Background:

There is a growing recognition that adverse experiences such as abuse, neglect and domestic violence in early life may have implications for cardiometabolic health later in life. But whilst a substantial body of evidence has examined the long term consequences of parental divorce on mental health, the potential implications for physical health including cardiometabolic health have received far less attention. Limited evidence suggests that children who experience parent divorce are at increased risk of obesity, poor self-rated health, asthma, cancer[1], and more recently, CVD mortality[2] and stroke[3]. Early life socio economic position is probably a main confounder of the association of interest. Cross cohort comparisons (here between ALSPAC, Pelotas and APCAPS) allow us to examine an association of interest in different settings, with differing confounding structures (e.g. in high and low income countries). The assumption is that if an association is consistent in both settings, it is less likely to be driven by residual confounding[4]. In addition, the role of age at parental divorce and the degree of conflict in the household prior to the parental separation as potential effect modifiers of the association between parental divorce and cardiometabolic health will be explored. Finally, a range of social, behavioural, and biosychosocial factors are likely to mediate associations between parent divorce and cardiometabolic health in later life. These will be identified and examined here.

Aims: Using detailed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), the 1993 Pelotas birth cohort from Brazil and the APCAPS cohort from India, we will examine the association of parental divorce with adiposity (BMI, DXA-determined total body fat mass) and cardiovascular risk factors (blood pressure, lipids, glucose and insulin) measured at 15-18 years.