Women's health and wellbeing: the roles of early life adversity, stress and lifestyle

Cardiovascular disease, including coronary heart disease and stroke, is becoming increasingly prevalent worldwide. Cardiovascular disease is currently the leading cause of death among women, and increasing rates of obesity play a role in the high mortality rates. In this thesis we investigated the association between early life adversity and cardiovascular risk factors in adulthood, and potential underlying hormonal, behavioral and psychological pathways. The effectiveness of lifestyle interventions to improve cardiovascular risk factors and mental wellbeing among obese women of reproductive age was assessed, as well as the role of a history of childhood adversity in the effectiveness of a lifestyle intervention in improving body composition.Early life adversity is associated with poor health behaviors and more stress symptoms, possibly through altered levels of stress hormones, and those behavioral as well as stress related factors may lead to future increased risk of cardiovascular disease. A preconception lifestyle intervention was successful in improving cardiovascular risk factors in the short-term, although we were not able to detect long-term maintenance of these effects. A meta-analysis showed that among overweight and obese women of reproductive age lifestyle interventions improve mental wellbeing. Ongoing research will shed light on the role of childhood adversity in the effectiveness of a lifestyle intervention in improving cardiovascular risk factors