Childhood use of antibiotics and antacids linked to heightened obesity risk

02 Nov 2018 --- The gut microbiome has been linked to various aspects of human health, including obesity. Researchers at Walter Reed National Military Medical Center have now found that certain drugs, such as antibiotics, acid suppressants-histamine 2 receptor antagonists (H2RA) and proton pump inhibitors (PPIs), can alter the type and volume of bacteria in the gut. These medications, which are often over-prescribed in children, may have significant negative effects on health that were previously underappreciated, the researchers note.

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 percent) had been prescribed an antibiotic; 39,488 (just under 12 percent) an H2RA; and 11,089 (just over 3 percent) a PPI during this period. Some 5868 children were prescribed all three types of drug. Some 46,993 (just over 14 percent) children became obese, of whom 9628 (11 percent) had not been prescribed any antibiotics or acid suppressants.

Boys, those born after a cesarean section, and those whose parents were below officer rank were more likely to become obese.

However, 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--the average age at which obesity was first identified in these children.

A prescription for antibiotics was associated with a 26 percent heightened risk of obesity. This association persisted, irrespective of antibiotic type, and strengthened with each additional class of antibiotic prescribed.

Acid suppressants were also associated with a heightened obesity risk, although to a lesser extent, and this association strengthened for each 30-day supply prescribed.

Although the largest study of its kind, it is nevertheless observational, and as such, can't establish the cause. 

“Variables that were unmeasured within our study, such as maternal obesity or infant breastfeeding status, are significant factors in the growth and development of young children. These unmeasured variables and their interaction with other early exposures are avenues for future research projects,” Dr. Nylund, from the Walter Reed National Military Medical Center, tells NutritionInsight.

“Human health and gut bacteria have a complex relationship that is not fully understood. At this time there is no clear scientific consensus on the ideal gut bacterial profile. The nutrition and health industry should push toward data-driven, evidence-based treatments that meet high safety standards prior to marketing microbial supplements to consumers,” he adds.

Further research is needed into the role of probiotics and whether they play a protective role. Additionally, studies of types of bacterial colonies that dominate pre- and post- medication exposure would offer valuable insight into a potential mechanism for our observed association.

Additional reporting by Lucy Gunn and Laxmi Haigh