Preliminary examination of differences in dietary behaviors and their relation to sleep and fasting metabolic markers among young adults with differential exposure to adverse childhood experiences

Introduction: Exposure to adverse childhood experiences (ACEs), severe psychosocial stressors that occur during childhood, confers a dose-dependent increase in cardiometabolic disease risk. The extent to which modifiable, biologically-relevant behaviors contribute to this risk remains poorly understood. We examined differences in dietary behaviors and their relation to sleep and fasting metabolic markers among young adults with low (ACELOW; 0-2 ACEs) versus high (ACEHI; ≥3 ACEs) ACE exposure. Hypothesis: We hypothesized that ACEHI would have greater energy consumption, lower dietary quality, and altered composition and timing of their last meal of the day compared with ACELOW. We further hypothesized that closer timing of the last meal of the day to bedtime and lower quality of this meal would be associated with lower sleep duration and efficiency, and increased levels of fasting blood glucose, triglycerides, and total cholesterol. Methods: Ninety-six participants (ACEHI, n=55 (78%F); ACELOW, n=41 (75%F)); visited the laboratory between 0700-0900 following an overnight fast, and a 24-h caffeine and 48-h alcohol and exercise abstinence protocol. Dietary recalls were collected using the Automated Self-Administered 24-hour dietary assessment tool (ASA-24h), which was used to assess total 24-h dietary intake and quality, eating windows, and composition and timing relative to sleep and last meal of the day. Sleep duration and efficiency were self-reported using the Consensus Sleep Diary the next day. Fasting venous blood samples were obtained and comprehensive metabolic panels were performed. Means±SDs are reported. Results: ACEHI consumed more total energy (2354±821 vs. 2033±763 kcal; p=0.026), protein (99±47 vs. 82±42 g; p=0.032), fat (105±44 vs. 88±38 g; p=0.019), and saturated fat (35±19 vs. 27±15 g; p=0.016). Macronutrient intake relative to total energy consumption was similar between ACEHI and ACELOW, except for saturated fat which was marginally higher in ACEHI than ACELOW (13.2±4.6% vs. 11.7±3.4%; p=0.07). There were no between-group differences in eating window duration (11.1±2.6 vs.11.3±2.0 h, p=0.65), nor in overall dietary quality as indicated by similar Healthy Eating Index-2020 (HEI) scores (53±12 vs. 53±14 points; p=0.81). Among participants who reported having dinner as their last meal of the day (ACEHI, n=37; ACELOW, n=33), ACEHI consumed more total energy (+395±234 kcals; p=0.037), protein (+28±17 g; p=0.038), and fat (+24±2 g; p=0.049) intake than ACELOW. Among these participants, each additional hour between the last meal of the day and bedtime was associated with shorter sleep duration in ACELOW (β=-0.23; R 2 =0.13; p=0.038). However, in ACEHI, greater HEI scores were associated with greater sleep efficiency (r=0.33, p=0.048) and lower fasting triglycerides (r=-0.37, p=0.032). Conclusion: ACEHI reported greater total energy, protein and fat intake during their last meal of the day than ACELOW, which accounted for the total daily differences in fat and macronutrient intake observed between ACEHI and ACELOW. Further, among ACEHI, lower dietary quality was associated with both poorer sleep quality and higher fasting triglycerides. These data suggest that dietary quality may interactively contribute to impairments in sleep quality and metabolic health among apparently healthy young adults with increased cardiometabolic risk due to prior ACE exposure. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.