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Mehra S, Salinas-Miranda AA, Buro AW, Marshall J, Kirby RS. The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder: National survey of Children's health 2018-2019. Disabil Health J 2024; 17:101550. [PMID: 37968201 DOI: 10.1016/j.dhjo.2023.101550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Adolescents with autism spectrum disorder (ASD) are at an increased risk of overweight/obesity and adverse childhood experiences (ACEs). OBJECTIVE This study examined whether ACEs increased the odds of overweight/obesity in adolescents with ASD. METHODS This cross-sectional study used National Survey of Children's Health (NSCH) 2018-2019 data (N = 31,533 children ages 10-17 years, including n = 480 children with mild ASD and n = 423 children with moderate/severe ASD with normal or overweight/obese BMI). Parent-reported body mass index (BMI) was coded as overweight/obesity vs. normal weight. The independent variable was the count of nine ACEs. Binary logistic regression was conducted, controlling for social ecological factors. RESULTS The odds of overweight/obesity in adolescents with ASD with 1-2 ACEs (OR 1.3, CI 1.1-1.4) and 3+ ACEs (OR 1.6, CI 1.3-2.0) were higher than those with 0 ACEs; odds increased with higher counts of ACEs. Household income level was the most significant sociodemographic influence on odds of obesity in adolescents with ASD (0-99 % Federal Poverty Level: OR 1.9, CI 1.6-2.3). Adolescents with moderate/severe ASD (OR 1.7, CI 1.2-2.5) and mild ASD (OR 1.6, CI 1.0-2.4) had higher odds of overweight/obesity after accounting for ACEs, race/ethnicity, sex, household income, and physical activity. CONCLUSION Findings indicated ACEs are associated with ASD, which calls for integration of ACEs information within trauma-informed care practices for obesity prevention and intervention for adolescents with ASD. Persistent disparities of overweight/obesity exist by race/ethnicity, sex, and household income within this population, which indicates the need for tailoring trauma-informed approaches to the unique needs of this population.
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Affiliation(s)
- Saloni Mehra
- University of South Florida, College of Public Health, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, United States.
| | - Abraham A Salinas-Miranda
- University of South Florida, College of Public Health, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, United States.
| | - Acadia W Buro
- University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, United States.
| | - Jennifer Marshall
- University of South Florida, College of Public Health, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, United States.
| | - Russell S Kirby
- University of South Florida, College of Public Health, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, United States.
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Lane JM, Merced-Nieves FM, Midya V, Liu SH, Martinez-Medina S, Wright RJ, Téllez-Rojo MM, Wright RO. Prenatal exposure to metal mixtures and childhood temporal processing in the PROGRESS Birth Cohort Study: Modification by childhood obesity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 917:170576. [PMID: 38309331 PMCID: PMC10922956 DOI: 10.1016/j.scitotenv.2024.170576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
Children are frequently exposed to various biological trace metals, some essential for their development, while others can be potent neurotoxicants. Furthermore, the inflammatory and metabolic conditions associated with obesity may interact with and amplify the impact of metal exposure on neurodevelopment. However, few studies have assessed the potential modification effect of body mass index (BMI). As a result, we investigated the role of child BMI phenotype on the relationship between prenatal exposure to metal mixtures and temporal processing. Leveraging the PROGRESS birth cohort in Mexico City, children (N = 563) aged 6-9 years completed a Temporal Response