The Longitudinal Relation Between Accumulation of Adverse Life Events and Body Mass Index From Early Adolescence to Young Adulthood

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.

Early childhood adversity and body mass index in childhood and adolescence: linking registry data on adversities with school health records of 53,401 children from Copenhagen

OBJECTIVE

We examined whether childhood adversity experienced in early childhood (0-5 years) is related to body mass index (BMI) in childhood (6-7 years) and adolescence (12-15 years).

METHODS

This study combined data from the nationwide register-based DANLIFE study on childhood adversities with data on height and weight of school children in Copenhagen. Data were available for 53,401 children born in Denmark between 1980 and 1996. Children were divided into groups of early childhood adversity by applying group-based multi-trajectory modelling using their yearly count of childhood adversity in three dimensions (i.e., material deprivation, loss or threat of loss, and family dynamics) from 0-5 years. Direct and total associations between the early childhood adversity groups and BMI z-scores in childhood and adolescence were estimated using sex-stratified structural equation models.

RESULTS

Five exclusive and exhaustive groups of early childhood adversity were identified, which were characterized by low adversity (51%), moderate material deprivation (30%), high material deprivation (14%), loss or threat of loss (3%) and high adversity (2%). Boys and girls exposed to moderate or high material deprivation and loss or threat of loss had a slightly higher BMI z-score, especially in adolescence, compared with those in the low adversity group, with the strongest association found for girls in the loss or threat of loss group (b (95% CI) = 0.18 (0.10, 0.26)). Additionally, boys in the high adversity group had a slightly lower BMI z-score in childhood than boys in the low adversity group (b (95% CI) = -0.12 (-0.22, -0.02)).

CONCLUSIONS

Whereas associations with BMI were found for children and adolescents exposed to material deprivation, loss or threat of loss, and high adversity, the effect sizes were generally small. Contrary to prevailing hypotheses, weight changes in childhood is probably not a major explanatory mechanism linking early childhood adversity with later-life morbidity.

Adverse childhood experiences, health behaviors, and associations with obesity among youth in the United States

Adverse Childhood Experiences (ACEs) affect almost half of youth in the U.S. and are linked to a host of deleterious medical and psychosocial outcomes. The current study examines the relationships among ACEs, childhood obesity, and modifiable lifestyle behaviors to inform clinical care, future research, and policy. Using data from the 2016-2018 National Survey of Children's Health (NSCH), associations between children's ACEs, weight status, and health behaviors that may influence the link between ACEs and obesity were examined. In the NSCH data, 25.3% of youth aged 10-17 years experienced one ACE with another 25.9% experiencing two or more ACEs. Having ACEs was related to excess screen time and inadequate sleep, and independently associated with obesity. Findings highlight the importance of providers screening and finding ways to intervene on behalf of youth with obesity. The present provides guidelines for providers on intervening with youth experiencing ACEs.

Comparison of nutritional status and growth curves of children and adolescents in the city of Goiânia, Goiás: cross-sectional study

BACKGROUND

Nutritional status and growth curves can affect cognitive development, increase the risk of infection, and contribute to the development of chronic diseases. Its etiology is related to food, socioeconomic, and maternal conditions. However, to date, no data on these parameters exist in the state of Goiás, Brazil.

OBJECTIVE

To compare the nutritional status and growth curves of children and adolescents in the city of Goiânia, Goiás, Brazil.

DESIGN AND SETTING

This was a cross-sectional study. A total of 529 individuals were recruited from a primary health center in the municipality.

METHODS

To assess nutritional status, the sample was divided into three categories: 3-4, 5-10, and 11-19 years, with z-score classification considering body mass index for age. The classification of growth curves was performed considering the median height values for age, assuming two references: (a) young Brazilian population and (b) one recommended for international use. The independent sample T-test was used to compare anthropometric variables.

RESULTS

The results showed that the classification of eutrophics represents a predominant percentage between both sexes (men: 03-04 = 55.4%; 05-10 = 57.6%; 11-19 = 53.5 % and women: 03-04 = 53.5%; 05-10 = 63.9%; 11-19 = 56.9%), and growth curves showed differences in specific periods in both sexes.

CONCLUSIONS

It can be concluded that children and adolescents from the city of Goiânia present as predominance the eutrophic nutritional status, followed by the risk of overweight, underweight, obesity, and malnutrition of both sexes.

Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding

In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic-pituitary-adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders-each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding "protective measure" theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.Level of evidence: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.

Maltreatment experience in childhood and average excess body mass from adolescence to young adulthood

BACKGROUND

Prior studies have suggested maltreatment is a strong predictor of later weight outcomes, such that maltreatment experiences in childhood increase the likelihood of being overweight or obese in adulthood. Estimates of this relationship may be biased due to: 1) inadequate selection of covariates; 2) improper operationalization of child maltreatment; and 3) restricting analyses to cross-sectional outcomes.

OBJECTIVES

Evaluate how latent classes of child maltreatment experiences are associated with a longitudinal BMI measure from adolescence to adulthood.

