Childhood morbidity and health in early adulthood: Life course linkages in a high morbidity context

Abstract

This paper examines whether morbidity in early and later childhood is associated with health later in life. I investigate the relationship between five types of childhood morbidity and risk factors for cardiovascular disease among Guatemalan adults who experienced high levels of morbidity in childhood. The analysis is based on the Human Capital Study (2002)(2003)(2004), a recent follow-up of the INCAP Longitudinal Study conducted between 1969 and 1977. I find that most types of childhood morbidity are associated with poorer adult health, independent of family background, adult socioeconomic status, and health behaviors. Higher levels of infections in childhood were associated with a low level of high density lipoprotein (HDL), and higher level of triglycerides, plasma glucose, waist circumference, and obesity (but not hypertension). These results are consistent with the literature that finds that childhood morbidity is associated with increased morbidity and mortality at older ages. However, diarrheal disease in later childhood was associated with lower levels of some risk factors, as measured by triglycerides and plasma glucose, suggesting that exposure to bacteria after infancy may be beneficial for some measures of adult health.

Early childhood growth failure and the developmental origins of adult disease: do enteric infections and malnutrition increase risk for the metabolic syndrome?

“…As seen above, data from multiple approaches, including cross‐sectional and cohort studies among children and adults, begin to support a hypothesis that early childhood illness and malnutrition (resulting in low BMI at 2 years of age and stunting of height) increases risk for findings related to MetS, consistent with the early origins of adult disease paradigm (Figure 4). The relationship of these issues to enteric infections is further supported by the independent association of frequent diarrheal illness in early childhood with elevations in MetS‐related factors as adults 62,63 . Similarly, these associations involving low early‐childhood BMI in regions of the world where enteric diseases are endemic suggest further links between environmental enteropathies and future risk.…”

“…The relationship persisted, with similar ORs resulting after adjustment for individual factors that included birth weight, overall childhood morbidity and socioeconomic status, and adult socioeconomic status 62 . Similarly, the number of days with fever had an OR of 1.15 for having elevated triglycerides as adults 63 . Additionally, a higher burden of early childhood diarrhea was associated with modest increases in risk for elevated fasting glucose (OR 1.51), 62 low high‐density lipoprotein cholesterol (OR 1.06), 63 and abdominal obesity (OR 1.07) 63 in adulthood.…”

“…As mentioned previously, the changes in growth and weight gain in early childhood appear to be related to both systemic inflammation and poor absorption of nutrients. In addition to investigating the relationship between poor childhood growth and nutrition and future MetS, other researchers have examined the relationship between childhood illness and metabolic outcomes, including data from the Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study, a prospective study of nutrition and health in Guatemala 62,63 . One component of this study involved the monitoring of health and burden of illness in children <2 years and reassessment of the same individuals 25–35 years later.…”

The impoverished gut—a triple burden of diarrhoea, stunting and chronic disease

“…Follow-up of children in the Nutrition Institute of Central America and Panama (INCAP) revealed links between early childhood diarrhoea and low HDL cholesterol levels, elevated fasting glucose levels, and abdominal obesity in adulthood (aged 25–37 years). 94,95 Febrile illness in early childhood was also associated with an increased risk of low HDL cholesterol levels, high levels of tri glycerides and metabolic syndrome in adulthood at ages 25–42 years. 95 The association of diarrhoea frequency with adult CVD risk factors provides early evidence that childhood enteric infections have a direct link with adult CVD risk.…”

Daily sugar-sweetened beverage consumption and insulin resistance in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

“…IR in children and adolescents has been associated with CVD and metabolic disorders such as hypertension, dyslipidaemia, hepatic steatosis and endothelial dysfunction (6,7) . All of these risk factors can track into adulthood, increasing the risk of cardiovascular morbidity and mortality (8,9) . Therefore, it is important to determine factors associated with IR in order to design and implement appropriate preventive programmes.…”