Adverse childhood experiences (ACEs) and childhood obesity are prevalent issues with far-reaching health implications; however, their interconnection has been critically overlooked. Additionally, the potential positive effects of Positive
childhood experiences (PCEs), which encompass nurturing, supportive, and enriching events or relationships during childhood, enhancing a child's well-being and development, remain inadequately studied in their role of protecting against
health issues and mitigating the effects of early adversity. This study used data from 4,895 participants in the demographically diverse Growing Up in New
Zealand (GUiNZ) longitudinal study to explore five research questions:
1. How prevalent are adverse childhood experiences (ACEs) (individually and cumulatively) at age 8 and how are they distributed across socioeconomic and ethnic groups?
2. How does exposure to ACEs (individually and cumulatively) influence the development of childhood obesity and how does the relationship vary by ethnicity, socioeconomic status, and gender?
3. Does exposure to ACEs increase the risk of obesogenic behaviours (unhealthy diet, inadequate sleep duration, excessive screen time, physical inactivity)?
4. How prevalent are positive childhood experiences (PCEs) (individually and cumulatively) and how are they distributed across socioeconomic and ethnic
groups?
5. Which PCEs have the potential to protect against obesity and mitigate against effects of ACEs?

We found that after adjustment for child’s prioritised ethnicity, child’s gender, and food insecurity children who experienced at least one ACE were twice as likely as children who had not experienced any ACEs to be obese at age 8. The risk
increased as the number of ACEs increased. Children who experienced 4+ ACEs
were almost three times more likely to be obese. Children who experienced ACEs were also more likely to adopt unhealthy weight-related behaviours. Furthermore, there was a relationship between ethnicity, poverty and increased risk for
reporting both ACEs and obesity. Children who experienced PCEs were less likely to be obese and experience of 4+ PCEs decreased the likelihood of developing
obesity, even among those who experienced high numbers of ACEs.

Our findings highlight the policy and clinical need to recognise the links between ACEs and obesity and implement well-supported initiatives to address contributing factors. This will require a holistic approach to child wellbeing by providing early support to prevent ACEs and responding to those who have experienced ACEs using trauma-informed and strengths-based approaches to provide healing opportunities. Importantly, our findings highlight the need to identify and promote positive factors in all New Zealand children’s lives to improve long-term health and wellbeing. (Executive summary). Record #9095