Do Tonsillectomies Promote Overweight?Tuesday, April 7, 2009
We certainly know that the root causes of the obesity epidemic are far from straightforward and that the factors accused of playing a role (genes, environmental toxins, sleep deprivation, virus infections, dieting, just to name a few) is an ever increasing list.
It is, however, always important to remember that to conclusively prove causality takes more than just finding an association between factor XYZ and obesity – ideally, one would also have (human?) intervention data demonstrating that changing XYZ also changes body weight. And of course, we’d like to see everything tied together with a likely biologically plausible hypothesis.
So here is a story that was news to me: in this month’s issue of Pediatrics Alet Wijga and colleagues from the National Institute for Public Health and the Environment, Bilthoven, Netherlands report that the accelerated weight gain (catch-up growth) after (adeno)tonsillectomy may increase the later risk of weight gain.
Their findings are based on an analysis of 3963 children participating in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort, which included not only data on weight and height, but also on adenoidectomy and tonsillectomy as well as a host of covariates (gender, birth weight, maternal education, maternal overweight, maternal smoking during pregnancy, breastfeeding, and smoking in the home).
According to their findings, (adeno)tonsillectomy between 0 and 7 years of age was significantly associated with overweight and obesity at age 8 – this finding was not explained by pre-existing overweight.
The authors suggest that the most likely explanation for this finding may indeed be the catch-up growth that often occurs once the adenoids and/or tonsils are out.
For a previous post on the possible detrimental effect of catch-up growth click here.
While I find this observation interesting, I am not sure what to do with this information. Clearly, you would not make a case for leaving infected and inflamed adenoids or tonsils in. Nor do I see parents depriving their faltering offspring of adequate nutrition to limit catch-up growth once the offending tissue is removed.
I guess this is one of those findings that make you wonder about just how connected things really are when it comes to body weight.