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Obesity link to early antibiotics

Wednesday October 31st, 2018

Children who are given antibiotics and antacids in early life may face an increased risk of becoming obese, researchers warn today.

The US authors of the observational study say that these medicines may alter the microbiome in the gut.

British doctors gave the findings a cautious welcome, calling for further investigations.

The team led by Dr Christopher Stark of the William Beaumont Army Medical Center in Texas, USA, looked at the potential link because some drugs, including antibiotics, acid suppressants-histamine 2 receptor antagonists and proton pump inhibitors can alter the balance of gut of bacteria.

In the BMJ journal Gut today (31 October) the team outline their study of medicines prescribed to 333,353 infants up to the age of two years. This information was recorded in the US Military Health System database.

Just under three-quarters of the children had been prescribed an antibiotic, about 12 per cent were given an acid suppressants-histamine 2 receptor antagonist, and three per cent a proton pump inhibitor.

The overall obesity rate by three years of age was 14 per cent, and this group was more likely to be male, born by caesarean, and have parents below officer rank.

Being given one of the three types of prescription was linked with a raised risk of obesity. The rate was highest for antibiotics, at 26 per cent higher than for children who did not take them, regardless of the type of antibiotic prescribed.

However, the researchers point out that the many influential factors were not measured, and they highlight "the current difficulty of drawing clear conclusions about the interplay between exposure history, gut microbiota and propensity to develop obesity."

Nevertheless, they believe: "There is an important therapeutic role for microbiota-altering medications. The long term risks to health must be weighed against the short-term benefits."

Dr Max Davie, of the UK Royal College of Paediatrics and Child Health, 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.”

Royal College of GPs chair Professor Helen Stokes-Lampard added: “This new study, linking antibiotic and antacid use with obesity, is extremely interesting, but does not prove causation. As such, it is very important that more research is conducted in this area, and that as further high-quality evidence emerges, it is taken into account as new clinical guidelines are updated and developed.

“People whose children have already been prescribed these medications should certainly not stop them on the basis of this research.”

Stark, C. M. et al. Antibiotic and acid-suppression medications during early childhood are associated with obesity. Gut 31 October 2018

http://gut.bmj.com/lookup/doi/10.1136/gutjnl-2017-314971

Tags: Child Health | Diet & Food | Gastroenterology | North America | Pharmaceuticals | UK News

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