Differentiation (TRD) task where they had to hold a lever down for 10-14 s. Blood and urinary metal (As, Pb, Cd, and Mn) measurements were collected from mothers in the 2nd and 3rd trimesters. Child BMI z-scores were dichotomized to normal (between -2 and +0.99) and high (≥1.00). Covariate-adjusted weighted quantile sum (WQS) regression models were used to estimate and examine the combined effect of metal biomarkers (i.e., blood and urine) on TRD measures. Effect modification by the child's BMI was evaluated using 2-way interaction terms. Children with a high BMI and greater exposure to the metal mixture during prenatal development exhibited significant temporal processing deficits compared to children with a normal BMI. Notably, children with increased exposure to the metal mixture and higher BMI had a decrease in the percent of tasks completed (β = -10.13; 95 % CI: -19.84, -0.42), number of average holds (β = -2.15; 95 % CI: -3.88, -0.41), longer latency (β = 0.78; 95 % CI: 0.13, 1.44), and greater variability in the standard deviation of the total hold time (β = 2.08; 95 % CI: 0.34, 3.82) compared to normal BMI children. These findings implicate that high BMI may amplify the effect of metals on children's temporal processing. Understanding the relationship between metal exposures, temporal processing, and childhood obesity can provide valuable insights for developing targeted environmental interventions.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, USA
| | - Sandra Martinez-Medina
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Smid MC, Metz TD, McMillin GA, Mele L, Casey BM, Reddy UM, Wapner RJ, Thorp JM, Saade GR, Tita ATN, Miller ES, Rouse DJ, Sibai B, Costantine MM, Mercer BM, Caritis SN. Prenatal Nicotine or Cannabis Exposure and Offspring Neurobehavioral Outcomes. Obstet Gynecol 2022; 139:21-30. [PMID: 34856574 PMCID: PMC8715943 DOI: 10.1097/aog.0000000000004632] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To study the association between nicotine or cannabis metabolite presence in maternal urine and child neurodevelopmental outcomes. METHODS We conducted a secondary analysis of two parallel multicenter randomized controlled trials of treatment for hypothyroxinemia or subclinical hypothyroidism among pregnant individuals enrolled at 8-20 weeks of gestation. All maternal-child dyads with a maternal urine sample at enrollment and child neurodevelopmental testing were included (N=1,197). Exposure was urine samples positive for nicotine (cotinine) or cannabis 11-nor-9-carboxy-delta-9-tetrahydrocannabinol [THC-COOH]) or both metabolites. Primary outcome was child IQ at 60 months. Secondary outcomes included cognitive, motor and language, attention, behavioral and social competency, and differential skills assessments at 12, 24, 36, and 48 months. Quantile regression analysis was performed with confounder adjustment. RESULTS Of 1,197 pregnant individuals, 99 (8.3%) had positive cotinine samples and 47 (3.9%) had positive THC-COOH samples; 33 (2.8%) were positive for both. Groups differed in self-reported race and ethnicity, education, marital status, insurance, and thyroid status. Median IQ was similar between cotinine-exposed and -unexposed children (90 vs 95, adjusted difference in medians -2.47, 95% CI -6.22 to 1.29) and THC-COOH-exposed and -unexposed children (89 vs 95, adjusted difference in medians -1.35, 95% CI -7.76 to 5.05). In secondary outcome analysis, children with THC-COOH exposure compared with those unexposed had higher attention scores at 48 months of age (57 vs 49, adjusted difference in medians 6.0, 95% CI 1.11-10.89). CONCLUSIONS Neither prenatal nicotine nor cannabis exposure was associated with a difference in IQ. Cannabis exposure was associated with worse attention scores in early childhood. Longitudinal studies assessing associations between child neurodevelopmental outcomes and prenatal nicotine and cannabis exposure with a focus on timing and quantity of exposure are needed. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT00388297.
