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Siewert-Markus U, Ittermann T, Klinger-König J, Grabe HJ, Stracke S, Völzke H, Targher G, Dörr M, Markus MRP, Töpfer P. Childhood maltreatment and risk of metabolic dysfunction-associated steatotic liver disease - Evidence of sex-specific associations in the general population. J Psychosom Res 2024; 183:111829. [PMID: 38896985 DOI: 10.1016/j.jpsychores.2024.111829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/30/2024] [Accepted: 06/08/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND AIMS Childhood maltreatment (CM) is linked to self-reported liver disease in adulthood. However, specific diagnostic entities, e.g., metabolic dysfunction-associated steatotic liver disease (MASLD) as the most frequent chronic liver disease, and sex-differences have previously not been considered. METHODS Cross-sectional analyses were conducted in 4188 adults from a population-based cohort in Northeastern Germany after excluding individuals with excessive alcohol consumption, cirrhosis, or chronic viral hepatitis. CM-exposure was assessed using the Childhood Trauma Questionnaire (CTQ). Liver-related outcomes included serologic liver enzymes, fibrosis-4 score (FIB-4) and, in 1863 subjects who underwent magnetic resonance imaging examination, liver fat content. Sex-stratified linear regression and logistic regression models predicting liver-related outcomes and risk for MASLD, respectively, from overall CTQ scores were adjusted for age, school education, alcohol consumption, and waist circumference. Exploratory analyses investigated effects of CTQ-subscales on liver-related outcomes and risk for MASLD. RESULTS In both sexes, overall CM-exposure was associated with higher levels of serum aspartate aminotransferase and FIB-4 score. In men, effects were mainly driven by physical abuse, and in women by emotional neglect. Only in men, overall CM-exposure (β = 0.70, 95%-CI 0.26-1.13, p = 0.002) and four CTQ-subscales were associated with greater liver fat content, and physical abuse (aOR = 1.22, 95%-CI 1.02-1.46, p = 0.034) and physical neglect (aOR = 1.25, 95%-CI 1.04-1.49, p = 0.015) were associated with higher risk for MASLD. CONCLUSIONS These results suggest sex differences in the association between CM and objective serum and imaging markers of MASLD in adulthood. For men especially, a history of CM-exposure may increase risk of developing MASLD in adulthood.
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Affiliation(s)
- Ulrike Siewert-Markus
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Johanna Klinger-König
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Sylvia Stracke
- Clinic and Polyclinic for Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Clinic and Polyclinic for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Clinic and Polyclinic for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD) Partner Site Greifswald, Greifswald, Germany
| | - Philipp Töpfer
- Clinic and Polyclinic for Internal Medicine A, University Medicine Greifswald, Greifswald, Germany.
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Wimmelmann CL, Sejling C, Clarke RB, Elsenburg LK, Sørensen TIA, Rod NH. Childhood adversity trajectories and weight status in young adult men: a register-based study including 359,783 Danish men. Int J Obes (Lond) 2024; 48:1157-1163. [PMID: 38816565 PMCID: PMC11281903 DOI: 10.1038/s41366-024-01540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Childhood adversity has previously been associated with overweight and obesity in adult life, but there is a need for larger population-based studies using prospectively obtained adversity trajectories across childhood to confirm these associations. Moreover, childhood adversity may also be associated with underweight, which is less often studied. The aim of the current study is to investigate the association between childhood adversity trajectories from 0-15 years with weight categories in young adult men. METHODS The Danish Life Course Cohort (DANLIFE) was linked with the Danish Conscription Registry resulting in a study sample of 359,783 men, who have been assigned to one of five previously identified adversity trajectories from 0-15 years: "low adversity", "early material deprivation", "persistent material deprivation", "loss or threat of loss", and "high adversity". Height and weight in young adulthood was assessed at a draft board examination at age 18-26 years. Associations of adversity trajectories and weight categories were investigated in multinomial regression models. RESULTS Compared with the "low adversity" group, the four other adversity groups had higher risks of underweight, overweight, and obesity. The "high adversity" group showed the strongest associations with both underweight (1.44 (1.32, 1.58)) and obesity (1.50 (1.39, 1.61)) when adjusted for parental origin, birth year, age at draft board examination, and maternal age. CONCLUSION Childhood adversity, experienced between 0 and 15 years of life, was associated with a higher risk of underweight, overweight, and obesity in young adulthood among men.
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Affiliation(s)
- Cathrine L Wimmelmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark.
