title: Adverse family experiences and obesity in children and adolescents in the United States.
abstract: While exposure to adverse family experiences (AFEs), subset of adverse childhood experiences (ACEs), has been associated with childhood obesity, less is known about the impact of exposures to each type of AFE. Using 2011-2012 National Survey of Children's Health data, we evaluated associations between exposure to individual AFEs and overweight/obesity status in children 10years or older, adjusting for socio-demographic factors. Caregivers reported their child's height, weight, and exposure to nine AFEs; body mass index (BMI) was classified by Center for Disease Control and Prevention's (CDC) guidelines. At Mayo Clinic, we calculated frequencies and weighted estimates of socio-demographic factors and AFEs. Unadjusted and adjusted weighted multinomial logistic regression models were employed to assess the independent associations of each AFE and the different AFE composite scores with BMI category. Exposure to two or more AFEs was independently associated with increased odds of overweight (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.13, 1.56) and obese (OR, 1.45; 95% CI, 1.21, 1.73) status after adjustment for age, household income, parents' education-level, race and sex. Death of parent (OR, 1.59; 95% CI, 1.18, 2.15) and hardship due to family income (OR, 1.26; 95% CI, 1.06, 1.50) were independently associated with obesity status with adjustment for other AFEs and socio-demographic factors. Our results suggest that, in addition to cumulative exposure to AFEs, exposure to certain childhood experiences are more strongly associated with childhood obesity than others. Death of parent and hardship due to family income are individual AFEs, which are strongly predictive of obesity.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: lynch.brian@mayo.edu.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Lynch
authors.affiliation: Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: agunwamba.amenah@mayo.edu.
authors.forename: Amenah
authors.initials: A
authors.lastname: Agunwamba
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: wilson.patrick@mayo.edu.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Wilson
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: kumar.seema@mayo.edu.
authors.forename: Seema
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Pediatric and Adolescent Medicine, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: jacobson.robert@mayo.edu.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Jacobson
authors.affiliation: Department of Health Sciences Research, Division of HealthCare Policy and Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: phelan.sean@mayo.edu.
authors.forename: Sean
authors.initials: S
authors.lastname: Phelan
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: cristiani.valeria@mayo.edu.
authors.forename: Valeria
authors.initials: V
authors.lastname: Cristiani
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: fan.chun@mayo.edu.
authors.forename: Chun
authors.initials: C
authors.lastname: Fan
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: rutten.lila@mayo.edu.
authors.forename: Lila J
authors.initials: LJ
authors.lastname: Finney Rutten
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D010287:Parent-Child Relations; D063766:Pediatric Obesity / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Adolescent; Child; Child abuse; Child maltreatment; Child neglect; Obesity; Pediatric