Table 4.
Adjusted relative risksa (RRs) and 95% confidence Intervals (CIs) for the joint exposure of obesity and adverse childhood experiences (ACEs) among Canadian adults in the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Exit Survey (September–December 2020) and interaction on the additive and multiplicative scales.
| Health domain | |||||
|---|---|---|---|---|---|
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 1.04 (0.96, 1.14); p = 0.34 | 1.17 (1.05, 1.30); p = 0.004 | 1.06 (0.90, 1.23); p = 0.49 | 1.50 (1.24, 1.81); p < 0.0001 |
| ACEs | 1.31 (1.19, 1.44); p < 0.0001 | 1.38 (1.26, 1.50); p < 0.0001 | 1.49 (1.35, 1.64); p < 0.0001 | 1.54 (1.36, 1.76); p < 0.0001 | 1.47 (1.24, 1.73); p < 0.0001 |
| Additive (RERI)b | REF | 0.02 (-0.12, 0.17); p = 0.74 | 0.01 (–0.16, 0.19); p = 0.87 | 0.18 (-0.06, 0.42); p = 0.15 | −0.34 (−0.71, 0.02); p = 0.07 |
| Multiplicative (RRR)c | REF | 1.01 (0.89, 1.14); p = 0.90 | 0.98 (0.85, 1.12); p = 0.73 | 1.12(0.92, 1.37); p = 0.27 | 0.74 (0.58, 0.96); p = 0.02 |
| Resources domain | |||||
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 1.09 (1.00, 1.19); p = 0.06 | 1.21 (1.09, 1.24); p = 0.0003 | 1.35 (1.17, 1.55); p < 0.0001 | 1.38 (1.14, 1.66); p = 0.001 |
| ACEs | 1.35 (1.23, 1.48); p < 0.0001 | 1.37 (1.26, 1.50); p < 0.0001 | 1.58 (1.44, 1.74); p < 0.0001 | 1.68 (1.49, 1.89); p < 0.0001 | 1.78 (1.54, 2.06); p < 0.0001 |
| Additive (RERI) | REF | –0.07 (–0.21, 0.08); p = 0.37 | 0.03 (-0.15, 0.20); p = 0.76 | –0.02 (–0.28, 0.24); p = 0.88 | 0.05 (-0.30, 0.40); p = 0.78 |
| Multiplicative (RRR) | REF | 0.93 (0.83, 1.05); p = 0.26 | 0.97 (0.85, 1.11); p = 0.68 | 0.92 (0.77, 1.11); p = 0.38 | 0.96 (0.76, 1.21); p = 0.71 |
| Relationships domain | |||||
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 0.98 (0.92, 1.05); p = 0.60 | 0.97 (0.89, 1.06); p = 0.50 | 1.07 (0.94, 1.20); p = 0.30 | 1.07 (0.90, 1.26); p = 0.43 |
| ACEs | 1.11 (1.03, 1.20); p = 0.01 | 1.17 (1.09, 1.25); p < 0.0001 | 1.19 (1.09, 1.25); p < 0.0001 | 1.12 (1.00, 1.25); p = 0.06 | 1.14 (0.98, 1.31); p = 0.08 |
| Additive (RERI) | REF | 0.08 (–0.2, 0.18); p = 0.13 | 0.11 (-0.2, 0.23); p = 0.09 | –0.06 (–0.24, 0.12); p = 0.51 | –0.04 (–0.29, 0.20); p = 0.72 |
| Multiplicative (RRR) | REF | 1.08 (0.97, 1.18); p = 0.15 | 1.10 (0.98, 1.24); p = 0.10 | 0.94 (0.80, 1.11); p = 0.49 | 0.96 (0.77, 1.19); p = 0.69 |
| Caregiving domain | |||||
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 0.98 (0.92, 1.05); p = 0.60 | 0.97 (0.89, 1.06); p = 0.50 | 1.07 (0.94, 1.20); p = 0.30 | 1.07 (0.90, 1.25); p = 0.43 |
| ACEs | 1.11 (1.03, 1.20); p = 0.007 | 1.17 (1.09, 1.25); p < 0.0001 | 1.19 (1.09, 1.28); p < 0.0001 | 1.12 (1.00, 1.25); p = 0.06 | 1.14 (0.98, 1.31); p = 0.08 |
| Additive (RERI) | REF | –0.08 (–0.29, 0.12); p = 0.42 | 0.04 (–0.20, 0.28); p = 0.76 | –0.05 (–0.41, 0.30); p = 0.77 | 0.13 (–0.33, 0.59); p = 0.57 |
| Multiplicative (RRR) | REF | 0.92 (0.77, 1.10); p = 0.38 | 1.02 (0.83, 1.26); p = 0.84 | 0.93 (0.70, 1.24); p = 0.62 | 1.10 (0.74, 1.63); p = 0.65 |
| Total number of stressors | |||||
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 1.03 (0.98, 1.08); p = 0.19 | 1.08 (1.02, 1.15); p = 0.01 | 1.14 (1.05, 1.24); p = 0.001 | 1.25 (1.11, 1.39); p = 0.0001 |
| ACEs | 1.23 (1.17, 1.30); p < 0.0001 | 1.28 (1.22, 1.34); p < 0.0001 | 1.38 (1.30, 1.45); p < 0.0001 | 1.39 (1.29, 1.50); p < 0.0001 | 1.42 (1.29, 1.55); p < 0.0001 |
| Additive (RERI) | REF | 0.01 (–0.07, 0.09); p = 0.78 | 0.06 (–0.03, 0.15); p = 0.21 | 0.01 (–0.12, 0.15); p = 0.84 | –0.06 (–0.25, 0.12); p = 0.50 |
| Multiplicative (RRR) | REF | 1.00 (0.94, 1.07); p = 0.94 | 1.03 (0.95, 1.11); p = 0.47 | 0.99 (0.88, 1.10); p = 0.80 | 0.92 (0.80, 1.07); p = 0.27 |
| Perceived consequences of the pandemic | |||||
| Normal weight RR (95% CI) | Overweight RR (95% CI) | Obesity class I RR (95% CI) | Obesity class II RR (95% CI) | Obesity class III RR (95% CI) | |
| No ACEs | 1.00 | 0.96 (0.93, 1.01); p = 0.09 | 0.99 (0.94, 1.04); p = 0.63 | 0.98 (0.90, 1.05); p = 0.53 | 0.98 (0.88, 1.08); p = 0.74 |
| ACEs | 1.06 (1.02, 1.11); p = 0.006 | 1.03 (0.99, 1.08); p = 0.13 | 1.00 (0.95, 1.05); p = 0.91 | 1.05 (0.98, 1.12); p = 0.17 | 1.11 (1.02, 1.19); p = 0.01 |
| Additive (RERI) | REF | 0.003 (-0.05, 0.6); p = 0.91 | –0.05 (–0.12, 0.02); p = 0.18 | 0.01 (−0.09, 0.11); p = 0.89 | 0.06 (−0.07, 0.20); p = 0.36 |
| Multiplicative (RRR) | REF | 1.01 (0.95, 1.06); p = 0.85 | 0.95 (0.89, 1.02); p = 0.19 | 1.01 (0.91, 1.11); p = 0.87 | 1.06 (0.93, 1.21); p = 0.38 |
CI confidence intervals, RR relative risk, REF reference.
aAdjusted for sex, age group, racial background, physical activity, household income, alcohol consumption and depression.
bInteraction on the additive scale using Relative Excess Risk due to Interaction (RERI); Standard error calculated using the delta method [41–43].
cInteraction on the multiplicative scale using Ratio of Relative Risks (RRR).