Childhood and Adolescent Nutrition Outcomes Among Girls Exposed to Gender-based Violence: A Rapid Evidence Assessment of Quantitative Research

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Feb 16

PMID 36795761

Authors

Luissa Vahedi

Manuela Orjuela-Grimm

Silvia Bhatt-Carreno

Sarah Rachel Meyer

Affiliations

Soon will be listed here.

Abstract

Background: An emerging evidence base has explored the nutritional consequences of gender-based violence (GBV) perpetrated against girls during childhood/adolescence. We conducted a rapid evidence assessment of quantitative studies describing associations between GBV and girls' nutrition.

Methods: We adapted systematic review methods and included empirical, peer-reviewed studies, published after 2000 (until November, 2022), that were written in Spanish or English and reported quantitative associations between girls' exposure to GBV and nutrition outcomes. A variety of GBV forms were considered: childhood sexual abuse (CSA), child marriage, preferential feeding of boys, sexual IPV and dating violence. Nutrition outcomes included anemia, underweight, overweight, stunting, micronutrient deficiencies, meal frequency, and dietary diversity.

Results: In total, 18 studies were included, 13 of which were conducted in high-income countries. Most sources utilized longitudinal or cross-sectional data to quantify associations between CSA, sexual assault, and intimate partner/dating violence and elevated BMI/overweight/obesity/adiposity. Findings suggest that CSA perpetrated by parents/caregivers is associated with elevated BMI/overweight/obesity/adiposity via cortisol reactivity and depression; this relationship may be compounded by additional intimate partner/dating violence in adolescence. The effects of sexual violence on BMI are likely to emerge during a sensitive period of development between late adolescence and young adulthood. Emerging evidence was found regarding the relationship between child marriage (and the related exposure: age at first pregnancy) and undernutrition. The association between sexual abuse and reduced height and leg length was inconclusive.

Conclusion: Given that only 18 studies were included, the relationship between girls' direct exposure to GBV and malnutrition has received little empirical attention, especially with respect to studies conducted in LMIC and fragile settings. Most studies focused on CSA and overweight/obesity, where significant associations were found. Future research should test the moderation and mediation effects of intermediary variables (depression, PTSD, cortisol reactivity, impulsivity, emotional eating) and consider sensitive periods of development. Research should also explore the nutritional consequences of child marriage.

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References

Rico E, Fenn B, Abramsky T, Watts C . Associations between maternal experiences of intimate partner violence and child nutrition and mortality: findings from Demographic and Health Surveys in Egypt, Honduras, Kenya, Malawi and Rwanda. J Epidemiol Community Health. 2010; 65(4):360-7. DOI: 10.1136/jech.2008.081810. View

Hill A, Pallitto C, McCleary-Sills J, Garcia-Moreno C . A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. Int J Gynaecol Obstet. 2016; 133(3):269-76. DOI: 10.1016/j.ijgo.2015.10.023. View

Heise L, Ellsberg M, Gottmoeller M . A global overview of gender-based violence. Int J Gynaecol Obstet. 2002; 78 Suppl 1:S5-14. DOI: 10.1016/S0020-7292(02)00038-3. View

Yount K, DiGirolamo A, Ramakrishnan U . Impacts of domestic violence on child growth and nutrition: a conceptual review of the pathways of influence. Soc Sci Med. 2011; 72(9):1534-54. DOI: 10.1016/j.socscimed.2011.02.042. View

Soares A, Matijasevich A, Menezes A, Assuncao M, Wehrmeister F, Howe L . Adverse Childhood Experiences (ACEs) and Adiposity in Adolescents: A Cross-Cohort Comparison. Obesity (Silver Spring). 2017; 26(1):150-159. PMC: 5765459. DOI: 10.1002/oby.22035. View

Brown S, Mitchell T, Fite P, Bortolato M . Impulsivity as a moderator of the associations between child maltreatment types and body mass index. Child Abuse Negl. 2017; 67:137-146. PMC: 5436933. DOI: 10.1016/j.chiabu.2017.02.029. View

Marques E, Hasselmann M, Vianna G, Mendonca E, Azeredo C . Association Between Interpersonal Violence With Inadequate Nutritional Status Among Brazilian Adolescents. J Interpers Violence. 2021; 37(13-14):NP12066-NP12085. DOI: 10.1177/0886260521997446. View

Li J, Hall M, Shalev I, Schreier H, Gonzalez Zarzar T, Marcovici I . Hypothalamic-pituitary-adrenal axis attenuation and obesity risk in sexually abused females. Psychoneuroendocrinology. 2021; 129:105254. PMC: 8217375. DOI: 10.1016/j.psyneuen.2021.105254. View

Bunea I, Szentagotai-Tatar A, Miu A . Early-life adversity and cortisol response to social stress: a meta-analysis. Transl Psychiatry. 2017; 7(12):1274. PMC: 5802499. DOI: 10.1038/s41398-017-0032-3. View

10.

Ross C . Psychodynamics of eating disorder behavior in sexual abuse survivors. Am J Psychother. 2009; 63(3):211-26. DOI: 10.1176/appi.psychotherapy.2009.63.3.211. View

11.

Dempster K, OLeary D, MacNeil A, Hodges G, Wade T . Linking the hemodynamic consequences of adverse childhood experiences to an altered HPA axis and acute stress response. Brain Behav Immun. 2020; 93:254-263. DOI: 10.1016/j.bbi.2020.12.018. View

12.

Merrick M, Ford D, Ports K, Guinn A, Chen J, Klevens J . Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention - 25 States, 2015-2017. MMWR Morb Mortal Wkly Rep. 2019; 68(44):999-1005. PMC: 6837472. DOI: 10.15585/mmwr.mm6844e1. View

13.

Noll J, Zeller M, Trickett P, Putnam F . Obesity risk for female victims of childhood sexual abuse: a prospective study. Pediatrics. 2007; 120(1):e61-7. DOI: 10.1542/peds.2006-3058. View

14.

Keeshin B, Luebbe A, Strawn J, Saldana S, Wehry A, DelBello M . Sexual abuse is associated with obese children and adolescents admitted for psychiatric hospitalization. J Pediatr. 2013; 163(1):154-9.e1. DOI: 10.1016/j.jpeds.2012.12.091. View

15.

Danese A, Tan M . Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry. 2013; 19(5):544-54. DOI: 10.1038/mp.2013.54. View

16.

Borooah V . Gender bias among children in India in their diet and immunisation against disease. Soc Sci Med. 2004; 58(9):1719-31. DOI: 10.1016/S0277-9536(03)00342-3. View

17.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

18.

Orta O, Huang T, Kubzansky L, Terry K, Coull B, Williams M . The association between abuse history in childhood and salivary rhythms of cortisol and DHEA in postmenopausal women. Psychoneuroendocrinology. 2019; 112:104515. PMC: 6935398. DOI: 10.1016/j.psyneuen.2019.104515. View

19.

Yakubovich A, Heron J, Feder G, Fraser A, Humphreys D . Intimate partner violence victimisation in early adulthood: psychometric properties of a new measure and gender differences in the Avon Longitudinal Study of Parents and Children. BMJ Open. 2019; 9(3):e025621. PMC: 6475136. DOI: 10.1136/bmjopen-2018-025621. View

20.

Silverman J, Raj A, Mucci L, HATHAWAY J . Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. JAMA. 2001; 286(5):572-9. DOI: 10.1001/jama.286.5.572. View