Antibiotic Exposure Linked to Excessive Weight Gain in Early Years
Recent studies have examined some drawbacks of antibiotic prescription in children. A study published in the JAMA Paediatrics reports, that use of broad-spectrum antibiotics in children under 2 years old is associated with increased risk of childhood obesity.
According to the World Health Organization (WHO), childhood obesity is one of the most serious global public health challenges for the 21st century. Obese children and adolescents are at an increased risk of developing various health problems, and are also more likely to become obese adults.
However, obesity is not simply a consequence of unhealthy lifestyle. Factors influencing childhood obesity include: maternal pre-pregnancy body mass index (BMI), nutritional intake, physical activity, sleep duration and screen time.
Recent evidence suggests that different gut bacteria may differently affect the growth of the host and antibiotic exposure influences the assortment and composition of gut-dwelling microbes, which in turn affects weight gain.
To demonstrate this, US researchers from the University of Pennsylvania and Bloomberg School of Public Health reviewed the health records of more than 64,500 American children between 2001 and 2013. The analysis included 64,580 children in total, who had annual visits at a clinic at the ages of 0-23 months, as well as one or more visits at ages 24-58 months. They were followed up until they reached five years of age. Of these children, 69% had received broad spectrum antibiotics before the age of 24 months, with an average of 2.3 antibiotic episodes per child. They found an increased risk of childhood obesity among the children, with antibiotic exposure, particularly who had been prescribed for four or more separate occasions.However, they were unable to find any correlation between obesity and use of narrow-spectrum antibiotics. The study reports the prevalence of overweight/obesity in the children across the study period:
- At 2 years – 10% obesity, 23% overweight
- At 3 years – 14% obesity, 30% overweight
- At 4 years – 15% obesity, 33% overweight
The researchers explain that, as obesity is a multi-factorial condition, reduction in prevalence depends on identifying and managing multiple risk factors, whose individual effects may be small but modifiable. The study shows that broad spectrum antibiotics usage before the age of 24 months may be one of the risk factors. Therefore limited antibiotic usage should be encouraged and inappropriate usage should be prohibited. At the same time, the parents are advised not to show reluctance to allow antibiotic use in their children.
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