Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children

被引:75
作者
Agustina, Rina [1 ,3 ]
Kok, Frans J. [3 ]
van de Rest, Ondine [3 ]
Fahmida, Umi [1 ]
Firmansyah, Agus [2 ]
Lukito, Widjaja [1 ]
Feskens, Edith J. M. [3 ]
van den Heuvel, Ellen G. H. M. [4 ]
Albers, Ruud [5 ]
Bovee-Oudenhoven, Ingeborg M. J. [4 ,6 ,7 ]
机构
[1] Univ Indonesia, SEAMEO RECFON Southeast Asian Ministers Educ Org, Jakarta, Indonesia
[2] Univ Indonesia, Dept Child Hlth, Div Pediat Gastroenterol, Fac Med, Jakarta, Indonesia
[3] Wageningen Univ, Div Human Nutr, NL-6700 AP Wageningen, Netherlands
[4] FrieslandCampina Res, NL-7400 AB Deventer, Netherlands
[5] Unilever Res Labs, Vlaardingen, Netherlands
[6] Top Inst Food & Nutr, Wageningen, Netherlands
[7] NIZO Food Res, Ede, Netherlands
关键词
acute diarrhea; calcium; children; developing country; probiotics; Indonesia; Lactobacillus casei CRL431; Lactobacillus reuteri DSM17938; PLACEBO-CONTROLLED TRIAL; C-REACTIVE PROTEIN; LACTOBACILLUS-REUTERI; PERSISTENT DIARRHEA; DOUBLE-BLIND; PREVENTION; GG; STRAIN; URBAN; SUPPLEMENTATION;
D O I
10.1542/peds.2011-1379
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: To investigate the effects of calcium and probiotics on the incidence and duration of acute diarrhea and acute respiratory tract infections (ARTIs) in low-socioeconomic communities of Jakarta, Indonesia. METHODS: We conducted a 6-month, double-blind, placebo-controlled study in 494 healthy children aged 1 to 6 years who received low-lactose milk with low calcium content (LC; similar to 50 mg/day; n = 124), regular calcium content (RC; similar to 440 mg/day; n = 126), RC with 5.10(8) colony-forming units per day of Lactobacillus casei CRL431 (casei; n = 120), or RC with 5.10(8) colony-forming units per day of Lactobacillus reuteri DSM17938 (reuteri; n = 124). Number and duration of diarrhea and ARTIs episodes were primary and secondary outcomes, respectively. RESULTS: Incidence of World Health Organization-defined diarrhea (>= 3 loose/liquid stools in 24 hours) was not significantly different between RC and LC (relative risk [RR]: 0.99 [95% confidence interval (CI): 0.62-1.58]), between casei and RC (RR: 1.21 [95% CI: 0.76-1.92]), or between reuteri and RC (RR: 0.76 [95% CI: 0.46-1.25]) groups. Incidence of all reported diarrhea (>= 2 loose/liquid stools in 24 hours) was significantly lower in the reuteri versus RC group (RR: 0.68 [95% CI: 0.46-0.99]). Irrespective of the definition used, reuteri significantly reduced diarrhea incidence in children with lower nutritional status (below-median height-and-weight-for-age z score). None of the interventions affected ARTIs. CONCLUSIONS: RC milk, alone or with L casei, did not reduce diarrhea or ARTIs in Indonesian children. L reuteri may prevent diarrhea, especially in children with lower nutritional status.
引用
收藏
页码:E1155 / E1164
页数:10
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