Adverse childhood experiences and disordered eating among middle-aged adults: Findings from the coronary artery risk development in young adults study

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Adverse childhood experiences (ACEs) include childhood abuse, neglect, and household substance abuse. Childhood abuse is a risk factor for disordered eating (DEB). Less well established are associations of childhood neglect and household substance abuse with DEB, and little research has examined ACE associations with DEB in middle adulthood. The objective of this study was to examine associations between ACEs and DEBs among middle-aged adults and examine sex differences. ACEs prior to age 18 were retrospectively assessed in the Coronary Artery Risk Development in Young Adults study in 2000–2001 (N = 3340, ages 32 to 46). DEB outcomes (i.e., concerns about weight and shape, anxiety about eating or food, unhealthy weight control behaviors, chronic dieting, overeating, and binge eating) were assessed in 1995–1996 (ages 27 to 41). Modified Poisson regressions estimated risk ratios (RRs) for associations of a history of any ACE, each ACE, and cumulative ACEs with DEB outcomes. Among women, emotional abuse, physical neglect, and emotional neglect were each modestly associated with most DEBs (RRs = 1.21–1.35, 1.21–1.45, and 1.23–1.41 across DEBs, respectively) after adjustment for sociodemographic variables, BMI, and depressive symptoms. A cumulative ACE score was associated with all DEBs in a stepwise manner (p for trend ≤0.05) except concerns about weight and shape and overeating. Among men, emotional abuse was most consistently related to the majority of DEBs (RRs = 1.23–1.92); household substance abuse was modestly associated with overeating (RR = 1.26, 95% CI = 1.04–1.53). ACEs were cumulatively associated with unhealthy weight control behaviors, overeating, and binge eating (p for trend <0.01).

Original languageEnglish (US)
Article number107124
JournalPreventive medicine
StatePublished - Sep 2022

Bibliographical note

Funding Information:
The CARDIA study is supported by contracts HHSN268201800003I , HHSN268201800004I , HHSN268201800005I , HHSN268201800006I , and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). Cynthia Yoon‘s time was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [ T32DK083250 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHLBI or NIDDK.

Publisher Copyright:
© 2022 Elsevier Inc.


  • Abuse
  • Adverse childhood experiences (ACEs)
  • Cohort
  • Disordered eating
  • Household substance abuse
  • Middle-aged adults
  • Neglect
  • Observational study

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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