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Affiliation(s)
- Marcela C Smid
- Departments of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, University of Texas-Southwestern, Dallas, Texas, Columbia University, New York, New York, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Texas Medical Branch at Galveston, Galveston, Texas, University of Alabama at Birmingham, Birmingham, Alabama, Northwestern University, Chicago, Illinois, Brown University, Providence, Rhode Island, University of Texas-Houston, Houston, Texas, The Ohio State University, Columbus, Ohio, Case Western Reserve University, Cleveland, Ohio, and University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Pathology, University of Utah Health and ARUP Laboratories, Salt Lake City, Utah; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Kirk S, Ogata B, Wichert E, Handu D, Rozga M. Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet 2022; 122:848-861. [DOI: 10.1016/j.jand.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
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Schroeder K, Schuler BR, Kobulsky JM, Sarwer DB. The association between adverse childhood experiences and childhood obesity: A systematic review. Obes Rev 2021; 22:e13204. [PMID: 33506595 PMCID: PMC8192341 DOI: 10.1111/obr.13204] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/13/2020] [Indexed: 12/14/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with numerous physical and mental health issues in children and adults. The effect of ACEs on development of childhood obesity is less understood. This systematic review was undertaken to synthesize the quantitative research examining the relationship between ACEs and childhood obesity. PubMed, PsycInfo, and Web of Science were searched in July 2020; Rayyan was used to screen studies, and the Newcastle-Ottawa Scale was used to assess risk of bias. The search resulted in 6,966 studies screened at title/abstract and 168 at full-text level. Twenty-four studies met inclusion criteria. Study quality was moderate, with greatest risk of bias due to method of assessment of ACEs or sample attrition. Findings suggest ACEs are associated with childhood obesity. Girls may be more sensitive to obesity-related effects of ACEs than boys, sexual abuse appears to have a greater effect on childhood obesity than other ACEs, and co-occurrence of multiple ACEs may be associated with greater childhood obesity risk. Further, the effect of ACEs on development of childhood obesity may take 2-5 years to manifest. Considered collectively, findings suggest a need for greater attention to ACEs in the prevention and treatment of childhood obesity.
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Affiliation(s)
| | - Brittany R. Schuler
- Temple University College of Public Health
- Temple University School of Social Work
| | - Julia M. Kobulsky
- Temple University College of Public Health
- Temple University School of Social Work
| | - David B. Sarwer
- Temple University College of Public Health
- Temple University Center for Obesity Research and Education
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Vervoort-Schel J, Mercera G, Wissink I, Van der Helm P, Lindauer R, Moonen X. Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103935. [PMID: 33756254 DOI: 10.1016/j.ridd.2021.103935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/12/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are an overlooked risk factor for behavioural, mental and physical health disparities in children with intellectual disabilities (ID) and borderline intellectual functioning (BIF). AIMS To gain insight into the presence of the 10 original Wave II ACEs and family context risk variables in a convenience sample of children with ID and BIF in Dutch residential care. METHODS AND PROCEDURES 134 case-files of children with ID (n = 82) and BIF (n = 52) were analysed quantitatively. OUTCOMES AND RESULTS 81.7 % of the children with ID experienced at least 1 ACE, as did 92.3 % of the children with BIF. The average number of ACEs in children with ID was 2.02 (range 0-8) and in children with BIF 2.88 (range 0-7). About 20 % of the children with moderate and mild ID experienced 4 ACEs or more. Many of their families faced multiple and complex problems (ID: 69.5 %; BIF 86.5 %). Multiple regression analysis indicated an association between family context risk variables and the number of ACEs in children. CONCLUSIONS AND IMPLICATIONS The prevalence of ACEs in children with ID and BIF appears to be considerably high. ACEs awareness in clinical practice is vital to help mitigate negative outcomes.
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Affiliation(s)
- Jessica Vervoort-Schel
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands.
