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Nutrients. 2017 Jun 27;9(7). pii: E669. doi: 10.3390/nu9070669.

Preventive Effect of Cow's Milk Fermented with Lactobacillus paracasei CBA L74 on Common Infectious Diseases in Children: A Multicenter Randomized Controlled Trial.

Author information

1
Operative Unit of Pediatrics and Neonatal Intensive Therapy, Mother and Child Department, University of Palermo, 90121 Palermo, Italy. giocors@alice.it.
2
Operative Unit of Pediatrics and Neonatal Intensive Therapy, Mother and Child Department, University of Palermo, 90121 Palermo, Italy. cxbn@unin.it.
3
Federazione Italiana Medici Pediatri Lombardia, 46100 Mantova, Italy. hetht@unin.it.
4
Pediatric Society of Primary Health Care (SICuPP), 20135 Milan, Italy. dafnfhm@unin.it.
5
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. gntm@unin.it.
6
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. csvbu@unin.it.
7
Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, 90121 Palermo, Italy. uhvbu@unin.it.
8
Family Pediatrician, 90133 Palermo, Italy. vignerip@gmail.com.
9
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. rtntm@unin.it.
10
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. ryhm@unin.it.
11
Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20143 Milan, Italy. sdvedd@unin.it.
12
Clinical Epidemiology Unit, Liver Research Center, Basovizza, 34012 Trieste, Italy. giorgiobedogni@gmail.com.
13
Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20143 Milan, Italy. fabio.mosca@mangiagalli.it.
14
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. paparolorella@gmail.com.
15
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. ritanocerino@alice.it.
16
Department of Translational Medical Science-Pediatric Section, University of Naples "Federico II" Via S. Pansini, 5, 80131 Naples, Italy. berni@unina.it.
17
European Laboratory for the Investigation of Food-Induced Diseases, University of Naples "Federico II", 80131 Naples, Italy. berni@unina.it.
18
CEINGE Advanced Biotechnologies, University of Naples "Federico II", 80131 Naples, Italy. berni@unina.it.

Abstract

Background: Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool.

OBJECTIVES:

To investigate the efficacy of dietary supplementation with cow's skim milk fermented with the probiotic Lactobacillus paracasei CBA L74 in reducing CIDs in children attending day care or preschool. Methods: Multicenter, randomized, double-blind, placebo-controlled trial on healthy children (aged 12-48 months) consuming daily 7 grams of cow's skim milk fermented with L. paracasei CBA L74 (group A), or placebo (maltodextrins group B) attending day care or preschool during the winter season. The main outcome was the proportion of children who experienced ≥1 episode of CID during a 3-month follow-up. Fecal biomarkers of innate (α- and β-defensins, cathelicidin) and acquired immunity (secretory IgA) were also monitored. Results: A total of 126 children (71 males, 56%) with a mean (SD) age of 33 (9) months completed the study, 66 in group A and 60 in group B. At intention to treat analysis, the proportion of children presenting ≥1 CID was 60% in group A vs. 83% in group B, corresponding to an absolute risk difference (ARD) of -23% (95% CI: -37% to -9%, p < 0.01). At per-protocol-analysis (PPA), the proportion of children presenting ≥1 CID was 18% in group A vs. 40% in group B, corresponding to an absolute risk difference (ARD) of -22% (95% CI: -37% to -6%, p < 0.01). PPA showed that the proportion of children presenting ≥1 acute gastroenteritis (AGE) was significantly lower in group A (18% vs. 40%, p < 0.05). The ARD for the occurrence of ≥1 AGE was -22% (95% CI: -37% to -6%, p < 0.01) in group A. Similar findings were obtained at PPA regarding the proportion of children presenting ≥1 upper respiratory tract infection (URTI), which was significantly lower in group A (51% vs. 74%, p < 0.05), corresponding to an ARD of -23% (95% CI: -40% to -7%, p < 0.01). Significant changes in innate and acquired immunity biomarkers were observed only in subjects in group A. Conclusions: Dietary supplementation with cow's skim milk fermented with L. paracasei CBA L74 is an efficient strategy in preventing CIDs in children.

KEYWORDS:

acquired immunity; acute gastroenteritis; gut microbiota; immunonutrition; innate immunity; probiotics; upper respiratory tract infections

PMID:
28654019
PMCID:
PMC5537784
DOI:
10.3390/nu9070669
[Indexed for MEDLINE]
Free PMC Article

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