UI SG 2013 | Dr. Rina Agustina, MSc, PhD | Effect of probiotics and calcium

Effect of probiotics and calcium on diarrhea, growth, iron and zinc status in Indonesian children – Dr. Rina Agustina, MSc, PhD

15 November 2013
Location : Studio Pelayanan dan Pengembangan Sumberdaya Pembelajaran Universitas Indonesia

Acute diarrhea and respiratory tract infections persist to be the leading infectious cause of morbidity and mortality among under-5 children in developing countries, including Indonesia. Moreover, undernutrition and multiple micronutrient deficiencies remains as the most serious nutritional problems among these children. The obvious effect of malnutrition on young children is slowed growth, and other detrimental outcomes such as micronutrient deficiencies, poor cognitive development, and increased illness and infection that can impact health throughout the lifecycle. Therefore, public health strategies are needed to increase the children’s resistance to infections and to improve child growth and nutritional status. Preventing diarrheal disease and improving child growth by probiotics and milk calcium supplementation as alternative strategy are promising. Several meta-analyses, systematic reviews and trials suggested that probiotics may prevent or reduce duration of diarrhea in children. However, the reported beneficial effects are probiotic strain and dose dependent and evidence was limited to small studies and obtained mainly in hospital-based settings in developed countries aiming at treatment of diarrhea. However, only few trials have focused on these outcomes in a community setting in the developing world. Therefore, we conducted a 6-month double-blind randomized controlled trial to investigate the efficacy of two probiotic strains, tested independently and calcium on incidence, duration and severity of diarrhea, growth, iron and zinc status among Indonesian children in low socioeconomic communities of Jakarta. Incidence and duration of diarrhea were the primary outcomes. Apparently healthy non-breastfed children (n=494) aged between 1 and 6 years old were randomly assigned to daily consume either low-calcium milk, regular milk, regular milk with probiotic Lactobacillus casei CRL 431 (5.108 CFU), or regular milk with the probiotic Lactobacillus reuteri DSM 17938 (5.108 CFU). Results indicated that consuming the L. reuteri-added milk may prevent diarrhea especially in children with lower nutritional status, reduce total duration of diarrheal episodes and modestly improve growth over 6 months, but does not affect diarrhea severity. L. casei modestly improves monthly weight velocity, but does not reduce diarrhea incidence, duration or severity. No influence of calcium or probiotic consumption on zinc or iron status was observed

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