Can the Wrong Gut Bacteria, and Antibiotics, Make You Fat? The very sad truth.

I started this paper to answer a question for you that I already knew the answer to, yes, your gut bacteria and antibiotics can definitely make you fat. But as I started writing this I found some rather disturbing facts associated with the use of antibiotics. I think you’ll find this shocking. 

Several studies, over the course of many years, have found that having a narrow spectrum of gut bacteria diversity, the wrong kind of bacteria, and the use of antibiotics can all make us fat.

One of the primary uses of antibiotics has been livestock to help fatten them up, not to combat disease.

“Improvement in growth due to antibiotics was first described in the mid 1940s, and within five years the addition of GPAs (growth-promoting antibiotics) became common practice…broiler production changed dramatically from 1955 to 1995: the average market weight of broilers has increased nearly 50%, and the time needed for broilers to reach market weight and the amount of feed required to produce one pound of broiler meat have both declined approximately 35%” — PubMed #PMC1804117

There are many more such research papers, but what I found next changed the course of this article.

Antibiotics work so well on livestock that some scientists have proposed using them to fatten up “malnourished children in developing countries”!  I guess screwing up their microbiome with antibiotics is cheaper than feeding these children more food!

“Doxycycline has been proposed for the treatment of malnourished children in developing countries, and its use has been associated with weight gain in healthy volunteers…Abnormal weight gain is a side effect of long-term doxycycline and hydroxychloroquine treatment. Gut microbiota modifications at the phylum level could play an instrumental role in this effect. We highlight the need for specific nutritional care in patients undergoing long-term antibiotic treatment, particularly treatment involving the use of doxycycline.” — PubMed #24687497

So I thought this was just being “proposed” by scientists, no, they’ve actually tested their theories on malnourished children (rather than feeding them enough food, they fed them antibiotics!). The following study took place in Malawi, Africa.

“The addition of antibiotics to therapeutic regimens for uncomplicated severe acute malnutrition was associated with a significant improvement in recovery and mortality rates…53% of the children are stunted (in Malawi)… A total of 924 children were randomly assigned to the amoxicillin group, 923 to the cefdinir group, and 920 to the placebo group… Weight gain from enrollment until the second follow-up visit (or until the one follow-up visit for children with only one) was significantly higher among children who received cefdinir than among those who received placebo. Children who received either antibiotic agent also had greater increases in mid-upper-arm circumference than did those who received placebo… The amoxicillin used in this study cost an average of $2.67 per child, and the cost of cef di nir was $7.85 but presumably would be lower if it were used on a large scale. For comparison, the cost of RUTF  (ready-to-use therapeutic food) was approximately $50 for the course of therapy.” RUTF is “usually a fortified spread consisting of peanut paste, milk powder, (vegetable) oil, sugar, and a micronutrient supplement”  — PubMed #PMC3654668   (links added)

The study above was a 7 day course of antibiotics. Obviously what is being proposed here is to provide antibiotics to these children rather than more food. They would have to continue to consume antibiotics for it to remain effective and continue to save money. The manufacturer of the RUTF food says that it was inspired by Nutella spread. Nutella is not the least bit healthy, but it does contain palm oil, rather than vegetable oil, which would be far healthier for them and more satisfying.

“RUTFs have a long shelf-life and that they are micro-organism contamination resistant, without the need for expensive packaging.”  — Wikipedia #1 , #2

The RUTF usually used is “Plumpy’Nut”, a United Nations approved food source for malnourished populations. “peanut-based paste, with sugar, vegetable oil and skimmed milk powder, enriched with vitamins and minerals”.  I love this comment from an ABC news story on Plumpy’Nut –

“While widespread distribution of a peanut-based product like Plumpy’nut could pose a danger to allergy-prone children in the United States, that is not a concern on the African continent.

“Food allergy seems far less common in poor countries than in rich countries,” said Briend. “This well-known observation has been explained by different factors, but apparently, crowding and repeated exposure to infections seem to play a role.”  — ABCNews

These poor children didn’t have peanut allergies when we arrived, but what happens to them after years of eating such food and being given antibiotics to fatten them up? I can’t find any evidence of follow up studies.

Even if you haven’t taken antibiotics in your life (though almost everyone in the West has), you have most likely been exposed to them in the food and water you consume.

“chronic exposures to low-residue antimicrobial drugs in food could disrupt the equilibrium state of intestinal microbiota and cause dysbiosis that can contribute to changes in body physiology. The obesity epidemic in the United States may be partly driven by the mass exposure of Americans to food containing low-residue antimicrobial agents… What such common exposures could alter the gut microbiota at the population level? Here, we review a body of literature to support a hypothesis that the American human intestinal microbiota may have been disrupted by chronic, widespread exposures to antimicrobial residues that have increasingly entered our food chain and the environment over the last 20 years. These exposures may be contributing to the obesity epidemic…One major potential source of antibiotics that enter the food chain in the US is the food animal reservoir. The intensification in livestock production and animal feeding operations (AFOs) greatly expanded in the 1990s, which also greatly expanded the therapeutic and prophylactic use of antibiotics… contamination can occur on surface water, groundwater, and soil. Based on the amount of antibiotics estimated to be used for growth promotion in animal husbandry, 7.5–18 million pounds of these antimicrobial drugs could be released into the environment annually” — PubMed #PMC3867737

“Obesity is a major public health challenge of the 21st century, and this condition has been associated with the elimination of some bacterial groups and reduced bacterial diversity in the microbiota…Many different classes of antibacterial agents, including macrolides, tetracyclines, and penicillins, promote animal growth…Antibiotics significantly reduce gut bacteria, and in certain patients, these medicines completely eliminate specific bacterial communities…” — PubMed #PMC4068504

I’m usually not a big conspiracy nut, but it’s looking more and more like the drug companies truly do want to get everyone hooked on their drugs, in this case getting everyone hooked on antibiotics, even people who are starving.