To determine whether adverse childhood experiences were associated with weight gain and obesity risk in adolescence.
We analyzed data from 6942 adolescents followed between 9 and 13 years of age in the Growing Up in Ireland cohort study. The main exposures were 14 adverse childhood experiences, 4 of which were included in the Adverse Childhood Experience (ACE) study. The primary outcome was incident overweight and obesity at 13 years. Secondary outcomes included prevalent overweight/obesity and weight gain.
More than 75% of the youth experienced an adverse experience and 17% experienced an ACE-specific experience before 9 years. At 13 years, 48% were female and 31.4% were overweight or obese. After adjusting for confounding, exposure to any adverse experience was associated with prevalent overweight/obesity (aOR: 1.56; 1.19–2.05) and incident overweight/obesity (adjusted IRR: 2.15; 95% CI: 1.37–3.39), while exposure to an ACE-specific exposure was associated weight gain (BMI Z score change = 0.202; 95% CI: 0.100–0.303). A significant interaction between income and adverse childhood experiences was observed for both incident overweight/obesity and weight gain (BMI Z change: −0.046; 95% CI: −0.092 to 0.000).
Adverse childhood experiences and low income interact and independently predict obesity risk in early adolescence.
Access optionsAccess options
Subscribe to Journal
Get full journal access for 1 year
only $64.85 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Ogden, C. L. et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 Through 2013-2014. JAMA 315, 2292–2299 (2016).
Lobstein, T. et al. Child and adolescent obesity: part of a bigger picture. Lancet 385, 2510–2520 (2015).
Wang, Y. et al. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes. Rev. 16, 547–565 (2015).
McGavock, J., Dart, A. & Wicklow, B. Lifestyle therapy for the treatment of youth with type 2 diabetes. Curr. Diab Rep. 15, 568 (2015).
Watts, A. W. et al. Socioeconomic differences in overweight and weight-related behaviors across adolescence and young adulthood: 10-year longitudinal findings from Project EAT. Prev. Med. 87, 194–199 (2016).
Flaherty, E. G. et al. Adverse childhood experiences and child health in early adolescence. JAMA Pediatr. 167, 622–629 (2013).
Howe, L. D., Tilling, K. & Lawlor, D. A. Studying the life course health consequences of childhood adversity: challenges and opportunities. Circulation 131, 1645–1647 (2015).
Elsenburg, L. K., van Wijk, K. J. E., Liefbroer, A. C. & Smidt, N. Accumulation of adverse childhood events and overweight in children: a systematic review and meta-analysis. Obesity (Silver Spring) 25, 820–832 (2017).
Danese, A. & Tan, M. Childhood maltreatment and obesity: systematic review and meta-analysis. Mol. Psychiatry 19, 544–554 (2014).
Elsenburg, L. K., Smidt, N., Hoek, H. W. & Liefbroer, A. C. Body mass index trajectories from adolescence to early young adulthood: do adverse life events play a role? Obesity (Silver Spring) 25, 2142–2148 (2017).
Suglia, S. F., Duarte, C. S., Chambers, E. C. & Boynton-Jarrett, R. Cumulative social risk and obesity in early childhood. Pediatrics 129, e1173–e1179 (2012).
Evans, G. W., Fuller-Rowell, T. E. & Doan, S. N. Childhood cumulative risk and obesity: the mediating role of self-regulatory ability. Pediatrics 129, e68–e73 (2012).
Michels, N. et al. Cross-lagged associations between children’s stress and adiposity: the Children’s Body Composition and Stress study. Psychosom. Med. 77, 50–58 (2015).
Slopen, N., Goodman, E., Koenen, K. C. & Kubzansky, L. D. Socioeconomic and other social stressors and biomarkers of cardiometabolic risk in youth: a systematic review of less studied risk factors. PLoS ONE 8, e64418 (2013).
Lumeng, J. C. et al. Overweight adolescents and life events in childhood. Pediatrics 132, e1506–e1512 (2013).
Gooding, H. C. et al. Exposure to violence in childhood is associated with higher body mass index in adolescence. Child Abus. Negl. 50, 151–158 (2015).
