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Do Antibiotics Make People Fat?

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The obesity epidemic is rampant, and there are many reasons for this big fat problem. Although asking if antibiotics make us fat may initially sound like some type of joke, recent articles in Scientific American and Science magazine shows that some researchers are taking it seriously.

Actually, evidence suggesting that antibiotics may make people fat is old (but forgotten and ignored) knowledge. As far back as 1955, research published in a leading nutrition journal showed that weight gain may be linked to prolonged antibiotic usage.(1)

It is well-known that farmers supply livestock with frequent doses of antibiotics in the guise of "preventing disease," but it is also widely known that prolonged antibiotic usage causes such disruption in the digestive tracts of these animals that the food that they eat is not properly assimilated, leading to significant weight gain. Normal bacteria in the gut help animals (and humans) metabolize fat, but the deficiency of these normal bacteria, caused by antibiotic usage, disrupts proper fat metabolism, leading to weight gain. The farmers benefit from being able to sell fatter and heavier meat, even though meat quality is significantly compromised.

An article in the December 16, 2009, issue of Scientific American expresses serious concern that antibiotics kill off many important microbes essential for human life.(2) The Scientific American has even chosen the word "extinction" to refer to the disappearance of certain important bacteria that are killed off by antibiotics.

This article reports some impacts from antibiotic usage are short term, but other impacts are much more long-lasting and deleterious. Martin Blaser, a professor of microbiology and chair of the Department of Medicine at New York University Langone Medical Center in New York City, notes, "the [antibiotic resistance] selection can persist for years and possibly permanently." The gastric Helicobacter pylori bacteria (commonly referred to as "H. pylori"), for example, have been facing eradication in the U.S. and other developed countries in large part as a result of widespread antibiotic use. Although the demise of these bacteria has some medical benefits, including a decrease in the incidence of ulcers and gastric cancer, its reduced population can also increase the risk for various reflux diseases by upsetting the regulation of hormones and pH levels.

However, even more serious problems result from killing off of the H. pylori.
Blaser and Stanley Falkow, of the Department of Microbiology and Immunology at Stanford School of Medicine, note, "H. pylori-positive individuals have lower risks of childhood asthma, allergic rhinitis and skin allergies than those without H. pylori." These scientists also posited that the bacteria's role in mediating the hormone ghrelin, which helps regulate fat development and hunger, might also "be contributing to the current epidemics of early-life obesity, type 2 diabetes and related metabolic syndromes."

Blaser wonders, "If [H. pylori is] disappearing...might there be other things that are disappearing?" He worries that many other, less well-known or understood microbial species and even certain metabolic pathways might also be on their way out due to antibiotic use.

Science magazine has just published on March 4, 2010, other important research that observed similar phenomena as Blaser.(3) Researchers at Cornell, Emory, and the University of Colorado have found that gut microbiota determines how food is digested and fat is stored in the body. They too noted that antibiotics disrupt certain bacteria in the gut that can lead to obesity as well as to increased inflammatory processes that can cause metabolic syndrome, a serious condition that can lead to high blood pressure, high cholesterol levels, and a higher risk for developing diabetes and heart disease.

The uniquely American obsession with eradicating germs is also creating other problems, not just obesity. A study published in the December 9, 2009, issue of the journal Proceedings of the Royal Society B: Biological Sciences, is the first to investigate whether microbial exposures early in life affect inflammatory processes related to diseases in adulthood.(4) Remarkably, the Northwestern study suggests exposure to infectious microbes in childhood may actually protect youngsters from developing serious illnesses, including cardiovascular diseases, when they grow into adults.

"Contrary to assumptions related to earlier studies, our research suggests that ultra-clean, ultra-hygienic environments early in life may contribute to higher levels of inflammation as an adult, which in turn increases risks for a wide range of diseases," Thomas McDade, lead author of the study.

"Medication-related weight gain has become far more important over the past decade as obesity increases in prevalence and more people are taking medications for chronic illnesses,"(5) says Lawrence Cheskin, M.D., Director of the Johns Hopkins Weight Management Center.

Ultimately, microbial flora in the digestive tract plays a role in converting nutrients into calories. Reduced variations in microbiota composition are found in obese humans and mice.

Didier Raoult, MD, PhD, full professor at Marseille School of Medicine, has found that the microbiota from an obese mouse confers an obese trait when transferred to a mouse.(6) Dr. Raoult further asserts that there is a large body of experimental evidence and empirical data in the food industry showing that both antibiotics, which modify the gut microbiota, can act as growth promoters, increasing the size and weight of animals. He therefore concludes that the current obesity pandemic in human may be caused, in part, by antibiotic treatments.

