Adverse childhood experiences and adult stress eating: A secondary analysis of the Southern Community Cohort Study.

Background: Adverse childhood experiences (ACEs) are a measure of childhood adversity, reflecting exposures to abuse, neglect, and household dysfunction prior to the age of 18. They have consistently been associated with worse adult health outcomes, as caused by psychological stress. Although these outcomes include metabolic disease, few studies have been able to examine the association of ACEs directly with adult stress eating. Thus, we examined the association of ACEs and frequent adult stress eating in a largely low-income and racially diverse population in the southern US. Methods: Among 32,209 Southern Community Cohort Study participants primarily recruited from clinics that serve the un- and under-insured in 12 southeastern states, we used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of ACEs with frequent adult stress eating, adjusted for age, sex, and income. As a secondary analysis, we calculated ORs further adjusted for adult mental and emotional well-being. Results: Individuals with any ACE were more likely to report frequent stress eating as an adult compared to those without ACEs (OR 1.47; 95% CI 1.38, 1.56). By number of ACEs, there was a significant dose-response trend, with ORs rising from 1.16 (95% CI 1.07, 1.25) for 1 ACE to 1.93 (95% CI 1.78, 2.09) for 4 or more ACEs (p for trend <0.0001) for the likelihood of frequent adult stress eating. These findings remained significant after further adjusting for mental and emotional well-being. Conclusions: With the finding that ACEs are associated with adult stress eating across populations, even beyond the impact of depression and other mental-emotional well-being factors, research is needed to explore whether trauma intervention strategies can mitigate adult stress eating behavior and related poor health outcomes.