Parental absence during childhood and weight status in adulthood among middle‐aged community dwellers in rural Vietnam

Abstract

Objectives While adverse childhood experiences (ACEs) have been shown to be associated with adulthood obesity, less is known about their association with underweight. We examined the associations between parental absence (i.e., a major component of ACEs) and both underweight and excess weight among middle‐aged rural community dwellers in Vietnam, where experiences of parental absence was not uncommon during and after the Vietnam War (1955–1975). Methods Data came from 3000 middle‐aged adults who participated in the baseline survey of Khánh Hòa Cardiovascular Study. Parental absence was defined as parental absence due to death, divorce, or out‐migration. Using information on the timing of such events, we categorized participants into those who experienced parental absence before the age of 3, between the ages of 3 and 15, and those without such experiences. BMI was calculated based on measured height and weight (kg/m2) and categorized into three groups: underweight <18.5; normal 18.5–24.9; excess weight ≥ 25. Multinomial logistic regression was then used to investigate the association between parental absence and adult weight status. Results Parental absence that occurred before the age of 3 was marginally significantly associated with underweight (relative risk ratio [RRR] = 1.44, 95% confidence interval [CI] 0.95, 2.20) but not with overweight/obesity. Parental divorce was associated with overweight/obesity (RRR = 2.48, 95% CI 1.28, 4.81), but not parental absence due to migratory work. Conclusions While previous studies in Western settings focused almost exclusively on the risk of obesity in relation to exposure to ACEs, our findings point to the potential importance of considering the risk of underweight in low‐ and middle‐income countries.

Adoption, Fostering, and Parental Absence in Vanuatu

“…In many settings, fostered children are at risk of abuse, domestic servitude, malnutrition, and bad educational outcomes (Bledsoe, 1990 ; Bledsoe et al, 1988 ; Hampshire et al, 2015 ; Madhavan & Townsend, 2007 ; Nelson, 2020 ; Rawson & Berggren, 1973 ; Scelza & Silk, 2014 ). Negative effects on mental and physical health may be long-term and persist into adulthood (Inoue et al, 2022 ; Yazawa et al, 2019 , 2022 ). In Oceania, adoptees can also be disadvantaged in decisions about land inheritance (Silk, 1980 ).…”