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Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

ABSTRACT: Adverse childhood experiences (ACEs) heighten the risk for adult obesity and cardiometabolic disease, but physiological factors underlying this connection are not well understood. We determined if ACEs were associated with physiological stress response and insulin resistance in adolescents at risk for adult obesity. Participants were 90 adolescents 12.0-17.5 years (50% female, 30% Hispanic/Latinx), at risk for adult obesity by virtue of above-average body mass index (BMI; kg/m² ≥ 70th percentile) or parental obesity (BMI ≥ 30 kg/m² ). ACEs were determined as presence (vs. absence) based upon the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Physiological stress response was measured as heart rate/blood pressure response to the Trier Social Stress Test. Homeostatic model assessment of insulin resistance was determined from fasting glucose/insulin. Sixty-one percent of adolescents reported positive ACE history. The presence of ACEs predicted greater heart rate (p < .001) and diastolic blood pressure (p = .02) response to stress, controlling for age, sex, race/ethnicity, puberty, and BMI standard score. Systolic blood pressure and insulin resistance did not differ by ACE history (p-values > .08). Findings suggest heightened sympathetic stress response in adolescence could be explanatory in how ACEs increase the risk for later cardiometabolic disease. Future studies should characterize ACEs in relationship to day-to-day variations in adolescents' stress physiology and glucose homeostasis.

SUBMITTER: Jimenez V

PROVIDER: S-EPMC8410633 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

Jimenez Virginia V Sanchez Natalia N Clark Emma L M ELM Miller Reagan L RL Casamassima Milena M Verros Megan M Conte Isabella I Ruiz-Jaquez Metztli M Gulley Lauren D LD Johnson Sarah A SA Melby Christopher C Lucas-Thompson Rachel G RG Shomaker Lauren B LB

Developmental psychobiology 20210515 6

Adverse childhood experiences (ACEs) heighten the risk for adult obesity and cardiometabolic disease, but physiological factors underlying this connection are not well understood. We determined if ACEs were associated with physiological stress response and insulin resistance in adolescents at risk for adult obesity. Participants were 90 adolescents 12.0-17.5 years (50% female, 30% Hispanic/Latinx), at risk for adult obesity by virtue of above-average body mass index (BMI; kg/m<sup>2</sup> ≥ 70th ...[more]

PMID: 33991342

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Project description:Background: Individuals impacted by adverse childhood experiences (ACEs) are at greater risk of developing obesity, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.Objective: To examine associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood.Methods: Data came from Growing Up in New Zealand. The study sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in an analytic sample of 4895 children. A newly developed ACEs index consisted of nine individual ACEs and cumulative ACEs scores (0, 1, 2, 3, 4+ ACEs), two obesity measures (BMI and waist circumference/height ratio), and eight obesogenic behaviours including unhealthy dietary behaviours, inadequate sleep duration, excessive screen time, and physical inactivity were included in the analyses.Results: ACEs were prevalent among this cohort of NZ children. By age eight, 87.1% of children experienced at least one ACE and 16% experienced at least 4 ACEs. Six individuals assessed ACEs showed significant associations with childhood obesity (AORs ranging from 1.22 to 1.44). A significant dose-response effect was observed where the experience of a higher number of ACEs was associated with greater risk for obesity (AORs increased from 1.78 for one ACE to 2.84 for 4+ ACEs). Further, a significant dose-response relationship was found between experiencing two or more ACEs and higher odds of adopting obesogenic behaviours (AORs ranging from 1.29 for physical inactivity to 3.16 for no regular breakfast consumption).Conclusions: ACEs exposure contributes to population-level burden of childhood obesity. Our findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

Project description:Importance:Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health. Objective:To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels. Design, Setting, and Participants:Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019. Main Outcomes and Measures:The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used. Results:In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES. Conclusions and Relevance:Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.

Project description:BackgroundMental ill-health and obesity are increasingly prevalent in childhood with both conditions likely to co-occur. Less is known about associations between adverse childhood experiences (ACEs) and mental ill-health and obesity (MH-OB) comorbidity in adolescence. The aim of this study was to examine associations between ACEs and MH-OB comorbidity in adolescents from a national cohort study.MethodsParticipants; 10,734 adolescents (males = 50.3%) from the Millennium Cohort Study with 6 ACEs (for e.g., parental MH, drug/alcohol misuse, physical punishment) collected prospectively between ages 3-11 years. MH-OB comorbidity (binary indicator) was based on objectively measured BMI (for overweight/obesity) and self-reported depression/anxiety at ages 14 and 17. Associations between: 1.total ACE scores (0, 1, 2 or ≥3) and additionally each individual ACE, and MH-OB, were analysed used logistic regression, separately at 14 and 17 years.ResultsAt age 14, ACE scores were associated with higher odds for MH-OB comorbidity, with a gradient of increasing odds ratios (OR) with increasing ACEs. Individuals with 1 (OR:1.22[95%CI: 1.1-1.6]), 2 (OR:1.7[1.3-2.3]), or ≥3ACEs (OR:2[1.5-2.6]) had increased odds for MH-OB comorbidity compared to those with 0 ACEs. At age 17, associations between ACE scores and MH-OB were attenuated and observed in individuals with ≥3ACEs (OR:1.54, 1.1-2.3). Parental MH (OR:1.5, 1.2-1.9), intimate-partner violence (OR:1.2, 1.1-1.6), physical punishment (OR:1.3, 1.1-1.6), bullying (OR:2, 1.6-2.5) were associated with MH-OB comorbidity age 14. However, only parental MH (OR:1.5, 1.1-2.1) and bullying (OR:1.6, 1.2-2.1) were associated with MH-OB comorbidity at age 17.ConclusionACEs are associated with increased risk of MH-OB comorbidity in between ages 14 and 17. These findings provide timely opportunity for interventions to reduce risk and are pertinent given that MH and obesity contribute significantly to global burden of disease and track across the lifecourse.

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Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

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Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

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