- Centre for Childhood Health, Islands Brygge 41, 2300 Copenhagen S, Copenhagen, Denmark.
| | - Christoffer Sejling
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Rebecca B Clarke
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Leonie K Elsenburg
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Centre for Childhood Health, Islands Brygge 41, 2300 Copenhagen S, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
- Section on Genomic Physiology and Translation, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Copenhagen, Denmark
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Copenhagen, Denmark
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Töpfer P, Siewert-Markus U, Klinger-König J, Grabe HJ, Stracke S, Dörr M, Völzke H, Ittermann T, Markus MRP. Sex-specific associations of childhood maltreatment with obesity-related traits - The Study of Health in Pomerania (SHIP). CHILD ABUSE & NEGLECT 2024; 149:106704. [PMID: 38395019 DOI: 10.1016/j.chiabu.2024.106704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Child maltreatment (CM) is linked to obesity in adulthood. However, sex-differences and direct measurements of body fat have previously been insufficiently considered in this context. OBJECTIVE To assess sex-specific associations of CM with anthropometric markers of overweight/obesity and direct measures of body fat. PARTICIPANTS AND SETTING Analyses were conducted in 4006 adults from a population-based cohort in Northeastern Germany (SHIP-TREND-0). METHODS CM was assessed using the Childhood Trauma Questionnaire (CTQ). Obesity-related traits included anthropometric indicators (i.e., height, weight, body mass index [BMI], waist [WC] and hip circumference [HC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]), fat mass (FM) and fat-free mass (FFM) derived from bioelectrical impedance analysis (BIA), and subcutaneous (SAT) and visceral adipose tissue (VAT) ascertained using magnetic resonance imaging (MRI). Sex-stratified linear regression models predicting obesity-related traits from total CTQ scores were adjusted for age and education. Exploratory analyses investigated effects of CTQ subscales on obesity-related traits. RESULTS In men, CM was positively associated with WHtR (β = 0.04; p = .030) and VAT (β = 0.02; p = .031) and inversely with body height (β = -0.05; p = .010). In women, CM-exposure was positively associated with body weight (β = 0.07; p = .018), BMI (β = 0.03; p = .013), WC (β = 0.07; p = .005), HC (β = 0.05; p = .046), WHR (β = 0.03; p = .015), WHtR (β = 0.04; p = .006), FM (β = 0.04; p = .006), and SAT (β = 0.06; p = .041). In both sexes, effects were mainly driven by exposure to emotional and physical abuse. CONCLUSIONS Results suggest that associations between CM-exposure and obesity-related traits in adulthood are primarily present in women. This may have implications for sex-specific obesity-related cardiometabolic risk after CM.
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Affiliation(s)
- Philipp Töpfer
- Department of Medical Psychology, University Medicine Greifswald, Germany.
| | | | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD) partner site Greifswald, Greifswald, Germany
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Kulak MJ, Lewis-de los Angeles W, Daniels TE, Mathis KJ, Gobin AP, Laumann LE, Beck Q, Tyrka AR. Increased Cardiometabolic Risk in Healthy Young Adults With Early Life Stress. Psychosom Med 2024; 86:72-82. [PMID: 38153259 PMCID: PMC10922275 DOI: 10.1097/psy.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between early life stress (ELS) and metabolic risk in healthy young adults and assess the role of health behaviors. METHODS Young adults aged 18 to 40 years ( N = 190) with no medical conditions or medication usage were recruited from the community. Participants with ELS ( N = 113) had a history of childhood maltreatment, and most also experienced parental loss ( n = 88). Controls ( N = 77) had no history of maltreatment or parental loss. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Blood pressure and anthropometrics were measured, and fasting plasma assayed for lipid profiles, glucose, insulin level, and hemoglobin A 1c . We calculated both a clinical cut-point and continuous composite metabolic risk score based on clinical risk factors and the mean of z scores of each measure, respectively. RESULTS ELS was significantly associated with increased clinical cut-point ( β = 0.68, 95% confidence interval [CI] = 0.20-1.17, p = .006) and continuous ( β = 0.23, 95% CI = 0.08-0.038, p = .003) composite metabolic risk scores. On sensitivity analysis, the association of ELS with the continuous composite metabolic risk score was reduced to a trend after adjusting for a range of psychosocial and health predictors ( β = 0.18, 95% CI = 0.00-0.36, p = .053), with both diet and college graduate status significant in the model. CONCLUSIONS Healthy young adults with a history of ELS have increased metabolic risk scores as compared with controls. This relationship may be partially due to health behaviors and socioeconomic factors. These findings underline that ELS is an early contributor to metabolic risk.
