Adverse Childhood Experiences (ACEs), metabolic health, and inequality: mechanisms in contemporary UK youth and lifetime economic consequences using LifeSim (360G-Wellcome-344839_Z_26_Z)

Background: Adverse Childhood Experiences (ACEs) are common and can shape health across the life course. While links between ACEs and adult metabolic dysfunction(e.g.,obesity, diabetes, or metabolic syndrome) are well established, young adulthood is an under-studied “turning point” when early risks may accelerate into long-term metabolic diseases. My systematic review found consistent evidence that ACE exposure is associated with higher BMI and emerging metabolic risk in young adults, with pathways through psychological distress and risk health behaviours. Approach: I will use UK longitudinal cohort data (primarily the Millennium Cohort Study) to estimate how ACEs relate to early metabolic risk and key mechanisms across adolescence and young adulthood. I will then integrate these estimates into the LifeSim - a well- established microsimulation model used in health economics to estimate life- course outcomes and policy impacts, providing monetary estimates of these impacts. The projected model outputs will be tested against real world evidence, including midlife patterns observed in other UK cohort data (i.e., BCS70). Impact: This project will quantify how much lifetime metabolic burden is already “locked in” by early adult risk due to ACE, identify actionable pathways for prevention, and provide policy-relevant scenario evidence on where early support could reduce long-term costs and inequalities.