Association between paracetamol use in infancy or childhood with body mass index

Area of Science:

• Pediatric Health
• Epidemiology
• Pharmacology

Background:

• Paracetamol (acetaminophen) is a common medication for pain and fever.
• Emerging evidence suggests a potential indirect link between paracetamol and weight gain via cannabinoid receptor activation.
• The relationship between early-life or recent paracetamol exposure and body mass index (BMI) requires further investigation.

Purpose of the Study:

• To investigate the association between paracetamol use in the first 12 months of life or recent high use and BMI in children and adolescents.
• To explore potential differences in this association based on country affluence.

Main Methods:

• A large, multicentre, cross-sectional study involving over 76,000 children and 188,000 adolescents across multiple countries.
• Data collected on paracetamol use (early life and recent) and anthropometric measurements (height and weight).
• Linear regression models adjusted for various covariates including age, sex, country income, and maternal smoking.

Main Results:

• Early-life paracetamol exposure was associated with a small increase in BMI (+0.07 kg/m2) in children from affluent countries only.
• Frequent recent paracetamol use was linked to higher BMI (+0.17 kg/m2) in adolescents from affluent countries, but not in children.
• No significant association was found between early-life paracetamol exposure and BMI in children from non-affluent countries.

Conclusions:

• Paracetamol use may be associated with increased BMI, particularly in affluent settings.
• The observed association could be causal or explained by confounding lifestyle or environmental factors common in affluent countries.
• Further research is warranted to elucidate the potential causal mechanisms and confirm these findings.