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Affiliation(s)
- Meghan J. Kulak
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - William Lewis-de los Angeles
- Department of Pediatrics, Hasbro Children’s Hospital and Bradley Hospital, RI, USA
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Teresa E. Daniels
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Karen J. Mathis
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- University of Rhode Island College of Nursing, Kingston, RI
| | - Asi P. Gobin
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Laura E. Laumann
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Quincy Beck
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Audrey R. Tyrka
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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5
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Kisely S, Siskind D, Scott JG, Najman JM. Self-reported child maltreatment and cardiometabolic risk in 30-year-old adults. Intern Med J 2023; 53:1121-1130. [PMID: 35607779 PMCID: PMC10947207 DOI: 10.1111/imj.15824] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Stephen Kisely
- Metro South Addiction and Mental Health ServiceBrisbaneQueenslandAustralia
- School of Clinical MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Departments of Psychiatry, Community Health and EpidemiologyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Dan Siskind
- Metro South Addiction and Mental Health ServiceBrisbaneQueenslandAustralia
- School of Clinical MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - James G. Scott
- Mental Health ProgramQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
- Metro North Mental Health ServiceBrisbaneQueenslandAustralia
- School of Public HealthThe University of Queensland, Public Health BuildingBrisbaneQueenslandAustralia
| | - Jake M. Najman
- School of Public HealthThe University of Queensland, Public Health BuildingBrisbaneQueenslandAustralia
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The relation between childhood adversity and adult obesity in a population-based study in women and men. Sci Rep 2021; 11:14068. [PMID: 34234182 PMCID: PMC8263764 DOI: 10.1038/s41598-021-93242-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
Childhood maltreatment has been shown to relate to adult obesity. In this epidemiological study, we investigate the association between childhood maltreatment and waist-to-height-ratio (WHtR) in a sample of the German adult population, comprising of N = 2936 participants. WHtR, an indicator for risk of obesity, was the primary outcome. Childhood maltreatment was assessed by the Childhood Trauma Screener (CTS), which assesses emotional and physical neglect, abuse as well as sexual abuse. Cohort-data were harmonized and analyzed within DataSHIELD. We used multivariable regression models to estimate the association of childhood maltreatment and WHtR at different levels of adjustments for potential confounders. Overall childhood maltreatment was associated with a higher WHtR in both sexes (women: p = 0.004, men: p < 0.001); associations were no longer significant in women after adding socioeconomic variables, but remained significant in men (p = 0.013). Additionally, we were able to identify sex specific patterns for childhood maltreatment predicting the WHtR. Emotional neglect and abuse had stronger impacts on the WHtR in women than in men, whereas physical neglect and abuse had stronger impacts in men. To our knowledge, this is the first comprehensive population-based study testing various types of childhood maltreatment with WHtR in sex-, region- and weight-stratified analyses. Future studies in clinical populations are warranted to examine U-shaped correlations between increased WHtR and childhood maltreatment.
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7
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Suglia SF, Crookes DM, Kaplan R, Sotres-Alvarez D, Llabre MM, Van Horn L, Carnethon MR, Isasi CR. Intergenerational Transmission of Childhood Adversity in Parents and their Children's BMI in the Hispanic Community Children's Health Study/Study of Latino Youth (HCHS/SOL Youth). J Psychosom Res 2020; 131:109956. [PMID: 32044520 PMCID: PMC7415479 DOI: 10.1016/j.jpsychores.2020.109956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/17/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America.
| | - Danielle M Crookes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States of America; Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, FL, United States of America
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States of America
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Bjertnaes AA, Grundt JH, Juliusson PB, Markestad TJ, Strand TA, Holten-Andersen MN. Sex-related change in BMI of 15- to 16-year-old Norwegian girls in cross-sectional studies in 2002 and 2017. BMC Pediatr 2019; 19:431. [PMID: 31718598 PMCID: PMC6849237 DOI: 10.1186/s12887-019-1790-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/16/2019] [Indexed: 01/22/2023] Open
Abstract
Background The prevalence of overweight and obesity (OWOB) has stabilized in some countries, but a portion of children with high body mass index (BMI) may have become heavier. This study aimed to describe the distributions of BMI and the point prevalence of OWOB in Norwegian adolescents in 2002 and 2017. Methods A cross-sectional study involving 15- to 16-year-old adolescents in Oppland, Norway, was undertaken in 2002 and 2017. We calculated their BMI, BMI z-scores (BMIz), and the prevalence of OWOB. Results The mean BMI increased from 20.7 to 21.4 (p < 0.001) for girls but remained unchanged at 21.5 vs 21.4 (p = 0.80) for boys. The prevalence of OWOB increased from 9 to 14% among girls (difference 5, 95% CI: 2, 8) and from 17 to 20% among boys (difference 3, 95% CI: − 1, 6%). The BMI density plots revealed similar shapes at both time points for both sexes, but the distribution for girls shifted to the right from 2002 to 2017. Conclusion Contrary to previous knowledge, we found that the increase in OWOB presented a uniform shift in the entire BMI distribution for 15–16-year-old Norwegian girls and was not due to a larger shift in a specific subpopulation in the upper percentiles.
