Exposure to Early Childhood Antacids and Antibiotic Use is Linked to Obesity

Written by Joyce Smith, BS. This study quantifies the potential long-term risk of obesity associated with early exposure to acid-suppressing medications and antibiotics.

Obesity related health issues are becoming more prevalent in children today ¹. The absence of a healthy diet and adequate exercise, both of which are modifiable risk factors, play heavily into the existing obesity epidemic affecting our children ². Gut microbiome disbiosis brought on by the use of commonly prescribed medications, may selectively promote or inhibit the growth of specific bacteria ³. In particular, the use of gastric acid -suppressing drugs can alter the pH of the GI tract while antibiotics can destroy healthy bacterial inhabitants ^4,5, thus causing long-term changes in indigenous gut microbiota ⁶. American farmers for some time now have exploited antibiotic use, fattening young livestock with antibiotics to accelerate growth and obesity ⁷. The role of exposure to microbiota-altering medications and the development of childhood obesity has not been well-studied and remains unclear; thus necessitating the need for further investigation ⁸.

Acting on the hypothesis that children who are exposed to microbiota-altering medications in the first 2 years of life are more likely to develop obesity later in life researchers collected data ⁹ on the prescription medicines prescribed to 333,353 infants whose medical records during the first two years of their lives were entered into the US Military Health System database between the years 2006 and 2013.Analysis of their data revealed the following:

• Of the 333,353 infants, 241,502 (72.5%) were prescribed an antibiotic; 39,488 (8%) and histamine-2-receptor antagonist (H2RA) H2RA; and 11,089 (3.3%) received a proton-pump inhibitor (PPI) during this period. Some 5,868 children were prescribed all three types of drug.
• Prescriptions to H2RAs, PPIs and antibiotics all increased the risk of developing obesity with each additional class of medication prescribed.
• A prescription for antibiotics was associated with a 26 % heightened risk of obesity. The association persisted irrespective of antibiotic type and was strengthened with each additional class of antibiotic prescribed.
• H2RAs heightened the obesity risk, although to a lesser extent, and this association was strengthened for each 30-day supply prescribed.
• Males who were born via caesarian section had an increased risk of developing obesity.
• Children born to junior and senior enlisted service members had increased obesity risk compared to higher-ranking officers possibly due to the differences in socioeconomic rank.

Although a very large study, it is nevertheless an observational one, and can, therefore, not establish cause. Potentially valuable information on mothers’ health status was lacking such as weight, smoking status and underlying health conditions. There was also a potential miscalculation of caesarean and premature births, whether treatment courses of antibiotics were completed and whether all dispensed medications were accounted for in the analyzed data. This study highlights the complex interaction between gut microbiota and antibiotics, H2RAs and PPI’s which exacerbates the difficulty in drawing definitive conclusions regarding an association between gut microbiota and obesity development. While there is an important therapeutic role for microbiota-altering medications, their long-term health risks must be diligently weighed against their short-term benefits so that over-prescribing of antibiotics and antacid medications does not occur.

Source: Stark, Christopher M., Apryl Susi, Jill Emerick, and Cade M. Nylund. “Antibiotic and acid-suppression medications during early childhood are associated with obesity.” Gut 68, no. 1 (2019): 62-69.

© Author(s) (or their employer(s)) 2019. No commercial re-use.

Posted October 20, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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