Bereavement in early life and later childhood overweight

Adverse childhood experiences and pre-pregnancy body mass index in the HUNT study: A population-based cohort study

OBJECTIVE

Investigate the association between adverse childhood experiences and pre-pregnancy body mass index (BMI) in a population-based cohort in Trøndelag county, Norway.

MATERIALS AND METHODS

We linked data from the third (2006-2008) or fourth (2017-2019) survey of the Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway for 6679 women. Multiple logistic regression models were used to examine the association between adverse childhood experiences and pre-pregnancy BMI. Adverse childhood experiences were self-reported in adulthood and included perceiving childhood as difficult, parental divorce, parental death, dysfunctional family environment, bad childhood memories and lack of support from a trusted adult. Pre-pregnancy BMI was derived from the Medical Birth Registry of Norway or BMI measurement from the HUNT survey conducted within 2 years prior to the woman's pregnancy.

RESULTS

Perceiving childhood as difficult was associated with higher odds of pre-pregnancy underweight (OR 1.78, 95%CI 0.99-3.22) and obesity (OR 1.58, 95%CI 1.14-2.2). A difficult childhood was positively associated with obesity with an adjusted OR of 1.19, 95%CI 0.79-1.81 (class I obesity), 2.32, 95%CI 1.35-4.01 (class II obesity) and 4.62, 95%CI 2.0-10.65 (class III obesity). Parental divorce was positively associated obesity (OR 1.34, 95%CI 1.10-1.63). Bad childhood memories were associated with both overweight (OR 1.34, 95%CI 1.01-1.79) and obesity (OR 1.63, 95%CI 1.13-2.34). Parental death was not associated with pre-pregnancy BMI.

CONCLUSIONS

Childhood adversities were associated with pre-pregnancy BMI. Our results suggest that the positive associations between childhood adversities and pre-pregnancy obesity increased with increasing obesity level.

Children of single-parent households are at a higher risk of obesity: A systematic review

The goal of this systematic review was to evaluate whether children living in single-parent households have a higher risk of obesity. Of the 539 studies identified using keywords, a total of 10 original studies met the inclusion criteria for this review. The outcome measures included objective assessment of adiposity (weight or body mass index (BMI)), dietary consumption, physical activity, and/or obesogenic behaviors (bedroom television, elevated television viewing time, insufficient physical activity, and infrequent family meals). Overall, the studies found higher BMIs and obesogenic behaviors in children of single-parent households. Characteristics identified with this association is comprised of being most prevalent among girls and Black children. Possible explanations for this association include single-parent households having higher time demands due to the lack of shared household responsibilities. Subsequently, a reduction of homemade meals, shared family meals, and physical activity can occur. Also, lower incomes and higher instability related to living transitions may be other possible challenges experienced in single-parent households. Based on the limited number of studies found, further research of the obesity risk in children from single-parent families is recommended. The findings can help provide clinicians and public health programs with a better understanding of how to effectively target family-based interventions for this population.

Childhood psychosocial challenges and risk for obesity in U.S. men and women

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.

Adverse family experiences and obesity in children and adolescents in the United States

While exposure to adverse family experiences (AFEs), subset of adverse childhood experiences (ACEs), has been associated with childhood obesity, less is known about the impact of exposures to each type of AFE. Using 2011-2012 National Survey of Children's Health data, we evaluated associations between exposure to individual AFEs and overweight/obesity status in children 10years or older, adjusting for socio-demographic factors. Caregivers reported their child's height, weight, and exposure to nine AFEs; body mass index (BMI) was classified by Center for Disease Control and Prevention's (CDC) guidelines. At Mayo Clinic, we calculated frequencies and weighted estimates of socio-demographic factors and AFEs. Unadjusted and adjusted weighted multinomial logistic regression models were employed to assess the independent associations of each AFE and the different AFE composite scores with BMI category. Exposure to two or more AFEs was independently associated with increased odds of overweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.13, 1.56) and obese (OR, 1.45; 95% CI, 1.21, 1.73) status after adjustment for age, household income, parents' education-level, race and sex. Death of parent (OR, 1.59; 95% CI, 1.18, 2.15) and hardship due to family income (OR, 1.26; 95% CI, 1.06, 1.50) were independently associated with obesity status with adjustment for other AFEs and socio-demographic factors. Our results suggest that, in addition to cumulative exposure to AFEs, exposure to certain childhood experiences are more strongly associated with childhood obesity than others. Death of parent and hardship due to family income are individual AFEs, which are strongly predictive of obesity.

Adverse childhood experiences: Prevalence and related factors in adolescents of a Brazilian birth cohort

Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities.

Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study

BACKGROUND

Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men.

METHODS

A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group). Median body mass index (BMI) and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) were estimated by logistic regression analysis adjusted for maternal educational level.

RESULTS

Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02) and obesity (9.8% versus 8.5%, p = 0.06) was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI): 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively). Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31). There was no elevated risk in those who experienced maternal bereavement postnatally.

CONCLUSION

Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

Stressful life-events in childhood and risk of multiple sclerosis: a Danish nationwide cohort study

Background:

Current knowledge concerning the association between exposure to stressful life-events (SFLEs) in childhood and later risk of multiple sclerosis (MS) is sparse.

Objectives:

We studied the associations between SFLEs in childhood and subsequent risk of MS in a nationwide cohort of 2.9 million Danes born from 1968 to 2011.

Methods:

A SFLE in childhood was defined as exposure before age 18 years to parental divorce, parental death, or death of a sibling, using information from the Danish Civil Registration System. MS cases in the cohort were identified in the Danish Multiple Sclerosis Registry. Associations of SFLE with MS risk were evaluated by incidence rate ratios (RR) of MS obtained in log-linear Poisson regression models.

Results:

Persons exposed to any SFLE in childhood were at 11% elevated risk of MS (RR = 1.11; 95% confidence interval: 1.03–1.20), compared to non-exposed persons. Stratification by subtype of SFLE showed that parental death and death of a sibling were not associated with MS risk. However, persons exposed to parental divorce were at 13% increased risk of developing MS compared to non-exposed (RR = 1.13; 1.04–1.23).

Conclusions:

Associations of SFLEs in childhood with risk of MS are weak. However, parental divorce is somehow associated with modestly increased risk of MS.