Body mass trajectories from adolescence to adulthood in the United States: Effects of racial identification and adverse childhood experiences

The non-Hispanic Black population in the U.S. has experienced one of the highest obesity rates, relative to the non-Hispanic White population and other racial groups. This study explores how adverse childhood experiences (ACEs) and racial identification influence body mass trajectories from adolescence to adulthood. Participants include non-Hispanic Black and non-Hispanic White individuals from the National Longitudinal Study of Adolescent to Adult Health (n = 5438). The outcome measure was body mass index (BMI). The Behavioral Risk Factor Surveillance System ACE Module and the CDC's Kaiser ACE research were used to create ACE categories. Multilevel growth curve models were utilized to address the study's objectives. BMI trajectories were steeper among female respondents who experienced multiple ACEs ($\hat{\beta }$ = 0.035; p < .01) than among females without any ACE. Among females, BMI trajectories were jointly moderated by ACEs and race (likelihood ratio test: ${\chi }^2$ = 130.76, p < .001), showing stronger ACE effects among non-Hispanic Black respondents. However, ACEs were not statistically associated with mean BMI or BMI trajectories among male respondents. Results further indicated that the effects of multiple ACEs were more evident at early ages and had a more marked impact on BMI among non-Hispanic Black females than non-Hispanic White females. Unhealthy BMI gains, especially among females, could be reduced through targeted interventions designed to support non-Hispanic Black children and adolescents.