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Affiliation(s)
- Asborg A Bjertnaes
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Anders Sandvigs gate 17, 2609, Lillehammer, Norway. .,Department of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Jacob H Grundt
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
| | - Petur B Juliusson
- Department of Health Registries, Norwegian Institute of Public Health, Oslo, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Trond J Markestad
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Mads N Holten-Andersen
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Anders Sandvigs gate 17, 2609, Lillehammer, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
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9
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Wall MM, Mason SM, Liu J, Olfson M, Neumark-Sztainer D, Blanco C. Childhood psychosocial challenges and risk for obesity in U.S. men and women. Transl Psychiatry 2019; 9:16. [PMID: 30655501 PMCID: PMC6336849 DOI: 10.1038/s41398-018-0341-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/13/2018] [Indexed: 12/31/2022] Open
Abstract
Childhood psychosocial challenges (i.e., adversities, mental and substance use disorders, social challenges) may relate to the onset of obesity and extreme obesity. Identifying the types of psychosocial challenges most strongly associated with obesity could advance etiologic understanding and help target prevention efforts. Using a nationally representative sample of U.S. adults (N = 24,350), the present study evaluates relationships between childhood psychosocial challenges and development of obesity and extreme obesity. After mutually controlling, childhood poverty was a risk in men OR = 1.2 (1.0-1.4) and a significantly stronger one in women OR = 1.6 (1.4-1.8); maltreatment increased odds of obesity in both men and women OR = 1.3, 95% CI (1.1-1.4), and specifically increased odds of extreme obesity in women OR = 1.5 (1.3-1.9). Early childrearing (before age 18) was an independent risk factor in both men OR = 1.4 (1.0-1.9) and women OR = 1.3 (1.1-1.5); not finishing high school was the strongest childhood psychosocial challenge risk factor for extreme obesity in both men (OR = 1.6, 1.1-2.2) and women (OR = 2.0, 1.5-2.5). Psychiatric disorders (MDD, anxiety disorder, PTSD) before age 18 were not independently associated with adult obesity in men nor women, but substance use disorders (alcohol or drug) were inversely associated with adult obesity. Individuals who have experienced childhood adversities and social challenges are at increased risk for obesity. Previous findings also indicate that these individuals respond poorly to traditional weight management strategies. It is critical to identify the reasons for these elevated weight problems, and to develop interventions that are appropriately tailored to mitigate the obesity burden faced by this vulnerable population.
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Affiliation(s)
- Melanie M. Wall
- 0000000419368729grid.21729.3fDepartment of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032 USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, NY USA
| | - Susan M. Mason
- 0000000419368657grid.17635.36Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN USA
| | - Jun Liu
- 0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, NY USA
| | - Mark Olfson
- 0000000419368729grid.21729.3fDepartment of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032 USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, NY USA
| | - Dianne Neumark-Sztainer
- 0000000419368657grid.17635.36Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN USA
| | - Carlos Blanco
- 0000 0004 0533 7147grid.420090.fNational Institute on Drug Abuse, 6001 Executive Blvd., Rockville, MD 20852 USA
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Mason SM, Santaularia NJ, Berge JM, Larson N, Neumark-Sztainer D. Is the childhood home food environment a confounder of the association between child maltreatment exposure and adult body mass index? Prev Med 2018; 110:86-92. [PMID: 29454080 PMCID: PMC5851654 DOI: 10.1016/j.ypmed.2018.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 02/12/2018] [Indexed: 01/10/2023]
Abstract
Childhood maltreatment is consistently associated with adult obesity, leading to calls for tailored weight interventions for people with maltreatment histories. However, it is possible that the maltreatment-obesity association is spurious and driven by unmeasured confounding, in which case such interventions would be misplaced. The home food environment in childhood is a potential confounder, but its role in the association of maltreatment with obesity has not been examined. We used a longitudinal dataset (Project EAT) to examine the association of adult retrospective reports of maltreatment history in childhood (1+ types of maltreatment before age 18 years) with previously-collected prospective childhood reports of home food environment characteristics (availability of healthy foods, availability of sweet/salty snack food, family meal frequency, and food insufficiency). We then estimated the association between maltreatment and adult body mass index (BMI, kg/m2) with and without adjustment for these home food environment factors. After adjustment for sociodemographics, maltreatment had a 0.84 kg/m2 (95% CI: 0.28, 1.41) higher BMI at age 24-39 years, compared to those with no maltreatment, after adjustment for sociodemographics, parenting style, and BMI in childhood. Additional adjustment for home food environment factors had little effect on this association (β = 0.78 kg/m2; 95% CI: 0.21,1.35), suggesting limited confounding influence of the home food environment factors. Findings provide additional robust evidence that childhood maltreatment is a risk factor for obesity that may warrant tailored interventions.
