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Objective: Childhood food insufficiency is associated with poor physical health and psychosocial development in children, but less is known about long-term health implications. The objective of this study was to elucidate the association of childhood food insufficiency with cardiometabolic risk factors and health outcomes in later life among a sample of elderly adults.Methods: We conducted cross-sectional analysis of data from the Puerto Rican Elderly: Health Conditions Project (n=2,712), a longitudinal, population-based sample of elderly adults (>60 y) living in Puerto Rico. Participants reported childhood food insufficiency at wave 2. Prevalence of cardiometabolic health outcomes was self-reported at wave 1 or 2, and included hypertension, diabetes, and cardiovascular disease (heart attack, heart disease, and stroke). Obesity was assessed at wave 2 using objective measurements. Multivariate-adjusted complex survey logistic regression models tested the associations of childhood food insufficiency with each condition, as well as with total number of cardiometabolic conditions (0-6).Findings: Nearly a third (31.8%) of the sample reported childhood food insufficiency; 71.0% reported hypertension, 33.0% reported diabetes, 34.3% reported cardiovascular disease, and 29.5% had obesity. Over half (55.2%) had two or more cardiometabolic conditions. In models adjusted for age, sex, childhood socioeconomics and health factors, and current socioeconomic status and smoking status (current/former/never), childhood food insufficiency was associated with increased odds of hypertension (Odds Ratio (OR), 95% Confidence Intervals (CI): 1.65 (1.03, 2.63)) and of having 1 (2.52 (1.36, 4.67)), 2 (2.38 (1.35, 4.20)), or 3 or more (2.36 (1.34, 4.17)) cardiometabolic conditions compared to no cardiometabolic conditions. Childhood food insufficiency was not significantly associated with cardiovascular disease (1.19 (0.82, 1.74)), diabetes (1.33 (0.92, 1.93)), or obesity (0.82 (0.54, 1.26)).Conclusions: Childhood food insufficiency may increase the likelihood of having hypertension or multiple cardiometabolic conditions in adulthood, independent from socioeconomic factors. Creating strategies to prevent and reduce food insufficiency in childhood may be a way to prevent eventual cardiovascular-related diseases.