Early Life Adversity and Later-Life Health

Dr. David Wiss

May 22, 2022

Trauma

Early life adversity exposing vulnerable individuals to potential harm during the first 18 years of life increases the risk for a wide range of adverse physical and mental health outcomes. Toxic stress during critical periods of development can disrupt brain circuitry and other regulatory systems in ways that negatively influence health behaviors later in life. One example of adverse health behaviors is disordered eating [2] which can lead to increasing BMIs over the life course [3] as well as increase the risk for restrictive eating disorders [4].

The most well-known forms of early life adversity are Adverse Childhood Experience (ACEs) [5], which traditionally include the categories of childhood maltreatment (emotional abuse, physical abuse, sexual abuse, emotional and physical neglect) and household dysfunction (mother treated violently, household substance abuse, household mental illness, incarcerated household member, and parental separation or divorce). 

While the original ACE measure captures specific exposures in the household, several expanded ACEs have been operationalized, such as low socioeconomic status (SES), single-parent home, parents always arguing, exposure to community violence, the experience of discrimination/racism, peer victimization/bullying, and below-average grades.

ACEs have been shown to associate with nonspecific risk for a wide range of adverse mental health conditions across all socioeconomic groups. It has been suggested that while people are made vulnerable to mental illness by deep-rooted poverty, food insecurity, social inequality, and discrimination, mental health disorders affect everyone not only the poorest or most disadvantaged [6]. Thus, ACEs can also be viewed as a psychosocial risk factor impacting mental health independent of other social patterns (e.g., among those with higher SES).

According to a recent meta-analysis, ACEs contributed to about 40% of depression cases and 30% of anxiety cases [8]. It has also been established that outcomes associated with multiple ACEs such as illicit drug use and mental health disorders can increase the risk for ACEs in the next generation, indicating intergenerational effects that can fasten families into cycles of adversity and disadvantage [9]. Links between trauma and addictions of various kinds have gotten a lot of attention in the popular press. Is it time to break the cycle?

In summary, life experiences during developmental periods can have a profound impact on adult health. Prolonged activation of the fight or flight response can affect brain architecture and lead to various mental health outcomes, most notably substance use disorder. However, it is possible to build up a positive stress response, but it takes time and deliberate effort. However, it does not need to be expensive. 

Challenges faced by children that may have once been viewed as “harmless” are increasingly understood as capable of influencing later health. The saying “what doesn’t kill you makes you stronger” is not always the case. The sequela of childhood adversity can be enduring over the lifespan, which is particularly concerning given that many exposures can be prevented. When childhood adversity cannot be prevented, we should invest our energy and resources into bolstering resilience resources. Did you know that nutrition can and should be a part of that process?

At Wise Mind Nutrition, our aim is to provide trauma-informed recovery-affirming care that always considers the potential difficulties faced by survivors of trauma. This approach focuses on the strengths of the individual and uses language that is supportive and non-stigmatizing. We are here to phase out the nutrition interventions that are triggering. They are obsolete! Let’s build up some resilience together, one bite at a time!

References

1. Garner AS, Shonkoff JP, Siegel BS, Dobbins MI, Earls MF, Garner AS, McGuinn L, Pascoe J, Wood DL (2012) Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health. Pediatrics 129:e224–e231

2. Wiss DA, Avena N, Gold M (2020) Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications. Nutrients 12:3521

3. Wiss DA, Brewerton TD (2020) Adverse Childhood Experiences and Adult Obesity: A Systematic Review of Plausible Mechanisms and Meta-Analysis of Cross-Sectional Studies. Physiol Behav 112964

4. Wiss DA, Brewerton TD, Tomiyama AJ (2021) Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding. Eat Weight Disord - Stud Anorexia Bulimia Obes 1–19

5. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 14:245–258

6. Allen J, Balfour R, Bell R, Marmot M (2014) Social determinants of mental health. International Review of Psychiatry 26:392–407

7. Sederer LI (2016) The Social Determinants of Mental Health. Psychiatric Services 67:234–235

8. Bellis MA, Hughes K, Ford K, Rodriguez G, Sethi D, Passmore J (2019) Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Heal. https://doi.org/10.1016/s2468-2667(19)30145-8

9. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public health 2:e356–e366