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Affiliation(s)
- S M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States.
| | - N J Santaularia
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - J M Berge
- Department of Family Medicine and Community Health, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - N Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - D Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
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11
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Dos Santos Gomes C, Pirkle CM, Zunzunegui MV, Taurino Guedes D, Fernandes De Souza Barbosa J, Hwang P, Oliveira Guerra R. Frailty and life course violence: The international mobility in aging study. Arch Gerontol Geriatr 2018; 76:26-33. [PMID: 29454241 DOI: 10.1016/j.archger.2018.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/04/2018] [Accepted: 02/04/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To estimate the prevalence of frailty in older adults in the IMIAS population, to examine associations between lifelong domestic violence and frailty and possible pathways to explain these associations. METHODS A cross-sectional study with 2002 men and women in the International Mobility in Aging Study, aged between 65 and 74 years old living in five cities of Tirana (Albania), Natal (Brazil), Kingston and Saint-Hyacinthe (Canada), and Manizales (Colombia). Domestic physical and psychological violence by family and intimate partner was assessed by the Hurt, Insult, Threaten and Scream (HITS) scale. Fried's phenotype was adopted to define frailty. Logistic regressions were fitted to estimate between frailty and lifelong violence. Mediation analyses using the Preacher and Hayes method was used to examine potential health pathways. RESULTS Frailty prevalence varies across cities, being lowest in Saint-Hyacinthe and Kingston, and highest in women in Natal. Women had a higher prevalence in Tirana and Natal. Adjusting for age, sex, education and research city, those reporting childhood physical abuse (CPA) had higher odds of frailty (OR = 1.68; 95% CI: 1.01; 2.78); those who had been exposed to psychological violence by their intimate partner had also higher odds of frailty (OR = 2.07; 95% CI: 1.37; 3.12). CPA effect on frailty was totally mediated by chronic conditions and depression symptoms. Effects of psychological violence by intimate partner were partially mediated by chronic conditions and depression symptoms. CONCLUSIONS Childhood physical abuse and psychological violence during adulthood leave marks on life trajectory, being conducive to adverse health outcomes and frailty in old age.
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Affiliation(s)
- Cristiano Dos Santos Gomes
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil.
