ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2018) 15 15.4 | DOI: 10.1530/ey.15.15.4

ESPEYB15 15 Editor’s Choice Antibiotic exposure and obesity (1 abstracts)

15.4 Antibiotic Exposure in Early Life Increases Risk of Childhood Obesity: A Systematic Review and Meta-Analysis

Shao X , Ding X , Wang B , Li L , An X , Yao Q , Song R & Zhang JA


Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China


To read the full abstract: Front Endocrinol (Lausanne) 2017;8:170

Increasing sedentary behaviours and availability of high energy dense processed foods are the obvious culprits to explain the trends towards more overweight and obese populations around the world. However, we should remember that many other hypotheses are proposed, including higher ambient room temperatures due to central heating, shorter sleep duration, more stress, estrogenic environmental chemicals etc. Among these hypotheses, the possible role of early life antibiotic exposure is growing in credence due to increasing evidence on the gut microbiome as a plausible biological mechanism in obesity, as well as much individual-level data on this association, as is well summarised by Shao et al. in this systematic review and meta-analysis. The overall associations are statistically robust, without much heterogeneity between studies, and they even find a clear dose-response relationship with increasing courses of antibiotics. The main drawback is the reliance on observational data, which means that confounding is the main alternative explanation. It is easy to imagine that in many developed settings, families who demand antibiotics for their infants may be from more deprived backgrounds and/or make other unhealthy diet and lifestyle choices that promote obesity. Hence, evaluation of this association in other settings, where obesity shows different social patterns, would be extremely helpful.

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