This review of the literature on antibiotics and weight gain does not necessarily mean that a single round of antibiotics will make someone fat. However, it is increasingly common for people to take multiple rounds of antibiotics for recurrent infections and long-term usage of antibiotics to treat acne and various other diseases, such as Lyme Disease. It may be to question what short-term and long-term problems result from repeated antibiotic usage.

While repeated courses of antibiotics may sometimes lead to weight gain, there is also a case that can be made that some people experience deleterious weight loss as a result of diarrhea caused by antibiotics. This type of weight loss is rarely considered beneficial to the person's health because many important nutrients are excreted with the diarrhea, and this weight loss may be just as deleterious to the person's health as weight gain can.

In any case, antibiotics kill off the pathogenic bacteria as well as many of the important and beneficial bacteria in our bodies. Because health depends upon a complex web of life, pharmaceutical agents such as antibiotics that simplify this inner ecosystem weaken the web, thereby creating a wide variety of possible acute and chronic diseases. Even many serious diseases, such as breast cancer, have been found to have significantly increased incidence based on the degrees of higher usage of these drugs. (7) It is indeed important and even vital for health that people respect inner microbial life and reduce antibiotic usage.

Considering Alternatives to Antibiotics

Ultimately, health and medical professionals as well as the general public have to consider using various alternatives to antibiotics whenever possible. The good news is that we will ALL benefit from such actions, and further, that there IS a body of evidence to show that some alternatives are effective. When skeptics say that there is no evidence that alternative or homeopathic treatments are effective for infectious diseases, they are simply showing their ignorance of history and of modern clinical research (sadly, this ignorance does not seem to stop some skeptics, who I prefer to call "deniers", from trying to provide misinformation).

A little known fact of history is that the primary reason that homeopathic medicine became so popular in the 19th century was its remarkable results in treating people suffering from the infectious disease epidemics that raged at the time.(8)(9) Epidemics of cholera, scarlet fever, typhoid, and yellow fever were rampant and killed large numbers of people who became ill with them. And yet, death rates in homeopathic hospitals were commonly one-half or even one-eighth of the death rates in the conventional medical hospitals (at the turn of the 20th century, there were over 100 homeopathic hospitals in the US, at least one in every large population center).

Today, the American Academy of Pediatrics and the American Academy of Family Physicians no longer recommend antibiotics as routine when treating children with an ear infection.(10) In fact, they assert that a viable option is to AVOID ANTIMICROBIAL AGENTS during the first 72 hours. Because ear infections represent the most common reason that children seek medical attention, knowing about the alternatives to antibiotic usage is essential.

A randomized, double-blind, placebo-controlled study prescribed individualized homeopathic medicines or placebo to 75 children.(11) There were 19.9 percent more treatment failures in children given a placebo. Diary scores showed a significant decrease in symptoms at 24 and 64 hours after treatment in favor of those given a homeopathic medicine. What was particularly impressive about these results was that improvement from homeopathic medicines occurred rapidly, within the first day of treatment.

Another study that also provided evidence of rapid resolution of ear infection in children given a homeopathic medicine was a trial of 230 children.(12) These children were given an individually chosen homeopathic medicine. If pain reduction was not sufficient after just six hours, another individually-chosen homeopathic medicine was prescribed. The researchers found that 39 percent of patients experienced sufficient pain reduction in the first six hours and another 33 percent after just 12 hours. This improvement was 2.4 times faster than in children prescribed a placebo (the speed of improvement for patients given a placebo was determined by an earlier meta-analysis of those children given a placebo in a conventional medical treatment trial).

A study was conducted with 499 children between 18 months and four years of age who had had at least five bouts of acute rhinopharyngitis (cold and sore throat) in 1999 and who had consulted a physician in 2000 either for preventive treatment or for treatment of a current episode.(13) A post-hoc analysis was conducted of these children, 268 of whom were treated by a homeopathic MD and 231 who were treated by a non-homeopathic MD. The researchers evaluated the children who had received at least one homeopathic medicine but no antibiotics and compared them with those children who were treated with antibiotics but no homeopathic medicines.

The researchers found that the children prescribed a homeopathic medicine were significantly more likely to experience a positive result of treatment compared with those children prescribed an antibiotic (the number of episodes of acute rhinopharyngitis: 2.71 vs. 3.97, P<0.001). The researchers also found that the children given a homeopathic medicine had significantly fewer complications and a higher quality of life. Further, the study found that the parents of the children given the homeopathic medicine had significantly less sick-leave days than the parents of children given an antibiotic (9.5 percent vs. 31.6 percent; P<0.001).

