Science Update

Antibiotic use before age 2 may increase risk of childhood obesity

According to new research published last Friday in Gastroenterology researchers found that administration of three or more courses of antibiotics before children reach the age of 2 years is associated with an increased risk of early childhood obesity.

Antibiotics have been used to promote weight gain in livestock for decades and this new research confirms that antibiotics have this same effect in humans. This does not mean antibiotics should not be used when necessary. However healthcare providers as well as parents must think about their usage in infants in the absence of confirmed indications.

In this study researchers conducted a large cohort study in the UK to assess the association between antibiotic exposure before the age of 2 and obesity at age 4 years. They found that children who had antibiotic exposure had a 25% increase in the risk of early childhood obesity. This risk proved to be strongest with repeated exposures to antibiotics.

This is another study that confirms how antibiotics alter the composition of the gut microbiome as well as its function predisposing children to obesity just like we see in livestock and animal models. There was a previous study published back in November which demonstrated how a single course of antibiotics could alter the gastrointestinal microbiome for up to one year.

Antibiotics are prescribed in approximately 49 million pediatric outpatient visits per year in the United States. Many of these antibiotics are prescribed without a clear indication although there is a stronger awareness of antibiotic resistance and other risks such as dermatologic and allergic concerns as well as increased risks of inflammatory bowel disease and autoimmune conditions.

If a patient is prescribed a course of antibiotics it is crucial that they concurrently take a probiotic such as Saccharomyces boulardii. This is a non-pathogenic yeast that protects the microbiome during antibiotic therapy. S. boulardii is protective to the intestinal epithelial cells and helps to maintain intestinal barrier function. It also increases SIgA secretion directly inhibits colonization of harmful bacteria and restores normal intestinal function in patients with diarrhea.

The growing levels of antibiotic resistance along with the exit of major pharmaceutical companies from antibiotic development make phage therapy another great treatment option for the rising number of untreatable infections. Phages have an 80 - 90 percent success rate against bacteria likely to show antibiotic resistance such as Escherichia coli.

In addition there are other options that should be considered including botanical extracts essential oils and silver that have long histories of antimicrobial properties while being relatively sparing to beneficial bacteria.

By Michael Jurgelewicz DC DACBN DCBCN

 

Source: Frank I. Scott Daniel B. Horton Ronac Mamtani Kevin Haynes David S. Goldberg Dale Y. Lee James D. Lewis. Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity. Gastroenterology 2016; DOI: 10.1053/j.gastro.2016.03.006