Adverse childhood experiences and diet quality in the national sample of Poles: The mediating role of emotion regulation

Adverse childhood experiences (ACEs) increase the risk of adverse psychological and physical outcomes and chronic disease in adulthood. The mechanism of this relationship is still unclear. ACEs might exert their negative influence on adult health via both dietary and psychological axes. Our study aimed to examine the relationship between ACEs and diet quality in the national sample of Poles. We also aimed to determine whether difficulty in regulating emotions act as a mediator of this relationship. The national Polish sample of adults (n = 3557) took part in this study. ACEs were assessed via the Adverse Childhood Experiences Questionnaire. Data on food consumption frequency over the past year, body weight and height were collected using the self-administered version of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN®). Two diet quality scores were evaluated: Pro-Healthy-Diet-Index-10 (pHDI) and Non-Healthy-Diet-Index-14 (nHDI). Emotion regulation (ER) was evaluated via the Difficulties in Emotion Regulation Scale (DERS). Path analysis was used to examine the associations between the variables, firstly formulated by theoretical assumptions expressed by directed acyclic graphs (DAGs). A higher number of ACEs was related to higher difficulties in ER in adults (p < 0.001), which in turn was related to lower pHDI (p < 0.001) and higher nHDI (p = 0.027). Our findings strengthen the rationale for ACEs screening as a potential risk factor for diet-related chronic disease in adulthood. They provide a framework for public health prevention strategies via interventions targeting diet quality and emotional regulation in the setting of multidisciplinary practice.