| | - Catherine McLean Pirkle
- Office of Public Health Studies, University of Hawaii, 2500 Campus Rd., Honolulu, HI 96822, United States
| | - Maria Vitoria Zunzunegui
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Dimitri Taurino Guedes
- Department of Physioterapy, Faculty of Health Sciences of Trairí, Federal University of Rio Grande Do Norte, R. Teodorico Bezerra, 2-122, Santa Cruz, RN, 59200-000, Brazil
| | - Juliana Fernandes De Souza Barbosa
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
| | - Phoebe Hwang
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Ricardo Oliveira Guerra
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
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12
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Abajobir AA, Kisely S, Williams G, Strathearn L, Najman JM. Childhood maltreatment and high dietary fat intake behaviors in adulthood: A birth cohort study. CHILD ABUSE & NEGLECT 2017; 72:147-153. [PMID: 28802911 DOI: 10.1016/j.chiabu.2017.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/16/2017] [Accepted: 08/01/2017] [Indexed: 05/24/2023]
Abstract
Childhood maltreatment has been associated with a wide range of chronic medical conditions including obesity, other metabolic events and eating disorders. However, little is known about the association between childhood maltreatment and high dietary fat intake. This study addresses the extent to which co-occurring and specific forms of substantiated childhood maltreatment are associated with self-reported high dietary fat intake in adulthood and whether there is a gender-childhood maltreatment interaction in predicting this association. The study also examines the association between age at substantiation of maltreatment, number of childhood maltreatment substantiations and high dietary fat intake-related behaviors. The data were from a prospective Australian pre-birth mother-child dyads study, the Mater-University of Queensland Study of Pregnancy. The study followed 7223 mother-child dyads following the birth of a live, singleton baby at the Mater hospital. Recruitment was early in pregnancy, and then follow-ups at 3-5days postpartum and again when the child was 6 months, 5, 14 and 21 years of age. The data were linked to agency-substantiated cases of childhood maltreatment 0-14 years. This study extended the data linkage to 3766 (47.4% female) participants who had complete data on dietary fat intake behaviors at the 21-year follow-up. Consecutive logistic regressions were used to estimate odds ratios with respective 95% confidence intervals for high dietary fat intake for multiple and specific forms of childhood maltreatment, as well as age at and number of childhood maltreatment substantiations. Finally, a gender-childhood maltreatment interaction term was used to predict the outcome. In both unadjusted and adjusted analyses, substantiated childhood maltreatment including physical abuse were associated with high dietary fat intake-related behaviors. Similarly, substantiation of childhood maltreatment between the ages of 5 and 14 years was significantly associated with high dietary fat intake-related behaviors as were two or more substantiations of maltreatment. Inclusion of gender-childhood maltreatment interaction only had a minor impact on the size and direction of the association. Chronic and severe forms of childhood maltreatment including physical abuse are associated with a higher rate of dietary fat intake in young adulthood. Further research to replicate this association might focus on possible neuro-hormonal mechanisms that might explain this behavior.
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Affiliation(s)
- Amanuel Alemu Abajobir
- Faculty of Medicine, School of Public Health, The University of Queensland, Public Health Building, Herston, 4006 Queensland, Australia.
| | - Steve Kisely
- Faculty of Medicine, School of Medicine, University of Queensland, Princess Alexandra Hospital, Woolloongabba, 4102 Queensland, Australia; Faculty of Medicine, Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Gail Williams
- Faculty of Medicine, School of Public Health, The University of Queensland, Public Health Building, Herston, 4006 Queensland, Australia
| | - Lane Strathearn
- Stead Family Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Iowa, Iowa City, IA, USA; Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Jake Moses Najman
- Faculty of Medicine, School of Public Health, The University of Queensland, Public Health Building, Herston, 4006 Queensland, Australia; Queensland Alcohol and Drug Research and Education Centre, The University of Queensland, Herston, 4006 Queensland, Australia; Faculty of Humanities and Social Sciences, School of Social Sciences, The University of Queensland, St. Lucia, 4072 Queensland, Australia
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13
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Guenzel N, Houfek J, Watanabe-Galloway S. Adverse Events in Childhood as a Risk Factor for Elevated BMI among People with Schizophrenia and Bipolar Disorder. Issues Ment Health Nurs 2016; 37:829-838. [PMID: 27681707 DOI: 10.1080/01612840.2016.1224281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Diseases of obesity have become a major cause of morbidity and mortality among people with schizophrenia and bipolar disorder. Childhood adversity has been associated with adult obesity in the general public, but has not been examined among people with mental illness. This study used a secondary analysis to examine childhood adversity and body mass index in people with schizophrenia and bipolar disorder. Among females, a history of physical abuse from parents or paternal emotional neglect was associated with an increased risk for obesity (OR = 3.34 and 2.44, respectively).
