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Pediatrics

Antibiotic treatment during infancy and increased body mass index in boys: an international cross-sectional study

International Journal of Obesity volume 38, pages 1115–1119 (2014)Cite this article

Subjects

Abstract

Objective:

To investigate whether antibiotic exposure during the first year of life is associated with increased childhood body mass index (BMI).

Design:

Secondary analysis from a multi-centre, multi-country, cross-sectional study (The International Study of Asthma and Allergies in Childhood Phase Three).

Subjects:

A total of 74 946 children from 31 centres in 18 countries contributed data on antibiotic use in the first 12 months of life and current BMI.

Methods:

Parents/guardians of children aged 5–8 years completed questionnaires that included questions about their children’s current height and weight, and whether in the child’s first 12 months of life, they had received any antibiotics, paracetamol, were breastfed or the mother/female guardian smoked cigarettes, and whether the child had wheezed in the past 12 months. A general linear mixed model was used to determine the association of antibiotic exposure with BMI, adjusting for age, sex, centre, BMI measurement type (self-reported or measured), maternal smoking, breastfeeding, paracetamol use, gross national income and current wheeze.

Results:

There was a significant interaction between sex and early-life antibiotic exposure. Early-life antibiotic exposure was associated with increased childhood BMI in boys (+0.107 kg m−2, P<0.0001), but not in girls (−0.008 kg m−2, P=0.75) after controlling for age, centre and BMI measurement type. The association remained in boys (+0.104 kg m−2, P<0.0007), after adjustment for maternal smoking, breastfeeding, paracetamol use and current wheeze. There was no interaction between age, maternal smoking, breastfeeding, paracetamol use, gross national income and current wheeze in the association between early antibiotic exposure and BMI.

Conclusions:

Exposure to antibiotics during the first 12 months of life is associated with a small increase in BMI in boys aged 5–8 years in this large international cross-sectional survey. By inference this provides additional support for the importance of gut microbiota in modulating the risk of obesity, with a sex-specific effect.

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Acknowledgements

EA Mitchell and I Braithwaite are supported in part by Cure Kids. The authors would like to thank ISAAC Phase Three Principal Investigators and Regional and National Coordinators as listed.

Author information

Author notes

  1. A full list of the study group members is given in the Appendix.

Authors and Affiliations

  1. Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand

    R Murphy

  2. School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand

    A W Stewart

  3. Medical Research Institute of New Zealand, Newtown, New Zealand

    I Braithwaite & R Beasley

  4. Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Otago, New Zealand

    R J Hancox

  5. Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand

    E A Mitchell

Authors
  1. R Murphy
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  4. R Beasley
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Consortia

the ISAAC Phase Three Study Group

Corresponding author

Correspondence to R Murphy.

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Appendix

Appendix

ISAAC Steering Committee: N Aït-Khaled* (International Union Against Tuberculosis and Lung Diseases, Paris, France); HR Anderson (Division of Community Health Sciences, St Georges, University of London, London, UK); MI Asher (Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand); R Beasley* (Medical Research Institute of New Zealand, Wellington, New Zealand); B Björkstén* (Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden); B Brunekreef (Institute of Risk Assessment Science, Universiteit Utrecht, Netherlands); J Crane (Wellington Asthma Research Group, Wellington School of Medicine, New Zealand); P Ellwood (Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand); C Flohr (Department of Paediatric Allergy and Dermatology, St Johns Institute of Dermatology, St Thomas’ Hospital, London, UK); S Foliaki* (Centre for Public Health Research, Massey University, Wellington, New Zealand); F Forastiere (Department of Epidemiology, Local Health authority Rome, Italy); L García-Marcos (Respiratory Medicine and Allergy Units,‘Virgen de la Arrixaca’ University Children’s Hospital, University of Murcia, Spain); U Keil* (Institut für Epidemiologie und Sozialmedizin, Universität Münster, Germany); CKW Lai* (Department of Medicine and Therapeutics, The Chinese University of Hong Kong, SAR China); J Mallol* (Department of Paediatric Respiratory Medicine, University of Santiago de Chile, Chile); EA Mitchell (Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand); S Montefort* (Department of Medicine, University of Malta, Malta), J Odhiambo* (Centre Respiratory Diseases Research Unit, Kenya Medical Research Institute, Nairobi, Kenya); N Pearce (Department of Medical Statistics, Faculty Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK); CF Robertson (Murdoch Children’s Research Institute, Melbourne, Australia); AW Stewart (Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand); D Strachan (Division of Community Health Sciences, St Georges, University of London, London, UK); E von Mutius (Dr von Haunerschen Kinderklinik de Universität München, Germany); SK Weiland† (Institute of Epidemiology, University of Ulm, Germany); G Weinmayr (Institute of Epidemiology, University of Ulm, Germany); H Williams (Centre for Evidence Based Dermatology, Queen’s Medical Centre, University Hospital, Nottingham, UK); G Wong (Department of Paediatrics, Prince of Wales Hospital, Hong Kong, SAR China). *Regional Coordinators; †Deceased.

ISAAC International Data Centre: MI Asher, TO Clayton, E Ellwood, P Ellwood, EA Mitchell, Department of Paediatrics: Child and Youth Health, and AW Stewart, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.

ISAAC Principal Investigators: Belgium: J Weyler (Antwerp); Estonia: M-A Riikjärv* (Tallinn); Hungary: G Zsigmond* (Svábhegy); India: SN Mantri (Mumbai (29)); Indonesia: CB Kartasasmita (Bandung); Japan: H Odajima (Fukuoka); Lithuania: J Kudzyte* (Kaunas); Mexico: M Barragán-Meijueiro (Ciudad de México (3)), BE Del-Río-Navarro (Ciudad de México (1)), FJ Linares-Zapién (Toluca); Nigeria: BO Onadeko (Ibadan); Poland: A Brêborowicz (Poznan), G Lis* (Kraków); Portugal: C Nunes (Portimao); South Korea: H-B Lee* (Provincial Korea, Seoul); Spain: RM Busquets (Barcelona), I Carvajal-Urueña (Asturias), G García-Hernández (Madrid), L García-Marcos* (Cartagena), C González Díaz (Bilbao), A López-Silvarrey Varela (A Coruña), MM Morales-Suárez-Varela (Valencia); Sultanate of Oman: O Al-Rawas* (Al-Khod); Syrian Arab Republic: S Mohammad* (Tartous); Y Mohammad (Lattakia); Taiwan: J-L Huang* (Taipei); C-C Kao (Taoyuan); Thailand: M Trakultivakorn (Chiang Mai); P Vichyanond (Bangkok)*; Uruguay: MC Lapides (Paysandú). *National Coordinator.

ISAAC Phase Three National Coordinators not identified above: India: J Shah; Indonesia: K Baratawidjaja; Japan: S Nishima; Mexico: M Baeza-Bacab; Portugal: JE Rosado Pinto; Uruguay: D Holgado.

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Murphy, R., Stewart, A., Braithwaite, I. et al. Antibiotic treatment during infancy and increased body mass index in boys: an international cross-sectional study. Int J Obes 38, 1115–1119 (2014). https://doi.org/10.1038/ijo.2013.218

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