Epigenetic Clock Acceleration and Its Physiological Correlates in Survivors of Prolonged Food Insecurity in North East Nigeria: A Post-Conflict Health Study

Background: Prolonged food insecurity and conflict-related adversity in North East Nigeria's insurgency-affected communities may accelerate epigenetic ageing, measurable as epigenetic clock acceleration using DNA methylation arrays. Epigenetic age acceleration is associated with elevated all-cause mortality, cardiometabolic disease, and immune dysregulation. No study has examined epigenetic ageing in conflict-affected Nigerian populations, making this an entirely original contribution. Objectives: This study aims to measure epigenetic age acceleration using the Horvath and GrimAge methylation clocks, profile inflammatory and metabolic biomarkers, and construct a structural model linking conflict exposure severity, nutritional rehabilitation history, and epigenetic clock acceleration to physiological health outcomes among food insecurity survivors resettled in Adamawa and Borno States. Methods: One hundred and twenty conflict-affected adults and forty internally displaced persons in resettlement camps will be recruited alongside sixty community controls with no conflict displacement. Whole-blood DNA methylation will be profiled using the Illumina EPIC 850K array. Linear regression with robust standard errors will model predictors of epigenetic age acceleration. Mediation analysis will examine nutritional rehabilitation as a pathway modifier. Expected Outcomes: Conflict-exposed individuals are hypothesised to demonstrate 3 to 7 years of epigenetic age acceleration compared to controls, with cumulative nutritional deprivation and inflammatory burden as independent mediators. Conclusion: This study will generate foundational epigenetic physiology evidence from a post-conflict African setting. Keywords: epigenetic clock, biological ageing, food insecurity, conflict, North East Nigeria.