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Affiliation(s)
- Nicholas Guenzel
- a University of Nebraska Medical Center , College of Nursing , Lincoln , Nebraska , USA
| | - Julia Houfek
- b University of Nebraska Medical Center , College of Nursing , Nebraska Medical Center, Omaha , Nebraska , USA
| | - Shinobu Watanabe-Galloway
- c University of Nebraska Medical Center, College of Public Health , Nebraska Medical Center, Omaha , Nebraska , USA
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14
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Palmisano GL, Innamorati M, Vanderlinden J. Life adverse experiences in relation with obesity and binge eating disorder: A systematic review. J Behav Addict 2016; 5:11-31. [PMID: 28092189 PMCID: PMC5322988 DOI: 10.1556/2006.5.2016.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/14/2016] [Accepted: 01/17/2016] [Indexed: 01/11/2023] Open
Abstract
Background and aims Several studies report a positive association between adverse life experiences and adult obesity. Despite the high comorbidity between binge eating disorder (BED) and obesity, few authors have studied the link between trauma and BED. In this review the association between exposure to adverse life experiences and a risk for the development of obesity and BED in adulthood is explored. Methods Based on a scientific literature review in Medline, PubMed and PsycInfo databases, the results of 70 studies (N = 306,583 participants) were evaluated including 53 studies on relationship between adverse life experiences and obesity, 7 studies on post-traumatic stress disorder (PTSD) symptoms in relation to obesity, and 10 studies on the association between adverse life experiences and BED. In addition, mediating factors between the association of adverse life experiences, obesity and BED were examined. Results The majority of studies (87%) report that adverse life experiences are a risk factor for developing obesity and BED. More precisely a positive association between traumatic experiences and obesity and PTSD and obesity were found, respectively, in 85% and 86% of studies. Finally, the great majority of studies (90%) between trauma and the development of BED in adulthood strongly support this association. Meanwhile, different factors mediating between the trauma and obesity link were identified. Discussion and conclusions Although research data show a strong association between life adverse experiences and the development of obesity and BED, more research is needed to explain this association.
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Affiliation(s)
| | - Marco Innamorati
- Department of Science and Technology of Education, University of Rome “Tor Vergata”, Rome, Italy
| | - Johan Vanderlinden
- Eating Disorder Unit, University Psychiatric Center K.U. Leuven, Leuven, Belgium
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15
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Mason SM, MacLehose RF, Katz-Wise SL, Austin SB, Neumark-Sztainer D, Harlow BL, Rich-Edwards JW. Childhood abuse victimization, stress-related eating, and weight status in young women. Ann Epidemiol 2015; 25:760-6.e2. [PMID: 26272779 DOI: 10.1016/j.annepidem.2015.06.081] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 06/08/2015] [Accepted: 06/22/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE Abuse in childhood predicts stress-related overeating and excess weight gain in young women. We investigated whether two stress-related overeating behaviors--binge eating and coping-motivated eating--explain childhood abuse associations with weight status in young women. METHODS Analyses included 4377 women participating in the Growing Up Today Study, a longitudinal cohort of youth enrolled at age 9 to 14 years. We used marginal structural models to estimate the effects of abuse before age 11 years on weight status at age 22 to 29 years with and without adjustment for binge eating and coping-motivated eating. RESULTS Women with severe physical, sexual, and emotional abuse had early adult body mass indexes (BMIs) that were 0.74 kg/m(2) (95% confidence interval [CI]: 0.15-1.33), 0.69 (95% CI: -0.46 to 1.83), and 0.85 (95% CI: 0.24-1.45) kg/m(2) higher, respectively, than those without abuse. Adjustment for coping-motivated eating attenuated the excess BMI associated with severe physical abuse, but no other important attenuations were found. CONCLUSIONS Physical, sexual, and emotional abuse before age 11 years were associated with higher early adult weight status, although the sexual abuse estimate was not statistically significant. Evidence for a role of stress-related eating in abuse--BMI associations was limited and inconsistent across abuse types.
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Affiliation(s)
- Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Sabra L Katz-Wise
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - S Bryn Austin
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Bernard L Harlow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Janet W Rich-Edwards
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA
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The Impact of Childhood Adversity on the Clinical Features of Schizophrenia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2015; 2015:532082. [PMID: 26345291 PMCID: PMC4539488 DOI: 10.1155/2015/532082] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/26/2015] [Indexed: 12/19/2022]
Abstract
Introduction. Recent research has drawn attention to the link between childhood maltreatment and schizophrenia. Child abuse and neglect may have an impact on symptoms and physical health in these patients. This association has not been studied to date in India. Materials and Methods. Clinically stable patients with schizophrenia (n = 62) were assessed for childhood adversity using the Childhood Trauma Questionnaire. The association of specific forms of adversity with symptomatology and associated variables was examined. Results. Emotional abuse was reported by 56.5% patients and physical abuse by 33.9%; scores for childhood neglect were also high. Persecutory delusions were linked to physical abuse, while anxiety was linked to emotional neglect and depression to emotional abuse and childhood neglect. Physical abuse was linked to elevated systolic blood pressure, while emotional abuse and neglect in women were linked to being overweight. Conclusions. Childhood adversity is common in schizophrenia and appears to be associated with a specific symptom profile. Certain components of the metabolic syndrome also appear to be related to childhood adversity. These results are subject to certain limitations as they are derived from remitted patients, and no control group was used for measures of childhood adversity.
