Academic Pediatrics ( IF 3.0 ) Pub Date : 2021-06-05 , DOI: 10.1016/j.acap.2021.05.024 Melissa Harada 1 , Alma Guerrero 2 , Sai Iyer 1 , Wendelin Slusser 3 , Moira Szilagyi 1 , Irene Koolwijk 1
Objective
To examine how adverse childhood experiences (ACEs) relate to healthy weight behaviors in children.
Methods
We examined data from the 2016 National Survey of Children's Health. ACE scores were calculated from 6 measures of household dysfunction. Outcome measures included 5 healthy weight behaviors. Logistic regression models assessed associations between ACEs and healthy weight behaviors controlling for sociodemographic variables.
Results
Children 6 to 17 years of age (n = 32,528) with 0 ACEs had increased odds of: watching 2 hours or less of television daily (6–12 years: odds ratio [OR] 1.46; 95% confidence interval [CI], 1.20–1.80, 13–17 years: OR 1.64; 95% CI, 1.39–1.94), using electronics for 2 hours or less daily (6–12 years: OR 1.44; 95% CI, 1.15–1.80, 13–17 years: OR 1.86; 95% CI, 1.60–2.16), sharing 4 or more family meals per week (6–12 years: OR 1.39; 95% CI, 1.17–1.66, 13–17 years: OR 1.68; 95% CI, 1.44–1.95), and getting adequate age-specific sleep (6–12 years: OR 1.50; 95% CI, 1.26–1.79, 13–17 years: OR 1.31; 95% CI, 1.11–1.55) when compared to children with one or more ACEs. Children 13 to 17 years of age with 0 ACEs had increased odds of exercising for 60 minutes daily (OR 1.27; 95% CI, 1.02–1.58) when compared to children with one or more ACEs. There was an overall gradient dose pattern; the odds of engaging in a healthy weight behavior decreased as the number of ACEs increased, with mixed significance levels.
Conclusions
In children, ACE exposure is associated with decreased healthy weight behaviors and behavior counseling alone may be insufficient. Trauma-informed care to address intra-familial adversity may be necessary.
中文翻译:
全国儿童样本中不良童年经历与体重相关健康行为之间的关系
客观的
研究不良童年经历 (ACE) 如何与儿童的健康体重行为相关。
方法
我们检查了 2016 年全国儿童健康调查的数据。ACE 分数是根据 6 项家庭功能障碍的测量值计算得出的。结果测量包括 5 种健康的体重行为。Logistic 回归模型评估了 ACE 与控制社会人口学变量的健康体重行为之间的关联。
结果
具有 0 ACE 的 6 至 17 岁儿童 (n = 32,528) 的几率增加:每天看 2 小时或更少的电视(6-12 岁:优势比 [OR] 1.46;95% 置信区间 [CI],1.20 –1.80、13–17 岁:OR 1.64;95% CI,1.39–1.94),每天使用电子产品 2 小时或更少(6–12 岁:OR 1.44;95% CI,1.15–1.80,13–17 岁: OR 1.86;95% CI,1.60–2.16),每周共享 4 次或更多家庭聚餐(6–12 岁:OR 1.39;95% CI,1.17–1.66,13–17 岁:OR 1.68;95% CI,1.44 –1.95),并获得充足的特定年龄睡眠(6-12 岁:OR 1.50;95% CI,1.26-1.79,13-17 岁:OR 1.31;95% CI,1.11-1.55)与有一个孩子的儿童相比或更多 ACE。与具有 1 个或多个 ACE 的儿童相比,具有 0 个 ACE 的 13 至 17 岁儿童每天锻炼 60 分钟的几率增加(OR 1.27;95% CI,1.02-1.58)。有一个整体梯度剂量模式;随着 ACE 数量的增加,参与健康体重行为的几率降低,具有混合的显着性水平。
结论
在儿童中,ACE 暴露与健康体重行为的减少有关,仅靠行为咨询可能是不够的。可能需要针对家庭内部逆境的创伤知情护理。