Fermented Milk Consumption and Common Infections in Children Attending Day-Care Centers: A Randomized Trial

Andrey Prodeus, Violeta Niborski, Juergen Schrezenmeir, Alexander Gorelov, Anna Shcherbina, Alexander Rumyantsev, Andrey Prodeus, Violeta Niborski, Juergen Schrezenmeir, Alexander Gorelov, Anna Shcherbina, Alexander Rumyantsev

Abstract

Objectives: This multicenter, double-blind, randomized, placebo-controlled clinical trial investigated the effect of a fermented milk product containing the Lactobacillus casei National Collection of Microorganisms and Cell Cultures (CNCM) I-1518 strain on respiratory and gastrointestinal common infectious diseases (CIDs) in children attending day-care centers in Russia.

Methods: Children ages 3 to 6 years received 100 g of a fermented milk product (n = 300) or a control product (n = 299) twice daily for 3 months, followed by a 1-month observation period. The primary outcome was the incidence of CIDs during the product consumption period.

Results: There was no significant difference in the incidence of CIDs between the groups (N = 98 with fermented milk product vs N = 93 with control product). The overall number of CIDs (and no severe cases at all) in both study groups and in all 12 centers, however, was unexpectedly low resulting in underpowering of the study. No differences were found between the groups in the duration or severity of disease, duration of sick leave from day-care centers, parental missed working days, or in quality-of-life dimensions on the PedsQL questionnaire (P > 0.05).There was, however, a significantly lower incidence of the most frequently observed CID, rhinopharyngitis, in children consuming the fermented milk product compared with those consuming the control product (N = 81 vs N = 100, relative risk 0.82, 95% confidence interval 0.69-0.96, P = 0.017) when considering the entire study period.

Conclusions: Although no other significant differences were shown between the fermented milk and control product groups in this study, lower incidence of rhinopharyngitis may indicate a beneficial effect of this fermented milk product.

Trial registration: ClinicalTrials.gov NCT01200173.

Conflict of interest statement

VN was an employee of Danone Research, France, at the time of study conduct. APP received funding from Danone Research, France, as the main investigator of the study. JS received fees for consulting and as speaker at symposia and funds for projects on probiotics, respectively, from Danone, Bauer, Campina, Chr Hansen. Danisco, Dr Fischer, HSO, Merck, Mueller, Nestlé, Orthomol, Wakunaga, and Yakult. The other authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Design of the study. D = day; M = month; OTC = over the counter; QoL = Quality of life questionnaire; V = visit; W = week.
FIGURE 2
FIGURE 2
Absolute number of cases with rhinopharyngitis experienced during different study periods in which the active (fermented milk) product group is indicated by diagonal lines. Statistically significant difference between active and control, as indicated, was found in the number of rhinopharyngitis cases (these being the major part of CIDs observed) during the total study period (including 3 months of products consumption period and 1 month of follow-up). CID = common infectious disease.

