The Relationship Between Adverse Childhood Experiences and Weight-Related Health Behaviors in a National Sample of...

To examine how adverse childhood experiences (ACEs) relate to healthy weight behaviors in children.

We examined data from the 2016 National Survey of Children's Health. ACE scores were calculated from 6 measures of household dysfunction. Outcome measures included 5 healthy weight behaviors. Logistic regression models assessed associations between ACEs and healthy weight behaviors controlling for sociodemographic variables.

Children 6 to 17 years of age (n = 32,528) with 0 ACEs had increased odds of: watching 2 hours or less of television daily (6-12 years: odds ratio [OR] 1.46; 95% confidence interval [CI], 1.20-1.80, 13-17 years: OR 1.64; 95% CI, 1.39-1.94), using electronics for 2 hours or less daily (6-12 years: OR 1.44; 95% CI, 1.15-1.80, 13-17 years: OR 1.86; 95% CI, 1.60-2.16), sharing 4 or more family meals per week (6-12 years: OR 1.39; 95% CI, 1.17-1.66, 13-17 years: OR 1.68; 95% CI, 1.44-1.95), and getting adequate age-specific sleep (6-12 years: OR 1.50; 95% CI, 1.26-1.79, 13-17 years: OR 1.31; 95% CI, 1.11-1.55) when compared to children with one or more ACEs. Children 13 to 17 years of age with 0 ACEs had increased odds of exercising for 60 minutes daily (OR 1.27; 95% CI, 1.02-1.58) when compared to children with one or more ACEs. There was an overall gradient dose pattern; the odds of engaging in a healthy weight behavior decreased as the number of ACEs increased, with mixed significance levels.

In children, ACE exposure is associated with decreased healthy weight behaviors and behavior counseling alone may be insufficient. Trauma-informed care to address intra-familial adversity may be necessary.