Lifetime antimicrobial use associated with weight in early adolescence
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Increasing lifetime exposure to antimicrobial agents was associated with increasing likelihood for overweight and obesity among older children, according to a study published in Pediatric Obesity.
In addition, researchers observed a dose-response relationship between antimicrobial exposure and weight status in adolescence, with less exposure associated with underweight.
“It is suggested that antimicrobial-induced microbiome alterations may increase susceptibility to intestinal infections, immune-mediated diseases and dysregulation of metabolism, likely contributing to weight gain especially in children,” Rejane Augusta de Oliveira Figueiredo, PhD, of the faculty of medicine at University of Helsinki, and colleagues wrote. “Overweight and obesity are global health problems, and to date, in Finland, the combined prevalence in children is around 15%. The contribution of accumulated lifetime antimicrobial use for the obesity epidemic is yet to be determined.”
The researchers analyzed data from 1996 to 2014 on 10,093 children (mean age, 11.2 years; 52.5% girls) and 6,708 of their mothers from the Finnish Health in Teens cohort and compared the number of antimicrobial purchases at any given age with weight status in early adolescence.
Among the cohort, 73.7% of children had normal weight, 11.1% of children had underweight and 15.2% had overweight or obesity. Similar percentages were observed for their mothers. Antimicrobials were purchased at least once for 97.9% of the children, with 46% of children using an antimicrobial during their first year and 65% by age 2 years. The number of antimicrobial purchases dropped off after age 2 years.
Children with overweight and obesity had the greatest number of lifetime purchases of antimicrobial agents (12.55) compared with children with normal weight (10.43) and those with underweight (9; P .001). A similar pattern was observed for the mothers.
Greater lifetime antimicrobial use was associate with higher likelihood of having overweight or obesity in adolescence (OR = 1.02; 95% CI, 1.02-1.03) and lower likelihood of having underweight (OR = 0.98; 95% CI, 0.97-0.99). The associations were unaffected by intrauterine exposure to antimicrobial agents, according to the researchers.
“Previous studies have reported that the use of antimicrobials during the first 6 months and the first 2 years of life have long-term effects on weight gain and obesity in children, and our findings are in line with these results,” the researchers wrote. “However, we uncovered that the total antimicrobial use until age 14, which is considered as lifetime antimicrobial use in this context, was even more important predictor of overweight in adolescents than the early use.”
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