References

    1. Feeney A, North F, Head J, et al. Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II Study. Occup Environ Med 1998; 55:91–98.
    1. McCutcheon H, Fitzgerald M. The public health problem of acute respiratory illness in childcare. J Clin Nurs 2001; 10:305–310.
    1. Berdeaux G, Hervié C, Smajda C, et al. Parental quality of life and recurrent ENT infections in their children: development of a questionnaire. Rhinitis Survey Group. Qual Life Res 1998; 6:501–512.
    1. Fleming DW, Cochi SL, Hightower AW, et al. Childhood upper respiratory tract infections: to what degree is incidence affected by day-care attendance? Pediatrics 1987; 79:55–60.
    1. Haskins R. Acute illness in day-care: how much does it cost? Bull N Y Acad Med 1989; 65:319–343.
    1. Benetictsdottir B. Upper airway infections in preschool children—frequency and risk factors. Scand J Prim Health Care 1993; 11:197–201.
    1. Louhiala PJ, Jaakkola N, Ruotsalainen R, et al. Form of day care and respiratory infections among Finnish children. Am J Public Health 1995; 85:1109–1112.
    1. Zutavern A, Rzehak P, Brockow I, et al. Day care in relation to respiratory-tract and gastrointestinal infections in a German birth cohort study. Acta Paediatrica 2007; 96:1494–1499.
    1. Silverstein M, Sales AE, Koepsell TD. Health care utilization and expenditures associated with child care attendance: a nationally representative sample. Pediatrics 2003; 111:e371–e375.
    1. Dales RE, Cakmak S, Brand K, et al. Respiratory illness in children attending daycare. Pediatr Pulmonol 2004; 38:64–69.
    1. Carabin H, Gyorkos TW, Soto JC, et al. Estimation of direct and indirect costs because of common infections in toddlers attending day care centers. Pediatrics 1999; 103:556–564.
    1. Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics—approaching a definition. Am J Clin Nutr 2001; 73 (suppl):361S–364S.
    1. Ritchie ML, Romanuk TN. A meta-analysis of probiotic efficacy for gastrointestinal diseases. PLoS ONE 2012; 7:e34938.
    1. Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev 2015; CD006895.
    1. Kang E-J, Kim SY, Hwang I-H, et al. The effect of probiotics on prevention of common cold: a meta-analysis of randomized controlled trial studies. Korean J Fam Med 2013; 34:2–10.
    1. King S, Glanville J, Sanders ME, et al. Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. Brit J Nutr 2014; 112:41–54.
    1. Goldenberg JZ, Ma SSY, Saxton JD, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2013; CD006095.
    1. Johnston BC, Ma SSY, Goldenberg JZ, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea—a systematic review and meta-analysis. Ann Intern Med 2012; 157:878–888.
    1. Lenoir-Wijnkoop I, Gerlier L, Bresson J-L, et al. Public health and budget impact of probiotics on common respiratory tract infections: a modelling study. PLoS ONE 2015; 10:e0122765.
    1. Aponte BG, Mancilla BCA, Pariasca CNY, et al. Probiotics for treating persistent diarrhea in children. Cochrane Database Syst Rev 2013; CD007401.
    1. Salari P, Nikfar S, Abdollahi M. A meta-analysis and systematic review on the effect of probiotics in acute diarrhea. Inflamm Allergy Drug Targets 2012; 11:3–14.
    1. Weizman Z. The role of probiotics and prebiotics in the prevention of infections in child day-care centres. Benef Microbes 2015; 6:181–183.
    1. H. Szajewska H, Skorka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther 2007; 25:257–264.
    1. Szajewska H, Skorka A, M. Ruszczynski M, et al. Meta-analysis: Lactobacillus GG for treating acute diarrhoea in children. Aliment Pharmacol Ther 2007; 25:871–881.
    1. Szajewska H, Urbańska M, Chmielewska A, et al. Meta-analysis: Lactobacillus reuteri strain DSM 17938 (and the original strain ATCC 55730) for treating acute gastroenteritis in children. Benef Microbes 2014; 5:285–293.
    1. Guerin-Danan C, Chabanet C, Pedone C, et al. Milk fermented with yogurt cultures and Lactobacillus casei compared with yogurt and gelled milk: influence on intestinal microflora in healthy infants. Am J Clin Nutr 1998; 67:111–117.
    1. Oozeer R, Goupil-Feuillerat N, Alpert CA, et al. Lactobacillus casei is able to survive and initiate protein synthesis during its transit in the digestive tract of human flora-associated mice. Appl Environ Microbiol 2002; 68:3570–3574.
    1. Oozeer R, Leplingard A, Mater DD, et al. Survival of Lactobacillus casei in the human digestive tract after consumption of fermented milk. Appl Environ Microbiol 2006; 72:5615–5617.
    1. Rochet V, Rigottier-Gois L, Levenez F, et al. Modulation of Lactobacillus casei in ileal and fecal samples from healthy volunteers after consumption of a fermented milk containing Lactobacillus casei DN-114 001Rif. Can J Microbiol 2008; 54:660–667.
