Young children prescribed antibiotics and, to a lesser extent, drugs to curb excess stomach acid, may be at heightened risk of obesity, suggests research published online in the journal Gut.
These drugs, particularly if taken for lengthy periods, may alter gut microbes that have been associated with weight gain, explain the researchers.
To try to find out if exposure to these drugs in early childhood might increase the risk of obesity, the researchers looked at the medicines prescribed to 333,353 infants, whose medical records had been input into the US Military Health System database between 2006 and 2013 in the first two years of their lives.
In all, 241, 502 (72.5%) had been prescribed an antibiotic; 39,488 (just under 12%) an H2RA (H2 receptor antagonist); and 11,089 (just over 3%) a PPI (proton pump inhibitor) during this period. 5,868 children were prescribed all three types of drug. 46,993 (just over 14%) children became obese, of whom 9,628 (11%) had not been prescribed any antibiotics or acid suppressants.
Boys born after a caesarean section and boys whose parents were below officer rank were more likely to become obese.
But after taking account of potentially influential factors, a prescription for antibiotics or acid suppressants was associated with a heightened risk of obesity by the age of 3 years, the average age at which obesity was first identified in these children.
A prescription for antibiotics was associated with a 26% heightened risk of obesity. This association persisted, irrespective of antibiotic type, and strengthened with each additional class of antibiotic prescribed.
Responding to the paper, Dr Max Davie, Officer for Health Promotion for the Royal College of Paediatrics and Child Health (RCPCH), said:
Although this is reported as the largest study of its kind, it has got its limitations - it is observational and so you can’t establish cause, information about the mother’s weight, whether they smoked or had other underlying conditions aren’t available and there are complex links between the environment and obesity that need to be taken into account. That said, childhood obesity levels in the UK are at crisis point with one in three children overweight or obese by the time they leave primary school. We are also battling antibiotic resistance so any avoidable doses throughout the life course would be beneficial to the cause. We therefore need to acknowledge these findings and would welcome further review.
In the meantime, children who are obese must receive tailored support to help them return to a healthy weight. We therefore call on the government to ensure specialist obesity services are appropriately funded to prevent obese children today becoming obese adults in future.