Childhood maltreatment and high dietary fat intake behaviors in adulthood: A birth cohort study

More Than What You Eat: A Review on the Association Between Childhood Maltreatment and Elevated Adult BMI

PURPOSE OF REVIEW

Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity.

RECENT FINDINGS

Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions.

Association of adverse childhood experiences with dietary patterns of school-age children: evidence from the birth cohort Generation XXI

BACKGROUND

Adverse Childhood Experiences (ACEs) have been associated with health-risk behaviors and several chronic diseases in adulthood. However, the relationship between exposure to ACEs and dietary patterns at school age is unknown.

OBJECTIVES

To investigate the association between ACEs and dietary patterns of 10-year-olds.

METHODS

The study included 5034 children from the Generation XXI cohort, recruited in 2005/2006 in Porto, Portugal. ACEs were assessed through a self-administered questionnaire covering the first 10 years (y) of life, quantified and grouped into 5 dimensions: "abuse," "school problems," "death/severe disease," "life changes," and "household dysfunction." Dietary patterns were identified by latent class analysis using data collected with a validated food frequency questionnaire. Five dietary patterns were studied: "low consumption," "energy-dense foods," "snacking," "intermediate consumption," and "healthier" (used as reference). Multinomial regression analyses were conducted, adjusted for the child's sex, household income, family structure, and mother's age [odds ratio (OR) and 99% confidence intervals (CIs)].

RESULTS

Most children were exposed to ≥1 ACE (96%), and ∼27% had reported 6 or more ACEs throughout life. Those reporting 4-5 and ≥6 ACEs were more likely to follow the "Energy-dense foods" dietary pattern compared with those with no ACEs (OR: 2.41; 99% CI: 1.00, 5.77 and OR: 2.65; 99% CI: 1.10, 6.39, respectively). Children exposed to "abuse" in the first 10 y showed 28% higher odds of following the "low consumption" dietary pattern when compared to children with no reported ACEs and using the "healthier" dietary pattern as a reference (OR: 1.28; 99% CI: 1.00, 1.63).

CONCLUSIONS

Exposure to ACEs was associated with less healthy dietary patterns in school-aged children. Results suggest a cumulative effect of the adverse experiences resulting in a dietary pattern higher in energy-dense foods. Children with ACEs reported under the dimension of "abuse" seemed to have reduced food consumption.

The Impact of Early Violence Exposure on Adolescent Flourishing : Is There Light at the End of the Tunnel?

Child maltreatment (CM) and intimate partner violence (IPV) are prevalent in the United States and associated with negative mental and physical health outcomes. Thus far, research and clinical care have focused on reducing symptoms of illness, but little is known about whether or how CM and IPV exposure can lead to flourishing in adolescence. To examine the impact of CM and IPV exposure on adolescent mental and physical flourishing as well as moderators and mediators affecting this pathway. A secondary data analysis of 2,232 children in the Future of Families Child Wellbeing Study (FFCWS) was conducted to examine waves 1-6 including variables on CM/IPV, general flourishing, mental flourishing, BMI, and healthy eating. Race, socioeconomic status (SES), and gender were included as moderators; depression and anxiety were included as mediating variables. Adolescent boys experienced significantly more general flourishing (β = 4.00, p < .001). There were significant direct effects of CM (p = .025) and anxiety (p = .019) on well-being, and anxiety mediated the pathway from CM to mental flourishing (CI [0.001, 0.017]). Depression (CI [0.001, 0.026]) and anxiety (CI [-0.023, - 0.005]) mediated the pathway from CM to BMI. Our findings indicated that exposure to CM and IPV impacted the likelihood of adolescent flourishing. Future research should evaluate whether and how these flourishing outcomes could be modified.

Association between adverse childhood experiences and fruit and vegetable intake among a national sample of U.S. adults

Few studies have examined the role adverse childhood experiences (ACEs) have on specific diet patterns. This study assessed the association between ACEs and daily fruit and vegetable intake (FVI). Data were derived from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) which surveys 50 states and three U.S. territories. Participants who completed the ACEs module were included in the analyses (N = 106,967). Total ACEs included the summed responses from the domains of abuse, household challenges, and neglect. FVI was reported by number of times consumed per day. The two fruit items included fruit (fresh, frozen, and canned) and fruit juice. The four vegetable items included leafy greens, fried potatoes, non-fried potatoes, and other vegetables. All fruit and vegetable items were analyzed separately to see which specific items drove the relationship between total ACEs and total FVI, equaling a total of 8 regression models. Every model controlled for poor mental health days, sex, age, ethnicity, income, body mass index, and physical activity. Total ACEs were positively associated with daily intake of fried potatoes (β = 0.008, p =.025), other potatoes (β = 0.008, p =.049), and other vegetables (β = 0.024, p <.001). Total ACEs were negatively associated with daily intake of fruit (β = -0.016, p <.001). ACEs had non-significant relationships with leafy greens and fruit juice. Findings suggests that those with increased ACEs scores report increased consumption of fried potatoes, non-fried potatoes, and other vegetables, and less of fruit. Findings highlight the need for understanding food context and preparation when analyzing the relationship between ACEs and diet intake.

