Adverse childhood experiences, child poverty, and adiposity trajectories from childhood to adolescence: evidence from the Millennium Cohort Study.

OBJECTIVE

This study investigated associations between adverse childhood experiences (ACEs) in early childhood (at ages 9 months and 3 years) and adiposity trajectories of children/adolescents from age 5 to age 17, and the potential interaction between ACEs and poverty on adiposity trajectories.

METHODS

Data from the UK Millennium Cohort Study was used. Eight commonly studied ACEs and poverty were measured when the child was aged 9 months and 3 years. ACEs were considered as a cumulative score and as individual experiences. Linear-mixed effect models were employed, modelling BMI and fat mass index (FMI) trajectories from age 5 to 17 (main outcome), adjusting for covariates and stratified by sex. Interactions with poverty were also tested. The sample sizes were 7282 and 6912 for BMI and FMI sample respectively.

RESULTS

Cumulative ACE score was associated with steeper increase in BMI and FMI among boys with 3+ ACEs (BMI: β = 0.13, 95% CI: 0.02-0.24; FMI: β = 0.09, 95% CI: 0.01-0.19). For individual ACEs, parental depression was associated with steeper increase in BMI/FMI trajectories in both sexes (BMI: boys: β = 0.15, 95% CI: 0.07-0.23, girls: β = 0.13, 95% CI: 0.05-0.20; FMI: boys: β = 0.09, 95% CI: 0.03-0.15, girls: β = 0.09, 95% CI: 0.02-0.16). In addition, parental separation and physical punishment were associated with steeper increase in BMI/FMI trajectories among girls (BMI: parental separation: β = 0.25; 95% CI: 0.06-0.44, physical punishment: β = 0.14; 95% CI: 0.03-0.26; FMI: parental separation: β = 0.20; 95% CI: 0.03-0.37, physical punishment: β = 0.12; 95% CI: 0.02-0.22). No interaction effect had been found between ACEs and poverty on the adiposity trajectories.

CONCLUSIONS

A complex relationship between ACEs in early childhood and adiposity trajectories for children/adolescents was found, highlighting the different effects of specific ACEs and sex differences in the association.