Research has also shown that homeopathic medicines can be real lifesavers for people with serious, even life-threatening infections, such as severe sepsis. The incidence of severe sepsis in the United States is between 70,000 to 300,000 patients per year. Septic shock often leads to death in-between 40 percent -- 90 percent of cases.

At a University of Vienna hospital, 70 patients with severe sepsis were enrolled in a randomized double-blind, placebo-controlled clinical trial, measuring survival rates at 30 days and at 180 days.(14) Those patients given a homeopathic medicine were prescribed it in the 200C potency only (in 12 hour intervals during their hospital stay). The survival rate at day 30 was 81.8 percent for homeopathic patients and 67.7percent for those given a placebo. At day 180, 75.8 percent of homeopathic patients survived but only 50.0 percent of the placebo patients survived (p=0.043). One patient was saved for every four who were treated.

The researchers concluded that homeopathy may be a useful addition with long-term benefit for severely septic patients.

Today's medicine needs alternatives to antibiotic treatment and, more than ever, we need an integrative model of medicine that brings together of best of conventional medicine and with the variety of natural therapeutic interventions. Welcome to the 21st century!

References:

(1) Haight T, Pierce W. Effect of Prolonged Antibiotic Administration on the Weight of Healthy Young Males. Journal of Nutrition. May 1955, Volume 56, Issue 1. http://jn.nutrition.org/cgi/reprint/56/1/151.pdf

(2) Harmon K. Bugs Inside: What Happens When the Microbes That Keep Us Healthy Disappear? Scientific American, December 16, 2009. http://www.scientificamerican.com/article.cfm?id=human-microbiome-change

(3) Vijay-Kumar et al. Metabolic Syndrome and Altered Gut Microbiota in Mice Lacking Toll-Like Receptor-5. Science 4 March 2010: science.1179721v1-1179721
DOI: 10.1126/science.1179721. Reported in: Park A. A Hidden Trigger of Obesity: Intestinal Bugs. Time. March 5, 2010. http://www.time.com/time/health/article/0,8599,1969807,00.htm

(4) McDade T. Early Origins of Inflammation: Microbial Exposures in Infancy Predict Lower Levels of C-reactive Protein in Adulthood," Proceedings of the Royal Society B: Biological Sciences. December 9, 2009. http://www.northwestern.edu/newscenter/stories/2009/12/germs.html

(5) http://www.johnshopkinshealthalerts.com/alerts/prescription_drugs/JohnsHopkinsPrescriptionsDrugsHealthAlert_656-1.html

(6) Raoult D. Obesity pandemics and the modification of digestive bacterial flora.
European Journal of Clinical Microbiology & Infectious Diseases. 27, 8(August, 2008): 631-4.

(7) Velicer CM, Heckbert SR, Lampe JW, Potter JD, Robertson CA, Taplin SH. Antibiotic use in relation to the risk of breast cancer. JAMA. 2004 Feb 18;291(7):827-35. http://www.ncbi.nlm.nih.gov/pubmed/14970061

(8) Bradford TL, The logic of figures: The comparative results of homeopathic and other treatments. Philadelphia: Boericke and Tafel, 1900.

(9) Coulter H.L., Divided Legacy (vol. II, III). Berkeley: North Atlantic, 1975, 1977.

(10) http://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1451#SEC10

(11) Jacobs, J, Springer, DA, Crothers, D, "Homeopathic Treatment of Acute Otitis Media in Children: A Preliminary Randomized Placebo-controlled Trial," Pediatric Infectious Disease Journal, 20,2 (February 2001):177-183.

(12) Frei, H, and Thurneysen, A, "Homeopathy in Acute Otitis Media in Children: Treatment Effect or Spontaneous Resolution?" British Homeopathic Journal, October, 2001,90:180-182.

(13) Trichard, M, Chaufferin, Nicoloyannis, N., Pharmacoeconomic Comparison Between Homeopathic and Antibiotic Treatment Strategies in Recurrent Acute Rhinopharyngitis in Children, Homeopathy (2005)94, 3-9.

(14) Frass M, Linkesch, M, Banjya, S, et al. Adjunctive homeopathic treatment in patients with severe sepsis: a randomized, double-blind, placebo-controlled trial in an intensive care unit. Homeopathy 2005:94;75-80.

Dana Ullman, MPH, is America's leading spokesperson for homeopathy and is the founder of www.homeopathic.com. He is the author of 10 books, including his bestseller, Everybody's Guide to Homeopathic Medicines. His most recent book is, The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy. Dana lives, practices, and writes from Berkeley, California. Dana has just returned from speaking on homeopathy at the American Medical Students Association's national conference.

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