Murray, A. et al. The Growing Up in Ireland Cohort: Design, Instrumentation and Procedures for the Child Cohort (Economic Social Research Institute, Dublin, 2010).
McCrory, C. & Layte, R. Breastfeeding and risk of overweight and obesity at nine-years of age. Soc. Sci. Med. 75, 323–330 (2012).
Dube, S. R. et al. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA 286, 3089–3096 (2001).
NLSCY Project Team - What works for Children. National Longitudinal Survey of Children, Overview of Survey Instruments for 1994-95 Data Collection Cycle 1 (Government of Canada, Ottawa, 1995).
Williams, J. G. et al. Growing Up in Ireland National Longitudinal Study of Children. The Lives of 9 Year Olds (Economic and Social Research Institute, Dublin, 2011).
Rodd, C., Metzger, D. L. & Sharma, A., Canadian Pediatric Endocrine Group Working Committee for National Growth C. Extending World Health Organization weight-for-age reference curves to older children. BMC Pediatr. 14, 32 (2014).
de Onis, M. et al. Development of a WHO growth reference for school-aged children and adolescents. Bull. World Health Organ. 85, 660–667 (2007).
Rodd, C. & Sharma, A. K. Recent trends in the prevalence of overweight and obesity among Canadian children. CMAJ 188, E313–E320 (2016).
OECD Project on Income Distribution and Poverty What are Equivalcy Scales. http://www.oecd.org/els/soc/OECD-Note-EquivalenceScales.pdf
Queally, M. et al. Do mothers accurately identify their child’s overweight/obesity status during early childhood? Evidence from a nationally representative cohort study. Int. J. Behav. Nutr. Phys. Act. 15, 56 (2018).
Hughes, K. et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2, e356–e366 (2017).
Brown, N. M. et al. Associations between adverse childhood experiences and ADHD diagnosis and severity. Acad. Pediatr. 17, 349–355 (2017).
Bellis, M. A. et al. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bull. World Health Organ. 92, 641–655 (2014).
Lee, H., Andrew, M., Gebremariam, A., Lumeng, J. C. & Lee, J. M. Longitudinal associations between poverty and obesity from birth through adolescence. Am. J. Public Health 104, e70–e76 (2014).
Wells, N. M., Evans, G. W., Beavis, A. & Ong, A. D. Early childhood poverty, cumulative risk exposure, and body mass index trajectories through young adulthood. Am. J. Public Health 100, 2507–2512 (2010).
Babey, S. H., Hastert, T. A., Wolstein, J. & Diamant, A. L. Income disparities in obesity trends among California adolescents. Am. J. Public Health 100, 2149–2155 (2010).
Casey, P. H. et al. The association of child and household food insecurity with childhood overweight status. Pediatrics 118, e1406–e1413 (2006).
Giovanelli, A., Reynolds, A. J., Mondi, C. F. & Ou, S. R. Adverse childhood experiences and adult well-being in a low-income, urban cohort. Pediatrics 137, e20154016 (2016).
Braveman, P. & Barclay, C. Health disparities beginning in childhood: a life-course perspective. Pediatrics 124(Suppl 3), S163–S175 (2009).
Garner, A. S. & Shonkoff, J. P. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 129, e224–e231 (2012).
Danese, A. & McEwen, B. S. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol. Behav. 106, 29–39 (2012).
Mason, S. M. et al. Child maltreatment’s heavy toll: the need for trauma-informed obesity prevention. Am. J. Prev. Med. 50, 646–649 (2016).
We are indebted to the families who participated in the Growing Up in Ireland Cohort study and the staff at the Economic and Social Research Institute in Dublin for data collection and management. Growing Up in Ireland was commissioned by the Irish Government and funded by the Department of Health and Children through the Office of the Minister for Children (OMC) in association with the Department of Social and Family Affairs and the Central Statistics Office. These analyses were funded through a grant awarded to J.M. from the Canadian Institutes of Health Research. J.M. holds a Applied Public Health Chair in Resilience and Obesity in Youth awarded by the Canadian Institutes of Health Research and the Public Health Agency of Canada. This work was also supported by Canadian Institutes of Health Research (CPP-137910), Department of Children and Youth Affairs (DCYA), and Republic of Ireland.