Self-reported child maltreatment and cardiometabolic risk in 30-year-old adults

BACKGROUND

Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect.

AIMS

To assess the association between five types of self-reported CM and a range of obesity and metabolic indicators in a subsample of a birth cohort.

METHODS

This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self-reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up.

RESULTS

One-fifth reported maltreatment (n = 362), most commonly emotional neglect (n = 175), followed by emotional abuse (n = 128), physical neglect (n = 123), sexual (n = 121) and physical abuse (n = 116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and HDL levels. Results for other outcomes were more equivocal.

CONCLUSIONS

Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity.

Leveraging Administrative Data to Better Understand and Address Child Maltreatment: A Scoping Review of Data Linkage Studies

BACKGROUND

This scoping review aimed to overview studies that used administrative data linkage in the context of child maltreatment to improve our understanding of the value that data linkage may confer for policy, practice, and research.

METHODS

We searched MEDLINE, Embase, PsycINFO, CINAHL, and ERIC electronic databases in June 2019 and May 2020 for studies that linked two or more datasets (at least one of which was administrative in nature) to study child maltreatment. We report findings with numerical and narrative summary.

RESULTS

We included 121 studies, mainly from the United States or Australia and published in the past decade. Data came primarily from social services and health sectors, and linkage processes and data quality were often not described in sufficient detail to align with current reporting guidelines. Most studies were descriptive in nature and research questions addressed fell under eight themes: descriptive epidemiology, risk factors, outcomes, intergenerational transmission, predictive modelling, intervention/service evaluation, multi-sector involvement, and methodological considerations/advancements.

CONCLUSIONS

Included studies demonstrated the wide variety of ways in which data linkage can contribute to the public health response to child maltreatment. However, how research using linked data can be translated into effective service development and monitoring, or targeting of interventions, is underexplored in terms of privacy protection, ethics and governance, data quality, and evidence of effectiveness.

Association Between Adverse Childhood Experiences and Diet, Exercise, and Sleep in Pre-adolescents

OBJECTIVE

To understand the relationship between adverse childhood experiences (ACEs) and diet, sleep, and exercise in pre-adolescents.

METHODS

Baseline and 1-year follow-up data from the adolescent brain and cognitive development (ABCD) study were analyzed (age 10-11, n = 11,875). ACEs were measured by parent report at baseline. Three levels of ACEs were created: none, exposure to one ACE, and exposure to two or more ACEs. Health-promoting behaviors were assessed at 1 year. Diet quality was measured from parent report; sleep problems were measured by parent report, with higher scores indicating worse sleep; and amount of exercise was measured by youth report. Linear regression analyses were used to assess the relationship between ACEs and each health-promoting behavior, adjusting for family income and sex.

RESULTS

Compared to children with no adversity, ACEs were associated with worse diet - one ACE (β = -0.30 [95% CI, -0.49 to -0.12], P = .002) and 2 or more ACEs (β = -0.56 [-0.78 to -0.34, P < .001). Similarly, ACEs were associated with poor sleep - one ACE (β = 1.51 [1.00-2.03], P < .001) and 2 or more ACEs (β = 2.96 [2.38-3.53], P < .001). Finally, amount of exercise was not different in children with ACEs - 2 or more ACEs (β = -0.24, 95% CI, -0.51 to 0.04, P = .08).

CONCLUSIONS

ACEs in pre-adolescents show a dose-response relationship with unhealthy diet and sleep disruption. These findings suggest potential behaviors to target to mitigate the negative impact of childhood adversity on adult health.

