The role of lifestyle factors in the association between early-life stress and adolescent psycho-physical health: Moderation analysis in two European birth cohorts

Serena Defina; Tom Woofenden; Vilte Baltramonaityte; Henning Tiemeier; Graeme Fairchild; Janine F Felix; Charlotte A M Cecil; Esther Walton

doi:10.1016/j.ypmed.2024.107926

The role of lifestyle factors in the association between early-life stress and adolescent psycho-physical health: Moderation analysis in two European birth cohorts

Prev Med. 2024 May:182:107926. doi: 10.1016/j.ypmed.2024.107926. Epub 2024 Mar 4.

Authors

Serena Defina¹, Tom Woofenden², Vilte Baltramonaityte², Henning Tiemeier³, Graeme Fairchild², Janine F Felix⁴, Charlotte A M Cecil⁵, Esther Walton⁶

Affiliations

¹ Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
² Department of Psychology, University of Bath, Bath, United Kingdom.
³ Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
⁴ Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
⁵ Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
⁶ Department of Psychology, University of Bath, Bath, United Kingdom. Electronic address: E.Walton@bath.ac.uk.

PMID: 38447658
DOI: 10.1016/j.ypmed.2024.107926

Abstract

Objective: Early-life stress (ELS) is an established risk factor for a host of adult mental and physical health problems, including both depression and obesity. Recent studies additionally showed that ELS was associated with an increased risk of comorbidity between mental and physical health problems, already in adolescence. Healthy lifestyle factors, including physical activity, sleep and diet have also been robustly linked to both emotional and physical wellbeing. However, it is yet unclear whether these lifestyle factors may moderate the association between ELS and psycho-physical comorbidity.

Methods: We investigated whether (a) participation in physical activity, (b) sleep duration, and (c) adherence to a Mediterranean diet, moderated the relationship between cumulative ELS exposure over the first 10 years of life and psycho-physical comorbidity at the age of 13.5 years. Analyses were conducted in 2022-2023, using data from two large adolescent samples based in the UK (ALSPAC; n = 8428) and The Netherlands (Generation R; n = 4268).

Results: Exposure to ELS was significantly associated with a higher risk of developing comorbidity, however this association was not modified by any of the three lifestyle factors investigated. Only physical activity was significantly associated with a reduced risk of comorbidity in one cohort (OR_ALSPAC [95%CI] = 0.73 [0.59;0.89]).

Conclusions: In conclusion, while we found some evidence that more frequent physical activity may be associated with a reduction in psycho-physical comorbidity, we did not find evidence in support of the hypothesised moderation effects. However, more research is warranted to examine how these associations may evolve over time.

Keywords: Adiposity; Adverse childhood experiences; Comorbidity; Depression; Diet; Mediterranean; Moderation analysis; Physical activity; Sleep.