Antibiotics’ childhood obesity link
Early, frequent use may alter bacteria mix in a baby’s gut, adding to risk, study shows.
Parents and pediatricians often reach for antibiotics to treat middle ear infections, strep throat, fevers and other common ailments of childhood. But new research suggests that doing so, and prescribing broad spectrum antibiotics in particular, increases those children’s risk of obesity, at least in early childhood.
A new study finds that babies who got broad-spectrum antibiotics in their first two years, or who were prescribed four or more courses of antibiotics in that period, were more likely to be obese at some point between their second and fifth birthdays than were those who had taken no antibiotics, or who were treated with medications designed to target a narrows pectrum of diseasecausing bacteria.
Broad- spectrum antibiotics — including amoxicillin, tetracycline, streptomycin, moxifloxacin and ciprofloxacin — are intended for treatment of major systemic infections, in cases where the bacteria causing the illness has not been identified, or where a patient is under attack by a strain of bacteria resistant to standard antibiotics. Though they can be highly effective, their antibiotic action is indiscriminate, and beneficial bacteria in the body are often killed off as collateral damage.
The latest study tapped the medical records of 64,580 babies and children in and around Philadelphia. It was published Monday in the journal JAMA Pediatrics.
The heightened risk of obesity linked to antibiotic use was not huge: Babies who got wide- spectrum antibiotics in their first two years were about 11% more likely to be obese between 2 and 5 than were those who got no such drugs.
Babies who had four or more courses of any antibiotics in the first two years were also 11% more likely to be obese in early childhood than those who’d had fewer exposures to antibiotics.
But among children who had four or more antibiotics prescriptions, including at least one wide-spectrum antibiotic, the risk of obesity rose to17%. And the earlier a baby’s exposure to wide spectrum antibiotic medications, the more likely he or she was, on average, to be obese between age 3 and 5.
The study’s findings add to mounting evidence that the mix of bacteria in the gut plays a potent role in obesity. A welter of research has shown that the diversity of the gut’s population of bacteria appears to confer protection from obesity, while an impoverished microbiotic environment in the gut has been linked to higher risk.
The new research suggests that very early childhood maybe a pivotal period in creating a rich and complex mix of microbiota in the gut — a condition that animal studies as well as epidemiological research have linked to reducedrisk of obesity. The gut microbiome is often the unintended victim of chronic exposure to antibiotics, and especially to wide-spectrum antibiotics.
The new research underscores that, for some, obesity may have origins in decisions made long before food preferences, eating habits and lifestyle decisions are developed or established.