PROBIOTICS WATCH - Probiotics In Practice

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PROBIOTICS WATCH ISSUE N°4 3. IN VIVO OUTCOMES OF PROBIOTIC INTAKE Contents : EDITORIAL THE MAIN POINTS OF THE QUARTER 1. CHARACTERISATION OF PROBIOTICS AND PROBIOTIC FOODS 2. PHYSIOLOGICAL INTERACTION WITH THE HOST 3. IN VIVO OUTCOMES OF PROBIOTIC INTAKE REFERENCES KEY DATES An efficacious bifidobacterium against respiratory infections in infants OBJECTIVES / BACKGROUND The impact of the administration of Bifidobacterium animalis subsp. lactis BB-12 (BB-12) on the risk of acute infectious diseases was studied in healthy infants. DESIGN Randomized, double-blind, placebo-controlled trial. SETTINGS & PARTICIPANTS 109 infants (1 month old) were assigned to a probiotics group receiving a tablet containing BB-12 (n=55) or to a control group receiving a control tablet (n=54). Tablets were administered from the age of 1-2 months to 8 months with a slow-release dummy or a spoon. Breastfeeding habits, dummy use, dietary habits, medication and all signs and symptoms of acute infections were registered. At the age of 8 months, faecal samples were collected for BB-12 determination. MAIN OUTCOME The primary outcome measures were the cumulative reported incidence of acute respiratory infections and doctor-diagnosed acute otitis media occurring before the age of 8 months. Successful intestinal passage of BB-12 was chosen as the secondary outcome measure. RESULTS The baseline characteristics of the two groups were similar, as was the duration of exclusive breastfeeding. BB-12 was recovered in the faeces of 62% of the infants receiving the BB-12 tablets. The daily duration of dummy sucking was not associated with the occurrence of acute otitis media. No significant differences between the groups were observed in reported gastrointestinal symptoms, otitis media or use of antibiotics. However, the infants receiving BB-12 were reported to have experienced fewer respiratory infections (65 vs. 94 %; RR 0·69; 95% CI 0·53, 0·89; P=0.014) than the control infants. CONCLUSION Controlled administration of B. lactis BB-12 in early childhood may reduce respiratory infections. The children participating in the present study were remarkably healthy, apart from respiratory-infections. Thus, for the other infectious and non-infectious diseases, the number of infants should have been higher to be able to detect any differences between the groups. With regard to these diseases, the present study did not even detect a trend for differences between the groups. Taipale T, Pienihäkkinen K, Isolauri E, Larsen C, Brockmann E, Alanen P, Jokela J, Söderling E. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in infancy. Br J Nutr. 2010 Sep 24:1-7. 8
PROBIOTICS WATCH ISSUE N°4 3. IN VIVO OUTCOMES OF PROBIOTIC INTAKE Contents : EDITORIAL THE MAIN POINTS OF THE QUARTER 1. CHARACTERISATION OF PROBIOTICS AND PROBIOTIC FOODS 2. PHYSIOLOGICAL INTERACTION WITH THE HOST 3. IN VIVO OUTCOMES OF PROBIOTIC INTAKE REFERENCES KEY DATES Symbiotic in preventing morbidities in young children OBJECTIVES / BACKGROUND This study reports a large randomized controlled trial, evaluating effect of providing combination of prebiotic and probiotic in milk for one year on both gut and non-gut related illnesses among children in a community based setting in India. DESIGN Randomized, double-blind, controlled trial. SETTINGS & PARTICIPANTS Children 1-3 years of age were randomly allocated to receive either control milk (n=312) or the same milk fortified with prebiotic oligosaccharide and Bifidobacterium lactis HN019 (n=312). The intervention was carried out for 1 year. Biweekly household surveillance was conducted to gather information on compliance and morbidity. MAIN OUTCOME Primary outcomes were not explicitly prespecified in the protocol; the intent was to evaluate impact on common childhood illnesses including diarrhoea, pneumonia, and febrile illness. Diarrhoea was defined as ≥3 loose or watery stools in 24 hours, and diarrhoeal episodes were considered recovered on first day of 3 diarrhoea free days. RESULTS Overall, there was no effect of prebiotic and probiotic on diarrhoea (6% reduction, 95% CI: -1 to 12%; P=0.08). Incidence of dysentery episodes was reduced by 21% (95% CI: 0 to 38%; P=0.05). Incidence of pneumonia was reduced by 24% (95% CI: 0 to 42%; P=0.05) and severe acute lower respiratory infection by 35% (95% CI: 0 to 58%; P=0.05). Compared to control group, children in probiotic/prebiotic group had 16% (95% CI: 5 to 26%, P=0.004) and 5% (95% CI: 0 to 10%; P=0.05) reduction in days with severe illness and high fever respectively. CONCLUSION This trial shows that consumption of a symbiotic resulted in a significant reduction of dysentery, respiratory morbidity and febrile illness in young children and in a lack of effect against diarrhoea. This finding suggests that fortification with prebiotic and probiotic together may provide one of the potential interventions to reduce the burden of common childhood morbidities. Sazawal S, Dhingra U, Hiremath G, Sarkar A, Dhingra P, Dutta A, Verma P, Menon VP, Black RE. Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial. PLoS One. 2010 Aug 13;5(8):e12164. 9
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PROBIOTICS WATCH - Probiotics In Practice

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