The probiotic Lactobacillus reuteri may reduce the incidence of diarrhea in children in developing countries, according to a study published online April 9 in Pediatrics.
Rina Augustina, MD, from the Division of Pediatric Gastroenterology, Department of Child Health, University of Indonesia, Jakarta, and colleagues conducted a 6-month randomized controlled trial involving 494 children aged 1 to 6 years who resided in a low-socioeconomic community of Indonesia during 2007 to 2008. The researchers randomly assigned the children into 4 groups, with 124 children receiving low-lactose milk with low calcium (about 50 mg/day) content and others receiving regular-calcium (about 440 mg/day) milk with placebo (126 children), Lactobacillus casei CRL431 (120 children), or L reuteri DSM17938 (124 children). Their objectives were to determine whether supplemented calcium and probiotics alleviated the incidence and duration of diarrhea and acute respiratory tract infections (ARTIs) in the community studied.
The researchers found that for all of the reported diarrheal episodes, on a broadly defined basis (2 or more loose/liquid stools in 24 hours), the children receiving the regular-calcium milk and L reuteri had a 32% lower incidence of diarrhea (relative risk, 0.68; 95% confidence interval, 0.46 - 0.99) compared with children receiving regular-calcium milk and placebo. None of the other interventions affected the incidence of diarrhea or the incidence or duration of ARTIs.
When the researchers applied a narrower World Health Organization (WHO) definition of diarrhea (3 or more loose/liquid stools in 24 hours), they found no significant difference among the groups. "Although the WHO definition is the best validated, it may not be generalizable to different settings such as our intervention, which included children of older age and in an urban community setting," the researchers write.
However, when they restricted their analysis to children with lower nutritional status, defined as those children who were below median height and weight for their ages, the researchers saw a significant protective effect of L reuteri under both definitions of diarrhea.
"Our results indicate that the effect of a probiotic, such as L reuteri DSM17938, on diarrhea is modified by nutritional status and is confined to children with lower nutritional status," the researchers conclude.
The authors report that their study is the first large randomized controlled trial involving calcium with or without 1 of 2 probiotic strains to reduce diarrhea and ARTIs. Previous studies, they write, provided mixed results and differed in strains.
In this study, mothers were instructed to provide 180 mL of sweetened chocolate milk twice a day for the children to drink through straws coated inside with oil drops as placebo, with L casei, or with L reuteri. The milk, packed in tetra packs, was kept cold throughout, and the probiotic dosage (5 × 108 colony-forming units/day) fell within guidelines of the Food and Agriculture Organization of the United Nations/WHO. The children maintained their regular diet but were requested to exclude any other "probiotic, prebiotic, or high-calcium foods/drinks other than the supplied ones."
"Our results underline that probiotic effects are strain specific, as we found protective effects of L reuteri DSM17938 against acute diarrhea in children, whereas supplementation of L casei CRL431 (without other strains) was without effect," the researchers write.
Although the results need to be confirmed by at least 1 more independent study, the authors conclude that L reuteri supplementation with regular calcium milk may reduce the burden of infectious diarrhea in children.
The researchers write that diarrhea and ARTIs contribute to 25% and 16%, respectively, of the mortality rate for young children in Indonesia, according to the republic's Ministry of Health.
Source: http://www.medscape.com/viewarticle/761711?sssdmh=dm1.774171&src=nldne
Welcome to my collection of health articles. Most of them contain little nuggets of health wisdom that we can easily apply to our daily lives. As you can gather, I've been consuming all sorts of supplements over the years, most of them from iherb. They deliver on time (DHL), and prices are good. If you're a first-time buyer, use my code 'pot089' to enjoy up to $10 off.
Showing posts with label probiotic. Show all posts
Showing posts with label probiotic. Show all posts
Wednesday, 27 June 2012
Friday, 11 November 2011
Some probiotics effectively reduce common GI symptoms
November 8, 2011 (National Harbor/Washington, DC) — Mounting evidence
is building a strong case for the use of probiotics, or "good"
bacteria, to alleviate common gastrointestinal (GI) symptoms, such as
diarrhea, bloating, and inflammation, according to several studies
highlighted during a press briefing here at the American College of
Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course.
In one meta-analysis, researchers from the Maimonides Medical Center in Brooklyn, New York, found that in 22 studies of more than 3000 patients, probiotic prophylaxis significantly reduced the odds of developing antibiotic-associated diarrhea and Clostridium difficile–associated diarrhea by about 60%.
In another meta-analysis, researchers from Beth Israel Deaconess Medical Center and Harvard Medical School, in Boston, Massachusetts, analyzed 28 randomized controlled trials in which more than 3000 patients received a single or a combination of antibiotics for various indications. In adult and pediatric populations, the preventive effect of probiotic use was significant, regardless of the species used and regardless of the antibiotic administered.
