childhood obesity

Researchers clarify the factor underlying the risk for childhood obesity.


Childhood obesity has become a public health crisis around the world. And with the rapid rise of childhood obesity, international organizations have conducted research on the factors underlying its risk.

Past studies have linked childhood obesity to antibiotic use in infancy. However, these studies did not clarify whether the risk of childhood obesity was due to the antibiotics themselves, or the underlying infections that the antibiotics were treating.

Researchers cannot act prematurely and discourage clinicians and parents from using antibiotics on infants for fear of obesity risk before disentangling the question: is the risk for childhood obesity linked to antibiotic use or an underlying infection in infancy? A recently published study in The Lancet sought to clarify this uncertainty.

For this study, researchers included a total of 260, 556 infants born between January 1, 1997, and March 31, 2013, and part of the Kaiser Permanente Northern California (KPNC), an integrated, managed care consortium.

The researchers used KPNC electronic medical records to obtain information on all infections diagnosed in infancy. These medical records also included information on clinical diagnoses, hospital admissions, and telephone consultations, among others. KPNC’s pharmacy database also keeps data on all prescription medications as well as prescription dates, doses, and daily amount. Through the KPNC database, they also obtained weight and height measurements from birth with up to 18 years of follow-up. This material allowed researchers to examine the effect of infection and antibiotic use in infancy on obesity throughout childhood, puberty, and adolescence – something that previous studies were not able to do because of their relatively short follow-up time.

After obtaining data, the researchers divided the participants into three groups:

  • Individuals with untreated infection (those diagnosed with infection but did not have a prescription)
  • Antibiotic users (those diagnosed with an infection and have prescribed antibiotics)
  • Unexposed controls (those without an infection or antibiotic use and have not been exposed to infections)

Of the total 260, 556 participants, 77, 889 had untreated infection, 138, 417 were antibiotic users, and 44, 250 neither had an infection nor used antibiotics.

The study found that treating infections with antibiotics in infancy was not associated with a risk of childhood obesity. However, they did find that infection alone – without exposure to antibiotics – was associated with an increased risk of childhood obesity. This finding was supported by a clear dose-response association between the number of infection episodes and obesity risk. Further, they found that the three most common types of infection during infancy were: respiratory infections, otitis media, and specific bacterial infections.

The authors of the study note that these findings do not rule out the potential effect of antibiotics on obesity risk if the antibiotics are used in infants without infection. However, the findings do suggest that when they are used to treat infections, antibiotic use in infancy is not a main contributor to childhood obesity. Clinicians and parents should always be judicious in using antibiotics on infants, but the benefits of treating infections seem to outweigh the possible risk.


Written By: Jessica Gelar, HBSc

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