Adverse Childhood Experiences and BMI: Lifecourse Associations in a Black-White U.S. Women Cohort

Dorothy T Chiu; Erika M Brown; A Janet Tomiyama; Kristy E Brownell; Barbara Abrams; Mahasin S Mujahid; Elissa S Epel; Barbara A Laraia

doi:10.1016/j.amepre.2023.09.004

Adverse Childhood Experiences and BMI: Lifecourse Associations in a Black-White U.S. Women Cohort

Am J Prev Med. 2024 Jan;66(1):73-82. doi: 10.1016/j.amepre.2023.09.004. Epub 2023 Sep 9.

Authors

Dorothy T Chiu¹, Erika M Brown², A Janet Tomiyama³, Kristy E Brownell⁴, Barbara Abrams⁵, Mahasin S Mujahid⁵, Elissa S Epel⁶, Barbara A Laraia⁷

Affiliations

¹ Community Health Sciences Division, Berkeley School of Public Health, University of California, Berkeley, California; Osher Center for Integrative Health, University of California San Francisco, San Francisco, California. Electronic address: dorothy.chiu@ucsf.edu.
² Community Health Sciences Division, Berkeley School of Public Health, University of California, Berkeley, California; California Policy Lab, Berkeley, California.
³ Department of Psychology, College of Life Sciences, University of California, Los Angeles, Los Angeles, California.
⁴ Community Health Sciences Division, Berkeley School of Public Health, University of California, Berkeley, California; Kaiser Permanente Division of Research, Oakland, California.
⁵ Epidemiology Division, Berkeley School of Public Health, University of California, Berkeley, California.
⁶ Weill Institute of Neurosciences, Department of Psychiatry, University of California San Francisco, San Francisco, California; The Center for Health and Community, University of California San Francisco, San Francisco, California.
⁷ Community Health Sciences Division, Berkeley School of Public Health, University of California, Berkeley, California.

PMID: 37690590
DOI: 10.1016/j.amepre.2023.09.004

Abstract

Introduction: Although adverse childhood experiences (ACEs) have been positively associated with adiposity, few studies have examined long-term race-specific ACE-BMI relationships.

Methods: A Black and White all-women cohort (N=611; 48.6% Black) was followed between 1987 and 1997 from childhood (ages 9-10 years) through adolescence (ages 19-20 years) to midlife (ages 36-43 years, between 2015 and 2019). In these 2020-2022 analyses, the interaction between race and individual ACE exposures (physical abuse, sexual abuse, household substance abuse, multiple ACEs) on continuous BMI at ages 19-20 years and midlife was evaluated individually through multivariable linear regression models. Stratification by race followed as warranted at α=0.15.

Results: Race only modified ACE-BMI associations for sexual abuse. Among Black women, sexual abuse was significantly associated with BMI (B_adjusted=3.24, 95% CI=0.92, 5.57) at ages 19-20 years and marginally associated at midlife (B_adjusted=2.37, 95% CI= -0.62, 5.35); among White women, corresponding associations were null. Overall, having ≥2 ACEs was significantly associated with adolescent BMI (B_adjusted=1.47, 95% CI=0.13, 2.80) and was marginally associated at midlife (B_adjusted=1.45, 95% CI= -0.31, 3.22). This was similarly observed for physical abuse (adolescent BMI: B_adjusted=1.23, 95% CI= -0.08, 2.54; midlife BMI: B_adjusted=1.03, 95% CI= -0.71, 2.78), but not for substance abuse.

Conclusions: Direct exposure to certain severe ACEs is associated with increased BMI among Black and White women. It is important to consider race, ACE type, and life stage to gain a more sophisticated understanding of ACE-BMI relationships. This knowledge can help strengthen intervention, prevention, and policy efforts aiming to mitigate the impacts of social adversities and trauma on persistent cardiometabolic health disparities over the lifecourse.

MeSH terms

Adolescent
Adverse Childhood Experiences*
Body Mass Index
Female
Humans
Obesity
Substance-Related Disorders*
White