Association Between Adverse Childhood Experiences and Diet, Exercise, and Sleep in Pre-adolescents

To understand the relationship between adverse childhood experiences (ACEs) and diet, sleep, and exercise in pre-adolescents.

Baseline and 1-year follow-up data from the adolescent brain and cognitive development (ABCD) study were analyzed (age 10-11, n = 11,875). ACEs were measured by parent report at baseline. Three levels of ACEs were created: none, exposure to one ACE, and exposure to two or more ACEs. Health-promoting behaviors were assessed at 1 year. Diet quality was measured from parent report; sleep problems were measured by parent report, with higher scores indicating worse sleep; and amount of exercise was measured by youth report. Linear regression analyses were used to assess the relationship between ACEs and each health-promoting behavior, adjusting for family income and sex.

Compared to children with no adversity, ACEs were associated with worse diet - one ACE (β = -0.30 [95% CI, -0.49 to -0.12], P = .002) and 2 or more ACEs (β = -0.56 [-0.78 to -0.34, P < .001). Similarly, ACEs were associated with poor sleep - one ACE (β = 1.51 [1.00-2.03], P < .001) and 2 or more ACEs (β = 2.96 [2.38-3.53], P < .001). Finally, amount of exercise was not different in children with ACEs - 2 or more ACEs (β = -0.24, 95% CI, -0.51 to 0.04, P = .08).

ACEs in pre-adolescents show a dose-response relationship with unhealthy diet and sleep disruption. These findings suggest potential behaviors to target to mitigate the negative impact of childhood adversity on adult health.