Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States.
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States.
Prev Med. 2018 May;110:86-92. doi: 10.1016/j.ypmed.2018.02.016. Epub 2018 Feb 14.
Childhood maltreatment is consistently associated with adult obesity, leading to calls for tailored weight interventions for people with maltreatment histories. However, it is possible that the maltreatment-obesity association is spurious and driven by unmeasured confounding, in which case such interventions would be misplaced. The home food environment in childhood is a potential confounder, but its role in the association of maltreatment with obesity has not been examined. We used a longitudinal dataset (Project EAT) to examine the association of adult retrospective reports of maltreatment history in childhood (1+ types of maltreatment before age 18 years) with previously-collected prospective childhood reports of home food environment characteristics (availability of healthy foods, availability of sweet/salty snack food, family meal frequency, and food insufficiency). We then estimated the association between maltreatment and adult body mass index (BMI, kg/m) with and without adjustment for these home food environment factors. After adjustment for sociodemographics, maltreatment had a 0.84 kg/m (95% CI: 0.28, 1.41) higher BMI at age 24-39 years, compared to those with no maltreatment, after adjustment for sociodemographics, parenting style, and BMI in childhood. Additional adjustment for home food environment factors had little effect on this association (β = 0.78 kg/m; 95% CI: 0.21,1.35), suggesting limited confounding influence of the home food environment factors. Findings provide additional robust evidence that childhood maltreatment is a risk factor for obesity that may warrant tailored interventions.
儿童虐待与成人肥胖密切相关，这促使人们呼吁针对有虐待史的人群开展有针对性的体重干预措施。然而，虐待与肥胖之间的关联可能是虚假的，是由未被测量的混杂因素引起的，在这种情况下，这种干预措施就会失当。儿童时期的家庭食物环境是一个潜在的混杂因素，但它在虐待与肥胖之间的关联中的作用尚未被研究。我们使用纵向数据集（EAT 项目）来研究童年时期成人回顾性报告的虐待史（18 岁之前有 1 种以上的虐待）与先前收集的前瞻性儿童家庭食物环境特征报告（健康食物的可获得性、甜咸零食的可获得性、家庭用餐频率和食物不足）之间的关联。然后，我们估计了在调整这些家庭食物环境因素前后，虐待与成人体重指数（BMI，kg/m）之间的关联。在调整了社会人口统计学因素、养育方式和儿童时期的 BMI 后，与没有遭受虐待的人相比，在 24-39 岁时，遭受虐待的人 BMI 高 0.84kg/m（95%CI：0.28，1.41）。进一步调整家庭食物环境因素对这种关联的影响很小（β=0.78kg/m；95%CI：0.21，1.35），表明家庭食物环境因素的混杂影响有限。这些发现提供了额外的有力证据，表明儿童虐待是肥胖的一个风险因素，可能需要有针对性的干预措施。