The Effects of Childhood Emotional and Physical Maltreatment on Adolescents' Disordered Eating Behaviors: The Mediating Role of Borderline Personality Features

Over time, a complex crossroad between disordered eating behaviors (DEBs) and borderline personality features (BPFs) and their association with childhood emotional and physical maltreatment have been established. The present study aimed at evaluating the direct and indirect effect of physical and emotional abuse and neglect on DEB via BPF in a nonclinical adolescent sample. A total of 786 adolescents (48.3% male; mean age, 16.25 years; SD, 1.76) participated in the study. The mediation model suggested the pivotal predictive role of emotional maltreatment compared with the physical one. Indeed, both emotional abuse and neglect directly and indirectly predicted disordered eating via BPF ( β = 0.097; p < 0.001 and β = 0.042; p < 0.01, respectively). Likely, the emotional maltreatment represents the beginning of a developmental cascade that culminates in DEB as a maladaptive coping strategy in response to negative emotions, through BPF. On the contrary, physical maltreatment seems to be less involved in the developmental cascade.

Investigating the associations between childhood trauma and cardiovascular health in midlife

Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross-sectional data from 1,251 participants in the National Survey of Midlife Development in the United States' II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association's Life's Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p < .001 to p = .018, and higher LS7 scores, p = .027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs = -0.306- -0.076, p < .001-p = .048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%-57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex-specific, trauma-informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.

A Comparison of Oral Health Outcomes of Self-Reported and Agency-Notified Child Maltreatment in a Population-Based Birth Cohort at 30-Year-Old Follow-Up

OBJECTIVE

Information on the oral health outcomes of childhood maltreatment in adulthood is limited and reliant on retrospective questionnaires that are subject to recall bias. There are no data from prospective studies using maltreatment reports to statutory agencies. We therefore assessed the effect on dental outcomes and oral health care at 30-year follow-up using both prospective agency notifications and retrospective self-reports of child maltreatment in the same birth cohort.

METHODS

There were 2456 adults with data on dental outcomes and oral health care at follow-up. Information on self-reported abuse was collected using the Child Trauma Questionnaire and linked to child maltreatment notifications to statutory agencies.

RESULTS

The prevalence of self- and agency-reported maltreatment was 599 (24.4%) and 142 (5.8%), respectively. At follow-up, 850 participants (34.6%) had undergone a dental extraction for infection or decay, and 810 had experienced significant dental pain over their lifetime. One-third had not visited a dental clinic in the previous 2 years, and 40% failed to brush their teeth at least twice daily. On adjusted analyses, both self- and agency-reported maltreatment showed significant associations with dental extraction (odds ratio = 1.47 [95% confidence interval = 1.21-1.80] and odds ratio = 1.44 [95% confidence interval = 1.01-2.06], respectively). There were similar results for brushing frequency, whereas self-reported maltreatment was associated with dental pain. However, associations were weaker for dental clinic visits and some child maltreatment subtypes.

CONCLUSIONS

Child maltreatment is associated with adverse oral health consequences in adulthood and is thus a dental and wider public health issue.

Association Between Family Physical Violence Victimization and Food Consumption Among Brazilian Adolescents

Few studies have evaluated the relationship between stressful events, such as child abuse and food consumption. Thus, the objective of this study is to assess whether family physical violence victimization is associated with food consumption in adolescents. We used data from the Brazilian National Adolescent School-based Health Survey, carried out in 2015, in a representative sample of 102,072 students attending ninth grade from public and private schools. We used Venn diagrams and logistic regression analysis to, respectively, graphically represent and evaluate the association between the consumption of ultra-processed food (soft drinks, sweets/candies, and salty biscuits, packaged snacks, or processed meat) and in natura food (beans, fruits and vegetables) with victimization from family physical violence. We found a lower consumption of in natura and higher consumption of ultra-processed foods among adolescent victims when compared with nonvictims of family physical violence. The probability of consuming 4 or more times a week increased by 44% for salty biscuits, packaged snacks, or processed meats; 38% for soft drinks; and 22% for sweets among adolescents who reported violence. On the contrary, the probability of consuming 4 or more times a week decreased by 25% for beans, 19% for vegetables, and 13% for fruits among adolescent victims of family physical violence. We conclude that family physical violence victimization is associated with high consumption of ultra-processed food and low consumption of in natura food among Brazilian adolescents. Therefore, issues related to violence in childhood and adolescence should be addressed in interventions aimed at altering food consumption and consequent prevention, control, and treatment of nutrition-related outcomes to increase their effectiveness.

