New study suggests that repeated antibiotic use
could lead to higher BMI long term. Kids who receive
antibiotics throughout the course of their
childhoods gain weight significantly faster than
those who do not, according to new Johns Hopkins
Bloomberg School of Public Health research.
The findings, published online Oct. 21 in the
International Journal of Obesity, suggest that
antibiotics may have a compounding effect throughout
childhood on body mass index (BMI), a measure often
used to determine whether someone is at a healthy
weight.
“Your BMI may be forever altered by the antibiotics
you take as a child,” says study leader Brian S.
Schwartz, MD, MS, a professor in the Department of
Environmental Health Sciences at the Bloomberg
School. “Our data suggest that every time we give an
antibiotic to kids they gain weight faster over
time.”
For the study, Schwartz and his colleagues analyzed
Geisinger Health System’s electronic health records
on 163,820 children between three and 18 years old
from January 2001 to February 2012.
They examined body weight and height (which are used
to determine BMI) and antibiotic use in the previous
year as well as any earlier years for which
Geisinger had records for the children.
At age 15, children who had taken antibiotics seven
or more times during childhood weighed about three
pounds more than those who received no antibiotics,
they found.
Approximately 21 percent of the kids in the study,
or almost 30,000 children, had received seven or
more prescriptions during childhood. Schwartz says
that the weight gain among those frequently
prescribed antibiotics is likely an underestimate
since the children did not stay with Geisinger
throughout childhood so their lifetime antibiotic
histories, including antibiotic use outside the
health system, would not have been recorded and
because the effect of certain antibiotic types was
even stronger than the overall average.
“While the magnitude of the weight increase
attributable to antibiotics may be modest by the end
of childhood, our finding that the effects are
cumulative raises the possibility that these effects
continue and are compounded into adulthood,” he
says.
Scientists working with penicillin learned early on
that its byproducts caused weight gain in animals.
This led to the modern industrial farming techniques
of including small quantities of antibiotics in
daily animal feed to fatten up the animals in an
accelerated time frame. So a connection with weight
gain does make biological sense, Schwartz says.
In humans, meanwhile, there is growing evidence that
antibiotics could lead to weight gain because of the
effect that they have on what is known as the
microbiota, or the microorganisms that inhabit the
body.
There are 10 times more bacterial cells in the human
body than our own cells. Many of these bacteria do
their work in the gastrointestinal tract, helping
the body to digest food and absorb nutrients.
Antibiotics kill off harmful bacteria but also those
vital to gastrointestinal health.
Research has shown that repeated antibiotics use can
forever change the microbiota, altering the way it
breaks down food and increasing the calories of
nutrients absorbed. This, in turn, can increase
weight gain.
Prior studies had suggested that use in the youngest
children may cause weight gain, but this study shows
that use at any age during childhood contributes to
weight gain that accelerates with age.
“Systemic antibiotics should be avoided except when
strongly indicated,” Schwartz says. “From everything
we are learning, it is more important than ever for
physicians to be the gatekeepers and keep their
young patients from getting drugs that not only
won’t help them but may hurt them in the long run.”
“Antibiotic Use and Childhood Body Mass Index
Trajectory” was written by Brian S. Schwartz, MD,
MS; Jonathan Pollak, MPP; Lisa Bailey-David, DEd,
RD; Annemarie Hirsch, PhD, MPH; Sara Cosgrove, MD,
MS; Claudia Nau, PhD; Amii M. Kress, PhD, MPH;
Thomas A. Glass, PhD; and Karen Bandeen-Roche, PhD.
The study was supported by a grant from the National
Institutes of Health’s Eunice Kennedy Shriver
National Institute of Child Health & Human
Development (U54 HD-070725) and the Global Obesity
Prevention Center at the Johns Hopkins Bloomberg
School of Public Health.
For more information
Antibiotic use and childhood body mass index
trajectory
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