Is There a Causal Link Between Antibiotic Exposure During Infancy and Risk for Obesity?

Abstract

In recent decades, obesity has surged to epidemic proportions in the developed world, and it has become crucial that obesity’s multifactorial pathophysiology be better understood, providing a means to prevent its increasing occurrence in children and adults.1 An initial observation, made in 2008, was that antibiotic use in infancy is associated with altered microbiota, possibly causing an increased risk for weight gain.2 Since then, numerous observational studies in which this hypothesis has been elucidated and 3 separate meta-analyses have been conducted, and authors have uniformly concluded that there is a weak but significant and positive association between exposure to antibiotics during infancy and weight gain during childhood.3–5 In this issue of Pediatrics , Block et al6 use an extensive database of 362 550 children to report results that are in agreement with the findings of 3 recent meta-analyses,3–5 further confirming a reported independent association between early-life antibiotics and greater weight. However, important questions remain: (1) Is there a causal relationship between early-life antibiotic use and future weight gain? (2) What is the clinical … Address correspondence to Antti Saari, MD, PhD, Department of Paediatrics, Kuopio University Hospital, PO Box 100, 70029 KYS, Finland. E-mail: antti.saari{at}kuh.fi