Child neglect and eating habits in primary schoolchildren: A prospective study in Wuhan, China

Child neglect (CN) has been associated with eating disorders, but little is known about its prospective association with the eating habits (EHs) of children. This study aimed to assess the cross-sectional and prospective associations of baseline CN with six common EHs in Chinese primary schoolchildren. We analyzed two-wave data of 1102 children (aged 9.1 ± 0.5 years) in Wuhan, China. Baseline CN was investigated by the Child Neglect Scale. Baseline and follow-up EHs, including fruit, vegetables, milk, sugar-sweetened beverages, and high-calorie snack and breakfast consumption frequency, were assessed by the Food Frequency Questionnaires. The association of baseline CN with baseline/follow-up EHs was analyzed by the generalized linear model (GLM). The association of baseline CN with the change of EHs from baseline to follow-up was examined by the Generalized estimating equation (GEE) model. After adjusting for demographic characteristics, pubertal stage, and body mass index, GLM indicated that higher baseline CN was associated with lower frequency of consuming fruit/vegetables/milk/breakfast and higher frequency of consuming sugar-sweetened beverages and high-calorie snacks at baseline, while it was only associated with lower frequency of vegetables/breakfast consumption and higher frequency of sugar-sweetened beverages consumption at follow-up. GEE results indicated that children with higher CN had a more rapid increase for the frequency of fruit/milk/breakfast consumption and a steeper decrease for the frequency of sugar-sweetened beverages consumption. In conclusion, higher CN was associated with unhealthy EHs. Yet simultaneously, children with higher CN have more scope to promote the health of their EHs. Targeting and reducing CN may be a promising approach for future interventions to improve subsequent EHs.

Do measures of healthy eating differ in survivors of early adversity?

Early life adversity has been linked to poor health, including obesity. Understanding the role of unhealthy food intake, may elucidate the importance of self-soothing behaviors in explaining the association between early life adversity and poor health in adulthood. The purpose of this study was to assess the association between early life adversity and dietary quality in a sample of adults from the Lifestyle Influences of Family Environment study. Early life adversity, demographic, and dietary data were obtained for 145 participants using formal interviews and two days of interviewer-administered 24-h recalls. Dietary quality was measured using the 2015 Healthy Eating Index (HEI) scoring algorithm to compute total and component scores. The association between early life adversity and dietary quality was assessed through linear regression and in models adjusted for age and sex. The mean ± SD HEI score for all participants was 54.6 ± 12.8. Individuals with early life adversity had a 4.51 lower overall HEI score when compared to those without early life adversity, 95% CI (0.35, 8.68). After adjusting for age and sex, early life adversity was associated with a 4.6 lower HEI score, 95% CI (0.45, 8.73). HEI component scores indicated that individuals with early life adversity were significantly more likely to have lower whole grain (0.7 versus 2.4) and total dairy (4.3 versus 6.1) scores compared to those without early life adversity. ELA was associated with lower measures of dietary quality. Results warrant future research on dietary and behavioral factors that underly the association between early life adversity and poor health outcomes.

Childhood maltreatment and disordered eating attitudes and behaviors in adult men and women:Findings from project EAT

This study examined gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors in adulthood. Data were derived from 1647 adults (ages 27-33) participating in a population-based, longitudinal study (Project EAT-IV: Eating Among Teens and Young Adults, 1998-2016). Childhood maltreatment (sexual abuse, physical abuse, emotional abuse, emotional neglect) and disordered eating attitudes and behaviors (overeating, binge eating, extreme weight control behaviors, unhealthy weight control behaviors, chronic dieting, weight and shape concerns) were assessed. Relative risk regression models were used to examine whether childhood maltreatment was related to individual disordered eating attitudes and behaviors. Gender differences in these associations were explored. A history of any childhood maltreatment was associated with more than 60% greater risk for chronic dieting and overeating, with additional associations found for binge eating, weight and shape concerns, and unhealthy weight control behaviors. All types of abuse and neglect were associated with at least one type of disordered eating outcome. Examination of the point estimates indicated that emotional neglect was most consistently related to higher risk for disordered eating attitudes and behaviors. Although there were no statistically significant gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors, the patterning of these effects highlighted unique qualitative similarities and differences in these relationships between men and women. Taken together, these findings implicate childhood maltreatment, particularly emotional neglect, as a meaningful risk factor for problematic eating outcomes in both men and women during adulthood.

History of child maltreatment and excessive dietary and screen time behaviors in young adults: Results from a nationally representative study