In the largest study to date on probiotics in a nonpatient population, researchers from the University of North Carolina at Chapel Hill evaluated the efficacy of Bifidobacterium infantis 35624, a probiotic that has relieved symptoms in patients with irritable bowel syndrome, to see how well it relieved abdominal discomfort and bloating in nonpatients.
The double-blind randomized placebo controlled study involved a 2-week placebo phase followed by a 4-week intervention phase, and was conducted at 10 clinical centers in the United States. More than 300 nonpatients who had experienced abdominal discomfort and bloating more than twice weekly, on average, for at least 3 months were included in the study. They had not seen a physician or received prescribed medication for their symptoms in the previous 12 months.
In contrast to previous clinical studies of irritable bowel syndrome patients, the researchers saw no statistically significant improvement in mean severity of abdominal discomfort or bloating after the nonpatient population took B infantis 35624.
However, an Irish group found that a nonpatient population receiving B infantis 35624 experienced significantly more bloat-free days.
The researchers hypothesized that microbial imbalance could explain the increased incidence of a wide range of inflammatory disorders. To test whether altering the balance between good and bad bacteria in the gut raises the immune regulatory response, which could lower inflammation, researchers from the Alimentary Pharmabiotic Centre at University College Cork, and Alimentary Health Ltd in Cork, Ireland, conducted a double-blind placebo controlled study. Their goal was to see if B infantis affects systemic proinflammatory biomarkers in patients with inflammatory disease.
The results of their study suggest that probiotics exert anti-inflammatory effects.
"By giving a specific probiotic orally, we could actually reduce the levels of these proinflammatory cytokines and actually enhance the production of an anti-inflammatory cytokine, which is the exact replication of what we identified in animal models and more basic models," said principal investigator Eamonn Quigley, MD, FACG, professor of medicine at the National University of Ireland in Cork.
Plasma levels of the anti-inflammatory cytokine interleukin (IL)-10 rose significantly in healthy volunteers and patients with psoriasis, but not in those who took the placebo for 8 weeks.
Plasma levels of 2 proinflammatory cytokines — tumor necrosis factor-alpha and IL-6 — dropped in all patients who received B infantis. C-reactive protein levels were also significantly lower in patients with psoriasis, ulcerative colitis, and chronic fatigue after treatment with the bacterium than after treatment with placebo.
Although not everybody who takes an antibiotic should also take a probiotic, the institutionalized elderly should, to minimize the chance of getting something like antibiotic-associated diarrhea or antibiotic-associated C difficile, said Fergus Shanahan, MD, FACG, a researcher involved in the Irish B infantis 35624 study, and professor and chair of the Department of Medicine at University College Cork.
Certain subsets of patients, such as those with cystic fibrosis or chronic urinary infections, who must take recurring courses of antibiotics might benefit from taking probiotics to minimize antibiotic-associated diarrhea.
"It's ironic that we would worry about taking an organism when we've got billions of organisms in the GI tract" and the amount is relatively small, Dr. Shanahan observed. Instead of worrying about drug toxicity in that population, "we're worried about something that has vanishingly low side effects. It can't be zero, but it is very, very low."
"If we paid more attention to prescribing antibiotics, we wouldn't have a lot of these problems," added Dr. Quigley.
According to Mark Mellow, MD, FACG, director of the Digestive Health Center at INTEGRIS Baptist Medical Center in Oklahoma City, Oklahoma, physicians aren't the only ones to blame for the indiscriminate use of antibiotics. Edicts from hospital compliance committees often establish rules that patients who come in with community-acquired pneumonia be placed on antibiotics soon after admission. These rules can have unintended consequences.
"Someone comes in with a fever and a cough and because there's not enough time to sort it out, they get put on an antibiotic," he said, whether or not they have a bacterial infection.
Dr. Quigley reports financial relationships with Alimentary Health, Norgine, Merck, Procter and Gamble, Movetis/Shire, Shire, Yakult, and Ironwood/Almirall. Dr. Shanahan reports a financial relationship with Alimentary Health Ltd. Dr. Mellow has disclosed no relevant financial relationships.
American College of Gastroenterology (ACG) 2011 Annual Scientific Meeting and Postgraduate Course: Abstracts P650, P120, P60, P283. Presented November 1, 2011.
Source: http://www.medscape.com/viewarticle/753108?sssdmh=dm1.732339&src=nldne
In one meta-analysis, researchers from the Maimonides Medical Center in Brooklyn, New York, found that in 22 studies of more than 3000 patients, probiotic prophylaxis significantly reduced the odds of developing antibiotic-associated diarrhea and Clostridium difficile–associated diarrhea by about 60%.
