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. 2021 Dec 8;8(1):3-11.
doi: 10.1002/osp4.497. eCollection 2022 Feb.

Family resilience and childhood obesity among children exposed to adverse childhood experiences in a national survey

William J Heerman  1 , Lauren R Samuels  2 , Tavia González Peña  3 , Chelsea van Wyk  1 , Lindsay S Mayberry  4 , Julie Lounds Taylor  1   5 , Nina C Martin  6
Affiliations

Family resilience and childhood obesity among children exposed to adverse childhood experiences in a national survey

William J Heerman et al. Obes Sci Pract. .

Abstract

Objective: Adverse childhood experiences (ACEs) contribute to poor overall health among children with obesity. This study evaluated how one potential protective factor-family resilience-affects the association between ACEs and childhood obesity.

Methods: This analysis was a secondary analysis of the 2016-2018 National Survey of Children's Health (NSCH), a repeated cross-sectional survey based on parent report. Nine ACEs were queried. Family resilience was assessed with four items (potential range 0-12). The primary outcome was child weight status. Multivariable ordinal logistic regression was used, adjusting for potential confounders and the interaction between ACEs and family resilience.

Results: For 49,365 children ages 10-17, the median number of ACEs was 1 (IQR 0, 2), the median family resilience score was 10 (IQR 8,12), 15.3% of children had overweight, and 15.4% of children had obesity. Among the 51.3% of children who experienced one or more ACEs, higher family resilience scores attenuated the odds of being in a higher weight category. This pattern was not observed in children with zero ACEs.

Conclusions: In the 2016-2018 NSCH, children ages 10-17 who were exposed to ACEs had higher rates of overweight and obesity, the odds of which may be reduced when children also have higher family resilience.

Keywords: adverse childhood experiences; childhood obesity; family resilience.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Percent of children who have experienced ≥4 adverse childhood experiences, by state
FIGURE 2
FIGURE 2
Percent of children experiencing each category of adverse childhood experience by race/ethnicity
FIGURE 3
FIGURE 3
Family resilience, adverse childhood experiences, and odds ratios for overweight/obesity. Odds ratios from the adjusted ordinal logistic regression model are shown for specific combinations of adverse childhood experience (ACE) count and family resilience score. Odds ratios are with respect to the reference categories of 0 ACEs and a family resilience score of 0. For example, children with a family resilience score of 4 and 4–9 ACEs have an odds of being in a higher versus lower weight category that is 1.72 times the odds for children with zero ACEs and a family resilience score of 0. “Being in a higher versus lower weight category” applies to either of the two possible dichotomizations: obesity versus overweight/normal/underweight, or obesity/overweight versus normal/underweight. Odds ratios in the figure are shown with 95% confidence intervals. The odds ratios reported are derived from combinations of odds ratios from the overall adjusted ordinal logistic regression model; the full output of which is shown in Table S5
FIGURE 4
FIGURE 4
Predicted probabilities of child obesity by race and ethnicity. The predicted probability of child obesity is shown for specific combinations of adverse childhood experience count and family resilience, based on the adjusted proportional odds regression model. The predicted probability is shown with the 95% confidence interval. To obtain these probabilities, covariate profiles were set to the specified race/ethnicity, with other covariates set to the median or mode. The predicted probabilities are derived from the overall adjusted ordinal logistic regression model, the full output of which is shown in Table S5
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References

    1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007‐2008 to 2015‐2016. JAMA. 2018;319(16):1723‐1725. - PMC - PubMed
    1. Iguacel I, Gasch‐Gallén Á, Ayala‐Marín AM, De Miguel‐Etayo P, Moreno LA. Social vulnerabilities as risk factor of childhood obesity development and their role in prevention programs. Int J Obes (Lond). 2020;45(1):1‐11. - PubMed
    1. Heerman WJ, Krishnaswami S, Barkin SL, McPheeters M. Adverse family experiences during childhood and adolescent obesity. Obes(Silver Spring). 2016;24(3):696‐702. - PMC - PubMed
    1. Lynch BA, Agunwamba A, Wilson PM, et al. Adverse family experiences and obesity in children and adolescents in the United States. Prev Med. 2016;90:148‐154. - PubMed
    1. Nurius PS, Logan‐Greene P, Green S. Adverse childhood experiences (ACE) within a social disadvantage framework: distinguishing unique, cumulative, and moderated contributions to adult mental health. J Prev Interv Community. 2012;40(4):278‐290. - PMC - PubMed

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