ASPO Abstracts
Adverse Childhood Experiences and Adult Diet Quality
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2021
Abstract Body:
Purpose: Adverse childhood experiences (ACEs) have been found to be associated with many poor health
outcomes, but few studies have evaluated the relationship between ACEs and diet quality, and none using a
comprehensive food frequency questionnaire. Thus, the purpose of this study was to examine the association of
ACEs and adult diet quality in a largely low-income and racially diverse population. Methods: We conducted a
cross-sectional study of 30,854 participants in the Southern Community Cohort Study
who completed both a food frequency and ACE questionnaire. Diet was assessed by calculating Healthy Eating
Index-2010 (HEI) scores. Using logistic regression, we estimated the odds of worse HEI score by any ACE,
number of ACEs, and ACE category (abuse, neglect, and household dysfunction) among all participants and in
four groups: Black women, Black men, White women, and White men. As a secondary analysis, we calculated
odd ratios adjusted for household income. In addition, we analyzed the association by any ACE with HEI
components.Results: Having experienced any ACE was associated with higher odds of worse HEI among all (OR:
1.22; 95% CI: 1.17, 1.27), and for all race-sex groups (Black women, OR: 1.13; 95% CI: 1.06, 1.21; Black men,
OR: 1.19; 95% CI: 1.09, 1.30; White women, OR: 1.22; 95% CI: 1.13, 1.32; White men, OR: 1.51; 95% CI: 1.36,
1.67). Increasing number of ACEs was also associated with increasing odds of a worse HEI (OR for four or more
ACEs: 1.34; 95% CI: 1.27, 1.42; p for trend <0.0001). These associations remained after adjustment for
household income, suggesting that there is an association between ACEs and HEI independent of socioeconomic
status. The association with worse HEI score was especially strong for ACEs in the household dysfunction
category, particularly experiencing a family member in prison (OR: 1.34; 95% CI: 1.25, 11.42) and parents
divorced (OR: 1.25; 95% CI: 1.20, 1.31). ACEs were associated with ten of the twelve HEI components, most
strongly with total fruit, whole fruit, and solid fat/alcohol/added sugar. Conclusions: Adverse childhood experiences
are associated with poor adult diet quality. More research is needed to evaluate whether trauma intervention
strategies can have a positive impact on adult diet quality.
Keywords: adverse childhood experiences, diet quality, healthy eating index