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ts and show value in studying this biological mechanism in future trials.Trial Registration Clinical Trials identifier NCT02888600. Poor mental health in childhood is associated with a greater risk of cardiometabolic disease in adulthood, but less is known about when these associations begin to emerge. This study tests whether poor mental health (indexed by emotional and behavioral problems) in early childhood predicts increases in cardiometabolic dysregulation over 4 years of follow-up. Data are from 4327 participants in the Generation R