Abstract
BackgroundThe prevalence of obesity is increasing worldwide, and there is growing interest in better delineating the role of the human gut microbiome in this phenomenon. Obesity-specific gut microbiome features have been observed in both human and animal studies, and these variations appear to play a causative role in increasing body weight. There is evidence that antibiotics can modify the composition and diversity of the gut microbiome and that this may contribute to body weight changes. The primary objective of the proposed systematic review is to evaluate and synthesize the existing evidence evaluating the possible association between antibiotic use, weight gain, and obesity.MethodsA comprehensive search of the MEDLINE and EMBASE databases will be performed. Both randomized and non-randomized studies (excluding case reports) in neonates, children, adults, and pregnant women will be included. The exposure of interest is antibiotics of any type, duration, and route given for any indication. All included studies must have a comparator group. The primary outcomes are the development of overweight and obesity. Secondary outcomes are percent weight-change from baseline and change in body mass index or waist circumference. Additional secondary outcomes in pregnant women are gestational weight gain, postpartum weight retention, offspring birth weight, childhood weight, and obesity. Risk of bias of included trials will be performed. Two reviewers will screen and perform data extraction independently.DiscussionThis systematic review will summarize the existing evidence evaluating the association between antibiotic use, weight gain, and obesity and facilitate the identification of important gaps and uncertainties in the literature.Systematic review registrationPROSPERO CRD42017069177
Highlights
The prevalence of obesity is increasing worldwide, and there is growing interest in better delineating the role of the human gut microbiome in this phenomenon
It has been proposed that the variations in gut bacteria associated with obesity may promote increased energy extraction from food passing through the gut via increased production of short-chain fatty acids [14]
Descriptive results will be grouped based on characteristics of participants, and antibiotic exposure will be explored to further evaluate and understand the existing evidence
Summary
The prevalence of obesity is increasing worldwide, and there is growing interest in better delineating the role of the human gut microbiome in this phenomenon. Obesity-specific gut microbiome features have been observed in both human and animal studies, and these variations appear to play a causative role in increasing body weight. Higher numbers of bifidobacteria at age 6 and 12 months have been shown to be predictive of childhood overweight and obesity at 7 years of age [10] Evidence that these variations in gut bacteria profiles likely play a causal role in weight gain has been elucidated through fecal transplantation studies. It has been shown that adult C57BL/6J germ-free mice gain less weight with a high fat, sugarrich diet as compared to conventionally raised mice with an intact gut microbiome, further confirming that gut bacteria likely play a role in metabolism [13]. The metabolism of bile acids, and certain phospholipids and amino acids, have been described as factors that may mediate interactions between the microbiota and human metabolism [14]
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