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  • Population Study Article
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Early life adversity and obesity risk in adolescence: a 9-year population-based prospective cohort study

Pediatric Research (2024)Cite this article

Abstract

Background

There are few prospective studies of factors that mediate the association between exposure to adverse childhood experiences (ACEs) and obesity in adolescence. Our aim was to address this limitation.

Methods

We used prospective data from the Growing up in Ireland cohort study, with measurements at 9, 13, and 18 years old. The exposures were 14 adverse experiences before age 9. The main outcome was body mass index (BMI) at 18 years. Mediators were daily activity, diet quality, self-image and behavioural difficulties at 13 years.

Results

Among the 4561 adolescents in the final cohort, 77.2% experienced any adversity, 50.5% were female and 26.7% were overweight/obese at 18 years. BMI Z was higher at ages 9 (0.54 vs 0.43, p < 0.05, 95% CI of difference: −0.22, −0.01) and 13 years (0.50 vs 0.35, p < 0.05, 95% CI of difference: −0.25, −0.06), in those exposed to an ACE, compared to those unexposed. Structural equation models revealed that behavioural difficulties (β = 0.01; 95% CI: 0.007–0.018, p < 0.001) and self-concept (β = 0.0027; 95% CI: 0.0004–0.0050, p = 0.026) indirectly mediate the association between exposure to ACEs and BMI at 18 years.

Conclusions

The association between ACEs and BMI in adolescence is mediated by behavioural difficulties and self-concept.

Impact

  • In a previous study, we found modest associations between exposure to a range of adverse childhood experiences and weight gain at 13 years of age.

  • The strength of the association between adverse childhood experiences and weight gain was lower at 18 years of age compared to the association observed at 13 years and was no longer significant after controlling for confounding and including possible mediators.

  • The association between adverse childhood experiences and BMI in adolescence is indirectly mediated by behavioural difficulties and self-concept.

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Fig. 1
Fig. 2: Biopsychosocial variables from age 9 to 18 years among youth stratified according to exposure to adversity in childhood.
Fig. 3: Standardized estimates of mediation paths for indirect and total relationships between adverse experiences and BMI.

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Data availability

The datasets used for the current study are available from the Irish Social Science Data Archive: https://www.ucd.ie/issda/data/guichild/.

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Acknowledgements

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.

Funding

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.

Author information

Authors and Affiliations

  1. Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada

    Hannah Steiman De Visser, Nicole Brunton N & Jonathan McGavock

  2. The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada

    Hannah Steiman De Visser, Nicole Brunton N & Jonathan McGavock

  3. Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Hannah Steiman De Visser, Nicole Brunton N & Jonathan McGavock

  4. Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Brenden Dufault

  5. George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada

    Brenden Dufault

  6. Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada

    Nicole Brunton N & Jonathan McGavock

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Contributions

J.M. devised the original proposal, secured funding for the analyses, and had overall responsibility for the study. H.S.D.V. helped develop the original proposal, was involved in the analysis of data, and drafted the manuscript. B.D. was responsible for data analysis and data interpretation. All authors contributed to data interpretation, reviewed and contributed to drafts of the manuscript, and approved the final report.

Corresponding author

Correspondence to Jonathan McGavock.

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Competing interests

The authors declare no competing interests.

Consent statement

All stages of the Growing Up in Ireland project were approved by the Health Research Board’s standing Research Ethics Committee based in Dublin, Ireland and these analyses were approved by the Biomedical Research Ethics Board at the University of Manitoba.

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De Visser, H.S., Dufault, B., Brunton N, N. et al. Early life adversity and obesity risk in adolescence: a 9-year population-based prospective cohort study. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03040-7

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