Early childhood diarrhea and cardiometabolic risk factors in adulthood: the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study

• Type of Material: Article
• Authors: Mark D. DeBoer, University of Virginia; David Chen, University of Virginia; David R. Burt, University of Virginia; Manuel Ramirez-Zea, Institute of Nutrition of Central America and Panama; Richard L. Guerrant, University of Virginia; Aryeh D Stein, Emory University; Reynaldo Martorell, Emory University; Max A. Luna, University of Virginia
• Language: English
• Date: 2013-06-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2013.03.012
• Title of Journal or Parent Work: Annals of Epidemiology
• ISSN: 1047-2797
• Volume: 23
• Issue: 6
• Start Page: 314
• End Page: 320
• Grant/Funding Information: The Human Capital Study (2002–2004) was funded by grant R01 TW-05598 (RM).; This work was funded by the following grant support: 5K08HD060739-04 (MDD).
• Keywords: FAMINE; Enteric disease; Science & Technology; GROWTH-RETARDATION; DISEASE; METABOLIC SYNDROME; LIFE; Malnutrition; IMPAIRED GLUCOSE-TOLERANCE; INCREASE RISK; CONSEQUENCES; Infection; Early origins of adult disease; PRENATAL EXPOSURE; Public, Environmental & Occupational Health; Metabolic syndrome; Life Sciences & Biomedicine; BLOOD-PRESSURE
• Research Categories: Health Sciences, Nutrition; Health Sciences, Medicine and Surgery; Health Sciences, Public Health

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.