Adverse childhood experiences, child poverty, and adiposity trajectories from childhood to adolescence: evidence from the Millennium Cohort Study

OBJECTIVE: This study investigated associations between adverse childhood experiences (ACEs) in early childhood (at ages 9 months and 3 years) and adiposity trajectories of children/adolescents from age 5 to age 17, and the potential interaction between ACEs and poverty on adiposity trajectories. METHODS: Data from the UK Millennium Cohort Study was used. Eight commonly studied ACEs and poverty were measured when the child was aged 9 months and 3 years. ACEs were considered as a cumulative score and as individual experiences. Linear-mixed effect models were employed, modelling BMI and fat mass index (FMI) trajectories from age 5 to 17 (main outcome), adjusting for covariates and stratified by sex. Interactions with poverty were also tested. The sample sizes were 7282 and 6912 for BMI and FMI sample respectively. RESULTS: Cumulative ACE score was associated with steeper increase in BMI and FMI among boys with 3+ ACEs (BMI: β = 0.13, 95% CI: 0.02-0.24; FMI: β = 0.09, 95% CI: 0.01-0.19). For individual ACEs, parental depression was associated with steeper increase in BMI/FMI trajectories in both sexes (BMI: boys: β = 0.15, 95% CI: 0.07-0.23, girls: β = 0.13, 95% CI: 0.05-0.20; FMI: boys: β = 0.09, 95% CI: 0.03-0.15, girls: β = 0.09, 95% CI: 0.02-0.16). In addition, parental separation and physical punishment were associated with steeper increase in BMI/FMI trajectories among girls (BMI: parental separation: β = 0.25; 95% CI: 0.06-0.44, physical punishment: β = 0.14; 95% CI: 0.03-0.26; FMI: parental separation: β = 0.20; 95% CI: 0.03-0.37, physical punishment: β = 0.12; 95% CI: 0.02-0.22). No interaction effect had been found between ACEs and poverty on the adiposity trajectories. CONCLUSIONS: A complex relationship between ACEs in early childhood and adiposity trajectories for children/adolescents was found, highlighting the different effects of specific ACEs and sex differences in the association.