Association Between Adverse Childhood Experiences and Diet, Exercise, and Sleep in Pre-adolescents

  • William W. Lewis-de los Angeles
    Address correspondence to William W. Lewis-de los Angeles, MD, Bradley Hospital, 1011 Veterans Memorial Parkway, Riverside, RI 02915.
    Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island

    Department of Pediatrics, Emma Pendleton Bradley Hospital, Riverside, Rhode Island
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      To understand the relationship between adverse childhood experiences (ACEs) and diet, sleep, and exercise in pre-adolescents.


      Baseline and 1-year follow-up data from the adolescent brain and cognitive development (ABCD) study were analyzed (age 10–11, n = 11,875). ACEs were measured by parent report at baseline. Three levels of ACEs were created: none, exposure to one ACE, and exposure to two or more ACEs. Health-promoting behaviors were assessed at 1 year. Diet quality was measured from parent report; sleep problems were measured by parent report, with higher scores indicating worse sleep; and amount of exercise was measured by youth report. Linear regression analyses were used to assess the relationship between ACEs and each health-promoting behavior, adjusting for family income and sex.


      Compared to children with no adversity, ACEs were associated with worse diet – one ACE (β = −0.30 [95% CI, −0.49 to −0.12], P = .002) and 2 or more ACEs (β = −0.56 [−0.78 to −0.34, P < .001). Similarly, ACEs were associated with poor sleep – one ACE (β = 1.51 [1.00–2.03], P < .001) and 2 or more ACEs (β = 2.96 [2.38–3.53], P < .001). Finally, amount of exercise was not different in children with ACEs – 2 or more ACEs (β = −0.24, 95% CI, −0.51 to 0.04, P = .08).


      ACEs in pre-adolescents show a dose-response relationship with unhealthy diet and sleep disruption. These findings suggest potential behaviors to target to mitigate the negative impact of childhood adversity on adult health.


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