title: Early childhood diarrhea and cardiometabolic risk factors in adulthood: the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study.
abstract: BACKGROUND
  Nutritional deficits in early life have been associated with a higher prevalence of the metabolic syndrome (MetS) in adulthood. Early childhood diarrhea contributes to undernutrition and may potentially increase the risk for adult noncommunicable diseases. Our objective was to examine associations between early childhood diarrhea burden and later development of MetS.
  
  
  METHODS
  We studied individuals who participated in the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study (1969-1977) and were followed up in 2002-2004. We used logistic regression to determine associations of diarrhea burden at ages 0 to 6, 6 to 12, and 12 to 24 months with odds of MetS and elevations in its components as adults.
  
  
  RESULTS
  Among 389 adults age 25 to 42 years at follow-up, the prevalence of MetS was 29%. Adjusting for several confounders including adult body mass index (BMI), each absolute 1% increase in diarrhea burden at age 0 to 6 months (but not at other time periods) was associated with increased odds of MetS (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.06). This was attributable primarily to associations with elevated blood pressure (OR, 1.03; 95% CI, 1.00-1.06) and waist circumference (OR, 1.03; 95% CI, 1.00-1.06).
  
  
  CONCLUSIONS
  Childhood diarrhea burden at 0 to 6 months is associated with MetS in adulthood after controlling for childhood growth parameters and adult BMI.
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA 22901, USA. deboer@virginia.edu
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
authors.forename: David
authors.initials: D
authors.lastname: Chen
authors.forename: David R
authors.initials: DR
authors.lastname: Burt
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramirez-Zea
authors.forename: Richard L
authors.initials: RL
authors.lastname: Guerrant
authors.forename: Aryeh D
authors.initials: AD
authors.lastname: Stein
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
authors.forename: Max A
authors.initials: MA
authors.lastname: Luna
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003967:Diarrhea / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D009749:Nutrition Surveys; D016017:Odds Ratio; D010176:Panama / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors