Key Points:
- Exposure to antibiotics before age 5 increases the risk of pediatric IBD.
- A Western diet high in processed foods and low in vegetables is also a risk factor.
- Lower socioeconomic status, having siblings, and exposure to pets appear to be protective factors.
A study presented at Digestive Disease Week® (DDW) 2023, suggests that children and adolescents are at a greater risk of developing Inflammatory Bowel Disease (IBD) when exposed to antibiotics, a Western diet at early ages or when their family has higher socioeconomic status.
The study’s lead author, Nisha Thacker, a gastrointestinal dietitian conducted a meta-analysis of 36 observational studies representing around 6.4 million children as part of her PhD studies at The University of Newcastle in Australia. Thacker found that any exposure to antibiotics before age 5 was linked to a three times greater risk of pediatric IBD, and exposure to four or more courses of antibiotics to a 3.5 times greater risk.
Moreover, a Western diet, high in sugars and ultra-processed foods, and low in vegetables is also a prime example of a risk factor. Conversely, the study found that lower socioeconomic status, having siblings, and exposure to pets appear to be protective factors.
Thacker advised families to be mindful of these modifiable factors and emphasized a diet rich in vegetables and minimally processed whole foods, use antibiotics cautiously in early childhood, prevent secondhand smoke exposure and avoid excessive worry about hygiene, especially in high-income countries. Furthermore, encouraging breastfeeding, followed by a healthy diet pattern for the child, may minimize the risk of developing IBD if a family has a history of IBD or a child has a history of eczema/rhinitis.
Ms. Thacker also noted that excessive hygiene can reduce microbes in the environment and interfere with the development of a robust microbiome, which is essential for a healthy gut. While basic hygiene is recommended, children should be allowed to play outdoors and interact with pets in a safe environment to develop a strong immune system.
In addition to these risk factors, the study found that early exposure to secondhand smoke doubles the risk of IBD in children. Furthermore, being a non-Caucasian child living in a high-income country triples the risk of pediatric IBD. Ms. Thacker’s next research focus is the influence of migration on pediatric IBD.