KMCRIC

Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children.

Agustina R, Kok FJ, van de Rest O, Fahmida U, Firmansyah A, Lukito W, Feskens EJ, van den Heuvel EG, Albers R, Bovee-Oudenhoven IM.

Pediatrics.

2012

129(5)

e1155-64.

10.1542/peds.2011-1379

22492764

http://www.ncbi.nlm.nih.gov/pubmed/22492764

Animals
Calcium, Dietary/therapeutic use
Child
Child, Preschool
Colony-Forming Units Assay
Cross-Sectional Studies
Developing Countries
Diarrhea/epidemiology
Diarrhea/prevention & control
Double-Blind Method
Female
Humans
Incidence
Indonesia
Infant
Lactobacillus casei
Lactobacillus reuteri
Male
Milk*/microbiology
Probiotics/administration & dosage
Respiratory Tract Infections/epidemiology
Respiratory Tract Infections/prevention & control

acute diarrhea; calcium; children; developing country; probiotics; Indonesia; Lactobacillus casei CRL431; Lactobacillus reuteri DSM17938

급성 설사; 칼슘; 어린이; 개발도상국; 프로바이오틱스; 인도네시아; 락토바실러스 카제이 CRL431; 락토바실러스 루테리

없음

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; ∼50 mg/day; n = 124), regular calcium content (RC; ∼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.

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