Trinity College of Arts & Sciences, Duke University, Durham, NC, USA.
Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
J Nutr Sci. 2021 Oct 29;10:e95. doi: 10.1017/jns.2021.85. eCollection 2021.
Childhood trauma is strongly associated with poor health outcomes. Although many studies have found associations between adverse childhood experiences (ACEs), a well-established indicator of childhood trauma and diet-related health outcomes, few have explored the relationship between ACEs and diet quality, despite growing literature in epidemiology and neurobiology suggesting that childhood trauma has an important but poorly understood relationship with diet. Thus, we performed a cross-sectional study of the association of ACEs and adult diet quality in the Southern Community Cohort Study, a largely low-income and racially diverse population in the southeastern United States. We used ordinal logistic regression to estimate the association of ACEs with the Healthy Eating Index-2010 (HEI-10) score among 30 854 adults aged 40-79 enrolled from 2002 to 2009. Having experienced any ACE was associated with higher odds of worse HEI-10 among all (odds ratio (OR) 1⋅22; 95 % confidence interval (CI) 1⋅17, 1⋅27), and for all race-sex groups, and remained significant after adjustment for adult income. The increasing number of ACEs was also associated with increasing odds of a worse HEI-10 (OR for 4+ ACEs: 1⋅34; 95 % CI 1⋅27, 1⋅42). The association with worse HEI-10 score was especially strong for ACEs in the household dysfunction category, including having a family member in prison (OR 1⋅34; 95 % CI 1⋅25, 1⋅42) and parents divorced (OR 1⋅25; 95 % CI 1⋅20, 1⋅31). In summary, ACEs are associated with poor adult diet quality, independent of race, sex and adult income. Research is needed to explore whether trauma intervention strategies can impact adult diet quality.
儿童时期创伤与健康状况不佳密切相关。尽管许多研究发现，儿童时期经历的不良事件（ACEs），即儿童创伤的一个既定指标，与饮食相关的健康结果之间存在关联，但很少有研究探讨 ACEs 与饮食质量之间的关系，尽管流行病学和神经生物学领域的文献越来越多表明，儿童创伤与饮食之间存在重要但尚未被充分理解的关系。因此，我们在美国东南部的南方社区队列研究中进行了一项横断面研究，该研究主要针对收入较低且种族多样化的人群，调查 ACEs 与成年人饮食质量之间的关系。我们使用有序逻辑回归估计 ACEs 与 2002 年至 2009 年间招募的 30854 名 40-79 岁成年人的健康饮食指数-2010（HEI-10）评分之间的关联。经历任何 ACE 都与所有人群的更差的 HEI-10 评分相关（比值比（OR）1.22；95%置信区间（CI）1.17，1.27），并且在所有种族和性别群体中，在调整成人收入后仍然显著。ACEs 的数量增加也与更差的 HEI-10 评分相关（4+ ACEs 的 OR：1.34；95%CI 1.27，1.42）。ACEs 中家庭功能障碍类别的 ACEs 与更差的 HEI-10 评分的关联尤其强烈，包括家庭成员入狱（OR 1.34；95%CI 1.25，1.42）和父母离异（OR 1.25；95%CI 1.20，1.31）。总之，ACEs 与成年人的饮食质量差有关，与种族、性别和成人收入无关。需要研究创伤干预策略是否会影响成年人的饮食质量。