    1. Guillemard E, Tondu F, Lacoin F, et al. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114001 reduces the duration of respiratory infections in the elderly in a randomized controlled trial. Br J Nutr 2010; 103:58–68.
    1. Pedone CA, Bernabeu AO, Postaire ER, et al. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract 1999; 53:179–184.
    1. Pedone CA, Arnaud CC, Postaire ER, et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000; 54:568–571.
    1. Agarwal KN, Bhasin SK, Faridi MM, et al. Lactobacillus casei in the control of acute diarrhea—a pilot study. Indian Pediatr 2001; 38:905–910.
    1. Sykora J, Valeckova K, Amlerova J, et al. Effects of a specially designed fermented milk product containing probiotic Lactobacillus casei DN-114 001 and the eradication of H. pylori in children: a prospective randomized double-blind study. J Clin Gastroenterol 2005; 39:692–698.
    1. Guillemard E, Tanguy J, Flavigny A, et al. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-110001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial. J Am Coll Nutr 2010; 29:455–468.
    1. Niborski V, Tanguy J, Ernouf C, et al. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei CNCM I-1518 improves clinical outcome of common infections and quality of life in adults under stress (firemen students) in a randomized controlled trial. 7th EFSMA–European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House 2011.
    1. Merenstein D, Murphy M, Fokar A, et al. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study—a patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. Eur J Clin Nutr 2010; 64:669–677.
    1. Cochrane Handbook for Systemic Reviews of Intervention, Version 5.1.0, updated March 2011, chapter 8. Available at: .
    1. Van Niel CW, Feudtner C, Garrison MM, et al. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 2002; 109:678–684.
    1. Presser HB. Place of child care and medicated respiratory illness among young American children. J Marriage Fam 1988; 50:995–1005.
    1. Hatakka K, Savilahti E, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomized trial. BMJ 2001; 322:1–5.
    1. Turchet P, Laurenzano M, Auboiron S, et al. Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomized, controlled pilot study. J Nutr Health Aging 2003; 7:75–77.
    1. Sandora TJ, Taveras EM, Shih M-C, et al. A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics 2005; 116:587–594.
    1. Cowling BJ, Fung ROP, Cheng CKY, et al. Preliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in households. PLoS ONE 2008; 3:e2101.
    1. Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2011; CD006207.
    1. Savolainen-Kopra C, Haapakoski J, Peltola PA, et al. Hand washing with soap and water together with behavioural recommendations prevents infections in common work environment: an open cluster-randomized trial. Trials 2012; 13:10–20.
    1. Benson V, Marano MA. Current estimates from the National Health Interview Survey, ∗1992. Vital Health Stat 1994; 10:1–269.
    1. Cardozo DM, Nascimento-Carvalho CM, Andrade AL, et al. The burden of acute nasopharyngitis among adolescents. Arch Dis Child 2006; 91:1045.
    1. Cypress BK. Patterns of ambulatory care in pediatrics: The National Ambulatory Medical Care Survey. Vital Health Stat 1983; 13:1–60.
    1. Hollinghurst S, Gorst C, Fahey T, et al. Measuring the financial burden of acute cough in pre-school children: a cost of illness study. BMC Family Practice 2008; 9:10–15.
    1. Van Cauwenberge P, Berdeaux G, Morineau A, et al. Use of diagnostic clusters to assess the economic consequences of rhinopharyngitis in children in Italy and France during the winter. Rhinitis Survey Group. Clin Ther 1999; 21:404–421.
    1. Winkler P, Ghadimi D, Schrezenmeir J, et al. Molecular and cellular basis of microflora-host interactions. J Nutr 2007; 137:756S–772S.
    1. de Vrese M, Winkler P, Rautenberg P, et al. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial. Clin Nutr 2005; 24:481–491.
    1. Gluck U, Gebbers JO. Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci). Am J Clin Nutr 2003; 77:517–520.
    1. Schuijt TJ, Lankelma JM, Scicluna BP, et al. The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia. Gut 2015; 0:1–9.
    1. Ichinohe T, Pang IK, Kumamoto Y, et al. Microbiota regulates immune defense against respiratory tract influenza A virus infection. Proc Natl Acad Sci USA 2011; 108:5354–5359.
    1. Samuelson DR, Welsh DA, Shellito JE. Regulation of lung immunity and host defense by the intestinal microbiota. Front Microbiol 2015; 6:1085–1098.

Source: PubMed

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