| | - Gabriëlle Mercera
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands
| | - Inge Wissink
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| | - Peer Van der Helm
- Expert Centre Social Work and Applied Psychology, Professional University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, the Netherlands; Fier, National Expertise and Treatment Centre, Holstmeerweg 1, 8936 AS Leeuwarden, the Netherlands; Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Ramón Lindauer
- Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Xavier Moonen
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
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Webb EL, Moffat A, Morris D, Satti F. Untangling the relationship between early adversity, placement breakdowns, and obesity in a secure adolescent developmental disorder service: A cross-sectional study. Disabil Health J 2021; 14:101121. [PMID: 34049846 DOI: 10.1016/j.dhjo.2021.101121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity is a growing global health concern, and those with a developmental disorder are at particular risk. Elevated levels of childhood trauma, placement breakdowns and obesity have been documented in the developmental disorder population, yet their relative associations remain unclear. OBJECTIVE A previous study (Morris et al., 2020) highlighted a high prevalence of adverse childhood experiences (ACEs) and obesity in adolescents with developmental disorders residing in a secure inpatient setting. The current cross-sectional study sought to further explore the prevalence of placement breakdowns and its relationship with Body Mass Index (BMI) in this sample. METHODS Secondary analysis was conducted on existing data for 34 adolescents, aged 10-17 years at admission, held in a secure mental health hospital developmental disorder service in the United Kingdom (UK) under the Mental Health Act. RESULTS Almost half of participants had experienced a placement breakdown (47.1%), the majority of whom typically experienced multiple breakdowns (M = 3.94, SD = 2.14). Placement breakdowns significantly predicted BMI and had a predictive effect that was independent to and above that of ACEs. CONCLUSIONS Placement breakdowns significantly contribute to risk for obesity, above that explained by early adversity. Those who have experienced placement breakdowns have a greater risk for obesity, irrespective of their level of exposure to ACEs. A history of previous placement breakdowns may act as a red flag for obesity.
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Affiliation(s)
- Elanor Lucy Webb
- Academic Centre, St Andrew's Healthcare, Billing Road, Northampton, Northamptonshire, NN1 5DG, UK.
| | - Abigail Moffat
- School of Psychology and Wellbeing, The University of Buckingham, Hunter Street, Buckingham, Buckinghamshire, MK18 1EG, UK; Institute for Sport and Physical Activity [ISPAR], School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire, MK41 9EA, UK
| | - Deborah Morris
- Academic Centre, St Andrew's Healthcare, Billing Road, Northampton, Northamptonshire, NN1 5DG, UK
| | - Faisal Satti
- School of Psychology and Wellbeing, The University of Buckingham, Hunter Street, Buckingham, Buckinghamshire, MK18 1EG, UK
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Schuler BR, Vazquez C, Kobulsky JM, Schroeder K, Tripicchio GL, Wildfeuer R. The early effects of cumulative and individual adverse childhood experiences on child diet: Examining the role of socioeconomic status. Prev Med 2021; 145:106447. [PMID: 33545230 PMCID: PMC7956050 DOI: 10.1016/j.ypmed.2021.106447] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 12/22/2022]
Abstract
Adverse Childhood Experiences (ACEs) have been associated with detrimental long-term health outcomes, including obesity risk. Existing research has yet to examine whether early life ACEs are associated with diet in early childhood within socioeconomic subgroups. Data were drawn from the Early Childhood Longitudinal Study-Birth Cohort (2001-2002). Mother-child dyads (n = 7000) were recruited when children were 9-months old, and followed longitudinally at 2 years, and 4 years. Mothers reported children's exposure to five ACEs at 9-months and 2 years and children's daily intake of fruits, vegetables, sweet snacks, and sugar-sweetened beverages (SSBs) at 4 years. Weighted multiple linear regression models tested the effect of cumulative and individual ACEs on child diet in full, low-, and high-SES samples. Cumulative ACE score was inversely associated with frequency of fruit intake in full (b = -0.08, p = 0.005) and low-SES samples (b = -0.10, p < 0.001). Domestic violence was associated with less frequent fruit intake in full (b = -0.21, p = 0.01) and low-SES samples (b = -0.29 p = 0.008). In the full sample, incarceration was associated with less frequent fruit intake (b = -0.24, p = 0.02), and domestic violence was associated with higher sweet snack (b = 0.22, p = 0.01) and SSB intake (b = 0.27, p = 0.009). Results provide preliminary evidence on the association between cumulative and specific ACEs and child diet, and how this relationship varies by SES context. Future research is needed to understand the complex multi-level mechanisms operating along this pathway in order to inform interventions supporting behavior change and to build evidence for policies that may reduce diet-related disparities in ACE exposure.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, Temple University College of Public Health, 1311 Cecil B Moore Ave., Ritter Annex 5(th) floor, Philadelphia, PA 19122, USA.