Child maltreatment is common and has been associated with substance use addictions, yet few studies have examined associations with potentially addictive dietary and screen time behaviors. The goal of this study was to assess associations between retrospectively self-reported child maltreatment (sexual abuse, physical abuse, emotional abuse, and neglect) and excessive self-reported dietary (sugar sweetened beverage and fast food consumption) and screen time behaviors (television/video watching and leisure time computer use) in early adulthood, overall and by sex and race/ethnicity. Associations were examined using data from 10,813 participants 24-32 years old from the National Longitudinal Study of Adolescent to Adult Health. We used predicted marginal proportions accounting for the complex sample design to obtain prevalence ratios (PRs) and adjusted for demographic characteristics and physical activity. In females, exposure to poly-maltreatment (2+ types of child maltreatment) was associated with excessive sugar sweetened beverage consumption, television/video watching, and leisure time computer use; in males, exposure to poly-maltreatment was associated with excessive sugar sweetened beverage consumption, television/video watching, and fast food consumption. Some associations were particularly strong in racial/ethnic minorities, especially Latina females (poly-maltreatment-sugar sweetened beverage association: aPR = 6.14, 95% CI:2.12, 17.75; poly-maltreatment-computer use association: aPR = 3.08, 95% CI:1.44, 6.58). These findings show that child maltreatment is associated with excessive dietary and screen time behaviors into adulthood, and these associations are present in racial/ethnic groups at high risk of cardiometabolic disease. Extension of an addiction paradigm to include dietary and screen time behaviors may inform health risks and disease prevention efforts in child maltreatment survivors.

Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.

What is bipolar disorder? A disease model of dysregulated energy expenditure

Advances in the understanding and management of bipolar disorder (BD) have been slow to emerge. Despite notable recent developments in neurosciences, our conceptualization of the nature of this mental disorder has not meaningfully progressed. One of the key reasons for this scenario is the continuing lack of a comprehensive disease model. Within the increasing complexity of modern research methods, there is a clear need for an overarching theoretical framework, in which findings are assimilated and predictions are generated. In this review and hypothesis article, we propose such a framework, one in which dysregulated energy expenditure is a primary, sufficient cause for BD. Our proposed model is centered on the disruption of the molecular and cellular network regulating energy production and expenditure, as well its potential secondary adaptations and compensatory mechanisms. We also focus on the putative longitudinal progression of this pathological process, considering its most likely periods for onset, such as critical periods that challenges energy homeostasis (e.g. neurodevelopment, social isolation), and the resulting short and long-term phenotypical manifestations.

Obesogenic food consumption among young children: the role of maltreatment

OBJECTIVE

To determine whether children exposed to a greater variety of acts of parent-to-child physical and psychological maltreatment will be at greater risk of consuming obesogenic foods at a higher frequency.

DESIGN

Survey research using a longitudinal panel design.

SETTING

In-home interviews with primary caregivers in twenty large US cities.ParticipantsA national sample of at-risk children and their families who participated in the Fragile Families and Child Wellbeing Study (FFCWS).

RESULTS

Child maltreatment emerged as a statistically significant (P&lt;0·01) and robust predictor of obesogenic food consumption, in both cross-sectional and longitudinal analyses. Child maltreatment also consistently emerged as one of the strongest predictors of obesogenic food consumption in these models. Ancillary analyses indicated that physical maltreatment plays a particularly important role in these associations.

CONCLUSIONS

A major implication of the present study is that child maltreatment prevention efforts should be reflected in interventions that seek to diminish unhealthy eating practices among children. Multi-professional teams can work together on obesity prevention not only via education but also by considering the interconnectedness of obesogenic food consumption and experiences of maltreatment.

Reported prevalence of childhood maltreatment among Chinese college students: A systematic review and meta-analysis

OBJECTIVE

To estimate the prevalence of childhood maltreatment among college students in China by a systematic review and meta-analysis.

METHODS

A systematic search of relevant articles in Pubmed, Wanfang Data, Chinese Scientific Journals Fulltext Database (CQVIP), China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBMdisc) was conducted on September 1, 2017. A random-effects model was used to estimate the pooled prevalence and sources of heterogeneity were explored using subgroup analyses.

RESULTS

In total, 32 studies were included in our review. The pooled prevalence of childhood maltreatment among college students was 64.7% (CI: 52.3%-75.6%). For childhood physical abuse(CPA), childhood emotional abuse(CEA), childhood sexual abuse(CSA), childhood physical neglect(CPN)and childhood emotional neglect (CEN), the pooled estimates were 17.4% (13.8%-21.3%), 36.7%(25.1%-49.1%), 15.7%(11.6%-20.2%), 54.9%(41.2%-68.1%) and 60.0% (45.0%-74.0%), respectively. Use of the Childhood Trauma Questionnaire (CTQ) yielded a higher pooled estimate than any other measurement tools in the subgroup analyses of CPA, CEA, CSA, CPN and CEN. The Egger's tests revealed no evidence of publication bias(P>0.05).

CONCLUSIONS

Childhood maltreatment is common among college students in China. Prevention policies and programmes should be urgently developed to stop the occurrence of child maltreatment, and special attention should be paid to maltreated college students.