Adverse childhood experiences (including violence and abuse) and obesity and obesogenic behaviors: result from a population-based sample of children in New Zealand

OBJECTIVES: 1) to investigate the association between a range of ACEs (including physical and psychological abuse and witnessing violence against mother) and childhood obesity, 2) to examine a potential pathway for ACEs-obesity relationship by exploring associations between ACEs and key childhood obesogenic behaviours. DESIGN: Secondary data analyses were performed on data extracted from eight data collection waves of the Growing Up in New Zealand study, the largest contemporary longitudinal study of child development in New Zealand. METHODS: Data were from 4,895 children and their parents. Logistic regressions examined the association between 9 ACEs, obesogenic behaviours (age-specific unhealthy dietary, sleep, screen, physical activity behaviours) and childhood obesity at age 8 adjusted for gender, area-deprivation level, food insecurity, and ethnicity. RESULTS: Six ACEs (emotional and physical abuse, parental mental illness, parental separation/divorce, exposure to discrimination, and peer-bullying) and exposure to more than one ACE significantly increased the risk of developing obesity. Cumulative ACEs exposure showed a positive dose-response relationship with the risk of obesity development (AORs ranging from 1.78, 95%CIs: 1.19-2.67 for one ACE to 2.84, 95%CIs:1.88-4.28 for 4+ ACEs) and the adoption of unhealthy weight-related behaviours (AORs ranging between 1.29, 95%CIs: 1.05-1.58 for one ACE and 3.16, 95%CIs: 2.08-4.81 for 4+ACEs). CONCLUSIONS: Our findings support new avenues for childhood obesity reduction efforts, which would benefit from a greater focus on preventing and responding to ACEs. Even traditional behavioural change interventions that target nutrition, sleep, screen time, and physical activity need to incorporate ACEs-informed services to succeed. These findings underscore the crucial need for health services to understand and respond to the social determinants of health including violence exposure.