In another meta-analysis, researchers from Beth Israel Deaconess Medical Center and Harvard Medical School, in Boston, Massachusetts, analyzed 28 randomized controlled trials in which more than 3000 patients received a single or a combination of antibiotics for various indications. In adult and pediatric populations, the preventive effect of probiotic use was significant, regardless of the species used and regardless of the antibiotic administered.
In the largest study to date on probiotics in a nonpatient population, researchers from the University of North Carolina at Chapel Hill evaluated the efficacy of Bifidobacterium infantis 35624, a probiotic that has relieved symptoms in patients with irritable bowel syndrome, to see how well it relieved abdominal discomfort and bloating in nonpatients.
The double-blind randomized placebo controlled study involved a 2-week placebo phase followed by a 4-week intervention phase, and was conducted at 10 clinical centers in the United States. More than 300 nonpatients who had experienced abdominal discomfort and bloating more than twice weekly, on average, for at least 3 months were included in the study. They had not seen a physician or received prescribed medication for their symptoms in the previous 12 months.
In contrast to previous clinical studies of irritable bowel syndrome patients, the researchers saw no statistically significant improvement in mean severity of abdominal discomfort or bloating after the nonpatient population took B infantis 35624.
However, an Irish group found that a nonpatient population receiving B infantis 35624 experienced significantly more bloat-free days.
The researchers hypothesized that microbial imbalance could explain the increased incidence of a wide range of inflammatory disorders. To test whether altering the balance between good and bad bacteria in the gut raises the immune regulatory response, which could lower inflammation, researchers from the Alimentary Pharmabiotic Centre at University College Cork, and Alimentary Health Ltd in Cork, Ireland, conducted a double-blind placebo controlled study. Their goal was to see if B infantis affects systemic proinflammatory biomarkers in patients with inflammatory disease.
The results of their study suggest that probiotics exert anti-inflammatory effects.
"By giving a specific probiotic orally, we could actually reduce the levels of these proinflammatory cytokines and actually enhance the production of an anti-inflammatory cytokine, which is the exact replication of what we identified in animal models and more basic models," said principal investigator Eamonn Quigley, MD, FACG, professor of medicine at the National University of Ireland in Cork.
Plasma levels of the anti-inflammatory cytokine interleukin (IL)-10 rose significantly in healthy volunteers and patients with psoriasis, but not in those who took the placebo for 8 weeks.
Plasma levels of 2 proinflammatory cytokines — tumor necrosis factor-alpha and IL-6 — dropped in all patients who received B infantis. C-reactive protein levels were also significantly lower in patients with psoriasis, ulcerative colitis, and chronic fatigue after treatment with the bacterium than after treatment with placebo.
Although not everybody who takes an antibiotic should also take a probiotic, the institutionalized elderly should, to minimize the chance of getting something like antibiotic-associated diarrhea or antibiotic-associated C difficile, said Fergus Shanahan, MD, FACG, a researcher involved in the Irish B infantis 35624 study, and professor and chair of the Department of Medicine at University College Cork.
Certain subsets of patients, such as those with cystic fibrosis or chronic urinary infections, who must take recurring courses of antibiotics might benefit from taking probiotics to minimize antibiotic-associated diarrhea.
"It's ironic that we would worry about taking an organism when we've got billions of organisms in the GI tract" and the amount is relatively small, Dr. Shanahan observed. Instead of worrying about drug toxicity in that population, "we're worried about something that has vanishingly low side effects. It can't be zero, but it is very, very low."
"If we paid more attention to prescribing antibiotics, we wouldn't have a lot of these problems," added Dr. Quigley.
According to Mark Mellow, MD, FACG, director of the Digestive Health Center at INTEGRIS Baptist Medical Center in Oklahoma City, Oklahoma, physicians aren't the only ones to blame for the indiscriminate use of antibiotics. Edicts from hospital compliance committees often establish rules that patients who come in with community-acquired pneumonia be placed on antibiotics soon after admission. These rules can have unintended consequences.
"Someone comes in with a fever and a cough and because there's not enough time to sort it out, they get put on an antibiotic," he said, whether or not they have a bacterial infection.
Dr. Quigley reports financial relationships with Alimentary Health, Norgine, Merck, Procter and Gamble, Movetis/Shire, Shire, Yakult, and Ironwood/Almirall. Dr. Shanahan reports a financial relationship with Alimentary Health Ltd. Dr. Mellow has disclosed no relevant financial relationships.
American College of Gastroenterology (ACG) 2011 Annual Scientific Meeting and Postgraduate Course: Abstracts P650, P120, P60, P283. Presented November 1, 2011.
Source: http://www.medscape.com/viewarticle/753108?sssdmh=dm1.732339&src=nldne
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