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Early-life antibiotic use and children with overweight and obesity: a Dutch twin cohort study

Rosa S Feil1, Elise M A Slob2,3,4, Jenny van Dongen5,6,7

  • 1Department of Pulmonary Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.

International Journal of Obesity (2005)
|July 15, 2026
PubMed

Insights

Early antibiotic use in children does not appear to increase the risk of developing obesity. This study found no association between antibiotic exposure before age two and childhood overweight or obesity.

Area of Science:

  • Pediatric Health
  • Public Health
  • Microbiome Research

Background:

  • Childhood obesity is a growing public health concern with long-term health implications.
  • Early-life antibiotic exposure can alter gut microbiota, potentially influencing metabolic health and obesity risk.

Purpose of the Study:

  • To investigate the association between early-life antibiotic use and the risk of childhood overweight and obesity.
  • To control for genetic and environmental factors using a co-twin control design.

Main Methods:

  • Retrospective analysis of 34,142 twins from the Netherlands Twin Register (ages 4.5-15.4 years).
  • Assessed antibiotic use before age 2 and childhood overweight/obesity status.
  • Utilized a co-twin control design, adjusting for multiple covariates including sex, birth factors, breastfeeding, and parental characteristics.

Main Results:

  • No significant association was found between early-life antibiotic use and the risk of obesity (OR 0.82) or overweight/obesity (OR 1.00).
  • Co-twin analyses yielded similar null results, indicating no increased risk.
  • Body Mass Index (BMI) Z-scores did not differ between children with and without early antibiotic exposure.

Conclusions:

  • Early-life antibiotic use is not associated with an increased risk of developing overweight or obesity in childhood.
  • Findings suggest that other factors may play a more significant role in the development of childhood obesity.
  • Further research may explore specific microbial pathways or other early-life exposures in relation to obesity.

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