Adverse childhood experiences and fruit and vegetable intake among older adults in Japan

Background: Although adverse childhood experiences (ACEs) have been linked to negative health behaviors in adulthood, few studies have investigated if the impact continues until late adulthood. We examined the association between ACEs and fruit and vegetable intake (FVI) among older adults in Japan. Methods: Data came from the Japan Gerontological Evaluation Study (JAGES), 2013 in which 24,271 individuals aged >= 65 years participated. The number of ACEs was calculated (0, 1 and >= 2) while low FVI was defined as consuming fruit and vegetables less than once a day. A sex-stratified multilevel Poisson regression analysis was used to investigate the association between ACEs and low FVI. Results: Among men, 35.4% reported at least one ACE while the corresponding figure for women was 30.6%. Compared to those without ACEs, the prevalence ratios for low FVI among those who reported >= 2 ACEs were 1.51 (95% confidence interval [CI] = 1.30-1.75) for women and 1.28 (95% CI = 1.14-1.44) for men after adjusting for age and childhood economic hardship. Although these associations were attenuated after adjusting for socio-demographic and health-related variables, the link between ACEs and low FVI remained statistically significant among women. Of the seven individual forms of ACE, psychological neglect was significantly associated with low FVI (PR = 1.16, 95% CI = 1.03-1.31) among women in the final model. Conclusions: ACEs are associated with low FVI among older Japanese adults. Our results suggest that the detrimental effect of ACEs on health behavior may stretch across the life course.