely experience metabolic syndrome in your lifetime. Yes, you’ve experienced childhood trauma that has changed your brain and body and increased your risk for multiple health concerns. But there are things we can do to support our HPA axes and to support our bodies. By implementing a few critical changes, we can effectively reduce our accumulated risk and live our healthiest lives now. Our past does not have to control us any longer.
If you’re a survivor of adverse childhood experiences, I encourage you to be proactive about your health. Take the ACE Assessment to find out your ACE score. When you do, I’ll send you a document that contains important information about how your score can affect your risk for metabolic syndrome-related concerns, mental health concerns, autoimmune conditions, reproductive concerns, and other health concerns. I’ll also share important tips you can implement right away to help you minimize your risk for these concerns.
If you already know your ACE score, check out my book, Set On Edge to learn how ACE survivors like us are kicking ACEs to the curb and finally living our healthiest and best lives now, in spite of our difficult pasts. ACEs no longer have to define you.