| | - Christian Vazquez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, USA.
| | - Julia M Kobulsky
- School of Social Work, Temple University College of Public Health, 1311 Cecil B Moore Ave., Ritter Annex 5(th) floor, Philadelphia, PA 19122, USA.
| | - Krista Schroeder
- Department of Nursing, Temple University College of Public Health, 3307 North Broad Street, Philadelphia, PA 19146, USA.
| | - Gina L Tripicchio
- Center for Obesity Research and Education, Temple University College of Public Health, 3223 N Broad St., Suite 175, Philadelphia, PA 19140, USA.
| | - Rachel Wildfeuer
- Department of Sociology, Temple University, 1115 Polett Walk, Gladfelter Hall 7(th) floor, Philadelphia, PA 19122, USA.
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Schroeder K, Day S, Konty K, Dumenci L, Lipman T. The impact of change in neighborhood poverty on BMI trajectory of 37,544 New York City youth: a longitudinal study. BMC Public Health 2020; 20:1676. [PMID: 33167949 PMCID: PMC7653753 DOI: 10.1186/s12889-020-09772-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neighborhood poverty may increase childhood obesity risk. However, evidence for the neighborhood poverty-obesity relationship is limited. The purpose of this study was to examine how moving to a higher or lower poverty neighborhood impacts body mass index (BMI) z-score trajectories among youth, with the goal of informing policy change, interventions, and clinical practices to reduce childhood obesity. METHODS Methods entailed secondary analysis of existing longitudinal data. The sample included youth attending New York City public schools in grades kindergarten through twelfth from school years 2006/2007 through 2016/2017. Eligibility criteria included moving to a higher or lower poverty neighborhood during the data midpoint [school years 2010/2011 through 2013/2014] of the 12-year data-period; New York City-specific metrics were used to define both neighborhood (Neighborhood Tabulation Area) and relevant neighborhood poverty levels (< 5, 5 to < 10%, 10 to < 20%, 20 to < 30%, 30 to < 40% and ≥ 40% of individuals below Federal Poverty Level). Two-piece latent growth curve models were used to describe BMI z-score trajectories of youth who moved to higher versus lower poverty neighborhoods, with propensity score weighting to account for preexisting differences between the two groups. Primary analyses were stratified by sex and exploratory subgroup analyses were stratified by sex and developmental stage (early childhood, middle childhood, and adolescence) to explore sensitive periods for neighborhood poverty exposure. RESULTS Of 532,513 youth with home address data, 18,370 youth moved to a higher poverty neighborhood and 19,174 moved to a lower poverty neighborhood (n = 37,544). Females and males who moved to a higher poverty neighborhood experienced less favorable BMI z-score trajectories for obesity risk, though effects were small. Exploratory subgroup analyses demonstrated that negative effects of neighborhood poverty were most pronounced among young and adolescent females and young males, whereas effects were mixed for other subgroups. CONCLUSIONS Youth who moved to higher poverty neighborhoods experienced less favorable BMI z-score trajectories for obesity risk, though effects were small and most consistent for females and younger youth. Additional research is needed to illuminate neighborhood poverty's impact on obesity, in order to inform policy, intervention, clinical, and research efforts to reduce obesity and improve child well-being.
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Affiliation(s)
- Krista Schroeder
- Temple University College of Public Health, 1101 West Montgomery Avenue, Philadelphia, PA 19122 USA
| | - Sophia Day
- New York City Department of Health and Mental Hygiene, Office of School Health, 42-09 28th Street, 14th floor, Long Island City, NY 11101 USA
| | - Kevin Konty
- New York City Department of Health and Mental Hygiene, Office of School Health, 42-09 28th Street, 14th floor, Long Island City, NY 11101 USA
| | - Levent Dumenci
- Temple University College of Public Health, 1101 West Montgomery Avenue, Philadelphia, PA 19122 USA
| | - Terri Lipman
- University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19140 USA
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