PARTICIPANTS

Data from the National Longitudinal Study of Adolescent to Adult Health.

METHODS

We evaluated how previously developed latent classes of child maltreatment experiences were associated with average excess BMI from adolescence to adulthood using multivariate linear regression.

RESULTS

In the unadjusted model, individuals in the poly-maltreatment class (b = 0.46, s.e. = 0.20) and individuals who experienced adolescent-onset maltreatment (b = 0.36, s.e. = 0.11) had higher average excess BMI compared to individuals in the no maltreatment class. After adjusting for confounders, the relationship between poly-maltreatment and average excess BMI abated, whereas the relationship between adolescent-onset maltreatment and average excess BMI sustained (b = 0.28, s.e. = 0.11).

CONCLUSIONS

Contrary to previous findings, our analyses suggest the association between maltreatment experiences and longitudinal weight outcomes dissipates after controlling for relevant confounders. We did find a relationship, however, between adolescent-onset maltreatment and average excess BMI from adolescence to adulthood. This suggests the importance of maltreatment timing in the relationship between maltreatment and weight.

Biomarkers of adverse childhood experiences: A scoping review

Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences that occur during childhood. Research has demonstrated a link between ACEs and risk of physical and mental health disorders, where early life adversity may become "biologically embedded" and have wide-ranging effects on various physiological systems. The aim of this study was to identify the extent and breadth of recent research activity relating to biological measures of ACEs in adulthood. We undertook a scoping review including published research articles. Medline and PsycINFO were searched for articles from 2007 to July 2017. Articles were eligible if they included adult participants, were written in English, and reported on a biomarker of childhood adversity in adulthood. Forty articles met our inclusion criteria. Studies investigated a range of ACEs that were often measured retrospectively. The studies identified biomarkers related to inflammation (e.g., CRP), cardio/metabolic systems (e.g., BMI), genetics (e.g., telomere length), and endocrine systems (e.g., cortisol), as well as composites of multiple physiological systems. However, not every study identified found significant associations. Health behaviours, emotional distress, social relationships, and socioeconomic factors may help explain some of these associations. Further research is needed to better understand biomarkers of ACEs in adulthood and their relationship to health conditions.

Gender, stressful life events and interactions with sleep: a systematic review of determinants of adiposity in young people

OBJECTIVES

Overweight and obesity among young people are high and rising. Social stressors and sleep are independently associated with obesity, but are rarely studied together or examined for gender-specific effects. The literature regarding adolescent populations is especially lacking. This review assesses whether experiencing stressful life events results in greater adiposity in young women and young men compared with those who do not experience stressful life events, and whether the relationship is modified by sleep problems.

DESIGN

We systematically searched six bibliometric databases (Web of Science, Embase Ovid, PsycINFO, CINHAL, PubMed, ProQuest Dissertations) supplemented by hand searches. Longitudinal prospective studies or reviews were eligible for inclusion when they examined gender-specific changes in adiposity in young adults (age 13-18 years) as a function of stressful life event alone or in combination with sleep problems.

RESULTS

We found one study eligible for inclusion reporting mixed impact of stressful life events on body mass index (BMI) between genders. The study assessed specific life events and showed significantly lower BMI at follow-up among young men who experienced a residence change, but significantly higher BMI among young women who experienced setting up a family and who reported internal locus of control.

CONCLUSIONS

Despite ample research on social stressors or sleep problems and weight, we still know little about the role of stressful life events, or combined effects with sleep, on obesity risk in adolescents from a gender perspective. Existing evidence suggests specific life events affect weight differently between the genders. Robust, high-quality longitudinal studies to decipher this dual burden on obesity during adolescence should be prioritised, as firm conclusions remain elusive.

Body Mass Index Trajectories from Adolescence to Early Young Adulthood: Do Adverse Life Events Play a Role?

OBJECTIVE

The aim of this study was to investigate whether there are different classes of body mass index (BMI) development from early adolescence to young adulthood and whether these classes are related to the number of adverse life events children experienced.

METHODS

Data were from the TRAILS (TRacking Adolescents' Individual Lives Survey) cohort (n = 2,218). Height and weight were objectively measured five times between participants' ages 10 to 12 years and 21 to 23 years. Parents reported on the occurrence of adverse life events in their child's life in an interview when children were 10 to 12 years old. Unconditional and conditional growth mixture modeling was used for statistical analysis.

RESULTS

"Normal weight" (75.1%), "late onset overweight" (20.1%), and "early onset overweight" classes (4.8%) were identified. In analyses unadjusted for additional covariates, children who experienced a higher number of adverse events had higher odds to be in the late onset overweight (OR [95% CI] = 1.08 [1.00-1.17]) than the normal weight class, but the association was attenuated in analyses adjusted for additional covariates (OR [95% CI] = 1.07 [0.98-1.16]).

CONCLUSIONS

Three BMI trajectory classes can be distinguished from early adolescence to young adulthood. The accumulation of adverse life events is not related to BMI trajectory class.