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Wedin S, Madan A, Correll J, Crowley N, Malcolm R, Karl Byrne T, Borckardt JJ. Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients. Eat Behav 2014; 15:619-24. [PMID: 25241076 DOI: 10.1016/j.eatbeh.2014.08.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/24/2014] [Accepted: 08/21/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Weight loss surgery (WLS) is an effective weight loss treatment for individuals with severe obesity. Psychosocial factors can affect short-term WLS outcomes. This study sought to identify psychosocial predictors of medium-term outcomes. METHODS In this prospective study, 250 consecutive WLS candidates were evaluated between January 1, 2010 and December 31, 2010. Each completed baseline medical, surgical, and psychological evaluations as part of standard of care. Two hundred and four patients had surgery (81.6%). Successful surgical outcome was defined as ≥50% excess weight loss two years post-surgery. RESULTS Comparison of study sample (n=80) and those lost to follow-up (n=124) revealed negligible differences across baseline characteristics. At follow-up, 60% (n=48) of the sample was classified as a success with an average of 72.58% (std dev=13.01%) excess weight lost. The remaining 40% (n=32) was classified as a failure with an average of 33.98% (std dev=13.19%) excess weight lost. Logistic regression revealed that pre-surgical marital status, emotional eating, and history of physical abuse were independently associated with outcome variables, p<0.05. CONCLUSIONS Being married, perhaps as a proxy for social support, is associated with 6.9 times increased odds of medium-term WLS success and emotionally driven disordered eating patterns are associated with 7.4 times increased odds of medium-term WLS success. A history of physical abuse is associated with an 84% decreased odds of successful medium-term outcomes. Further research that studies both the quality and impact of spousal support on weight loss as well as longer-term effects of emotional eating on outcomes is needed. Addressing longer-standing consequence of abuse may improve WLS outcomes.
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Affiliation(s)
- Sharlene Wedin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States.
| | - Alok Madan
- The Menninger Clinic, 12301 South Main St., Houston, TX 77035, United States; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States
| | - Jennifer Correll
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
| | - Nina Crowley
- Bariatric Surgery Program, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States
| | - Robert Malcolm
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
| | - T Karl Byrne
- Bariatric Surgery Program, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States
| | - Jeffrey J Borckardt
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
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Hemmingsson E, Johansson K, Reynisdottir S. Effects of childhood abuse on adult obesity: a systematic review and meta-analysis. Obes Rev 2014; 15:882-93. [PMID: 25123205 DOI: 10.1111/obr.12216] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/17/2014] [Accepted: 06/21/2014] [Indexed: 12/13/2022]
Abstract
Controversy exists surrounding the role of childhood abuse in obesity development. This is a meta-analysis of observational studies on the role of childhood abuse in adult obesity. Systematic searches of PubMed, PsycInfo, Medline and CINAHL resulted in 23 cohort studies (4 prospective, 19 retrospective) with n=112,708 participants, containing four abuse types (physical, emotional, sexual, general). Four studies reported dose-response effects. A random effects model was used to quantify effect sizes, meta-regression/subgroup analysis for identifying potential moderating variables and Egger's test for publication bias. Adults who reported childhood abuse were significantly more likely to be obese (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.24-1.45, P<0.001). All four types of abuse were significantly associated with adult obesity: physical (OR: 1.28, 95% CI: 1.13-1.46), emotional (OR: 1.36, 95% CI: 1.08-1.71), sexual (OR: 1.31, 95% CI: 1.13-1.53) and general abuse (OR: 1.45, 95% CI: 1.25-1.69). Severe abuse (OR: 1.50, 95% CI: 1.27-1.77) was significantly more associated with adult obesity (P=0.043) compared with light/moderate abuse (OR: 1.13, 95% CI: 0.91-1.41). We found no significant effects of study design (prospective vs. retrospective, P=0.07), age (P=0.96) or gender (P=0.92). Publication bias was evident (Egger's test P=0.007), but effect sizes remained statistically significant in sensitivity analyses. Childhood abuse was clearly associated with being obese as an adult, including a positive dose-response association. This suggests that adverse life experiences during childhood plays a major role in obesity development, potentially by inducing mental and emotional perturbations, maladaptive coping responses, stress, inflammation and metabolic disturbances.
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Affiliation(s)
- E Hemmingsson
- Obesity Center, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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