Association between childhood maltreatment and body composition: a systematic review

To systematically review the evidence on the association between child maltreatment and body composition indicators.

Original studies examining child maltreatment before 18 years of age as the exposure and body composition as the outcome were eligible. Searches were conducted in MEDLINE, Embase, LILACS, Scopus, PsycINFO and Web of Science databases, without language or date restrictions, up to 23 April 2026. Screening was conducted independently by two reviewers using the Rayyan platform, following PRISMA 2020 guidelines. Data were extracted into a standardized spreadsheet, and study quality was assessed using the Newcastle-Ottawa Scale and its adapted version for cross-sectional studies. Owing to substantial methodological heterogeneity in exposure and outcomes assessment, a qualitative synthesis was performed.

Of 2993 records identified, 12 studies met the inclusion criteria, published between 2015 and 2026, with sample sizes ranging from 75 to 151,143 participants, aged 3-90 years, and most studies (n = 9) conducted in high-income countries. Three studies had a longitudinal design, five were cross-sectional, and four reported cross-sectional analyses within longitudinal design. Nine studies found a positive association between child maltreatment and increased adiposity, particularly among adults in high-income countries, with physical abuse being the most frequently implicated exposure. Total and visceral body fat were the most frequently assessed outcomes.

These findings highlight the need for further research on the relationship between maltreatment and adiposity in children, adolescents, and populations from low- and middle-income countries, as well as for longitudinal studies to clarify the specific effects of different types of maltreatment and inform targeted prevention strategies.

Most included studies relied on retrospective assessment of child maltreatment, and substantial heterogeneity across studies precluded quantitative synthesis. This study was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) through the PROEX Program. PROSPERO REGISTRATION : CRD42024581666.