Association of adverse childhood experiences with dietary patterns of school-age children: evidence from the birth cohort Generation XXI

Autores da FMUP

• Sílvia Jesus Silva Fraga

  Autor

• Andreia Cristina Matos Oliveira

  Autor

Participantes de fora da FMUP

• Ferreira, Pedro

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Background: Adverse Childhood Experiences (ACEs) have been associated with health-risk behaviors and several chronic diseases in adulthood. However, the relationship between exposure to ACEs and dietary patterns at school age is unknown. Objectives: To investigate the association between ACEs and dietary patterns of 10-year-olds. Methods: The study included 5034 children from the Generation XXI cohort, recruited in 2005/2006 in Porto, Portugal. ACEs were assessed through a self-administered questionnaire covering the first 10 years (y) of life, quantified and grouped into 5 dimensions: ``abuse,'' ``school problems,'' ``death/severe disease,'' ``life changes,'' and ``household dysfunction.'' Dietary patterns were identified by latent class analysis using data collected with a validated food frequency questionnaire. Five dietary patterns were studied: ``low consumption,'' ``energy-dense foods,'' ``snacking,'' ``intermediate consumption,'' and ``healthier'' (used as reference). Multinomial regression analyses were conducted, adjusted for the child's sex, household income, family structure, and mother's age [odds ratio (OR) and 99% confidence intervals (CIs)]. Results: Most children were exposed to >= 1 ACE (96%), and similar to 27% had reported 6 or more ACEs throughout life. Those reporting 4-5 and similar to 6 ACEs were more likely to follow the ``Energy-dense foods'' dietary pattern compared with those with no ACEs (OR: 2.41; 99% CI: 1.00, 5.77 and OR: 2.65; 99% CI: 1.10, 6.39, respectively). Children exposed to ``abuse'' in the first 10 y showed 28% higher odds of following the ``low consumption'' dietary pattern when compared to children with no reported ACEs and using the ``healthier'' dietary pattern as a reference (OR: 1.28; 99% CI: 1.00, 1.63). Conclusions: Exposure to ACEs was associated with less healthy dietary patterns in school-aged children. Results suggest a cumulative effect of the adverse experiences resulting in a dietary pattern higher in energy-dense foods. Children with ACEs reported under the dimension of ``abuse'' seemed to have reduced food consumption.

Keywords

• feeding behavior; diet; adversity; cohort studies; childhood