A-Z Index × Submit A-Z Index × Submit A-Z Index Search Dropdown × Submit Facebook Twitter LinkedIn Syndicate Emerging Infectious Disease journal ISSN: 1080-6059 Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
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Chronic obesity is a growing public health threat in the United States; >40% of adults are affected. We retrospectively assessed the frequency of medically attended infection in infants born during 2008–2012 relative to absolute weight and body mass index outcomes at age 4–6 years of age and 10–15 years of age. Multivariable regression revealed those with early clinical infection had higher rates of obesity at 4–6 years and 10–15 years than those without, proportional to the number of infections diagnosed and corresponding to significant weight increases. Compared with infants whose infections were not treated with antimicrobial drugs, treatment was less predictive of weight outcomes. Most infections were viral. Our investigation found a correlation between infections diagnosed in infancy and later weight outcomes, but we could not determine the cause.
Obesity is a major public health threat in the United States; >40% adults are affected, and obesity is a risk factor for chronic diseases such as diabetes and heart disease ( 1 ). Obesity itself is also recognized as a chronic disease that has a cumulative relation to mortality that is especially marked when starting earlier in life ( 2 – 4 ) or prolonged over a decade ( 5 ). Childhood obesity is a growing problem; ≈1 in 5 children and adolescents are now obese ( 6 ), and adolescent obesity frequently leads to adult obesity. Chronic obesity, although traditionally thought of as a condition of choice, is socioeconomically, genetically, and biologically driven, with complicated and multifactorial roots emphasized in US medical practice guidelines ( 7 ). Infections are well-established drivers of other chronic diseases, and a well-recognized link between infections and long-term weight loss (e.g., tuberculosis, parasites) belies a less self-explanatory link between early viral infection and long-term weight gain and obesity, observed in the United States and globally.
This link between infection and long-term weight gain was observed in a longitudinal prospective study of in the Philippines ( 8 ) observed from infancy. The participants in that study were followed under the hypothesis that early infections and other adverse conditions in infancy and early childhood would be correlated with long-term decreased weight relative to uninfected patients, but a correlation of prospectively reported early upper respiratory infections with long-term increase in body mass index (BMI) as adults was observed. Infection-related antimicrobial drug exposure was a possible explanation for the increased BMI finding. The study did not control for antimicrobial drug use, and antimicrobial drugs have been associated with weight gain and obesity ( 9 – 12 ). However, a subsequent large retrospective study in the United States revealed early antimicrobial drug exposure to be a proxy for early infection and association with obesity, rather than the opposite. Medically attended infections in infancy, defined as infections for which medical care was sought, were shown to be independent predictors of obesity, and the risk of obesity increa…