Corsello Giovanni, Carta Maurizio, Marinello Roberto, Picca Marina, De Marco Giulio, Micillo Maria, Ferrara Dante, Vigneri Patrizia, Cecere Gaetano, Ferri Pasqualina, Roggero Paola, Bedogni Giorgio, Mosca Fabio, Paparo Lorella, Nocerino Rita, Berni Canani Roberto
Operative Unit of Pediatrics and Neonatal Intensive Therapy, Mother and Child Department, University of Palermo, 90121 Palermo, Italy.
Federazione Italiana Medici Pediatri Lombardia, 46100 Mantova, Italy.
Nutrients. 2017 Jun 27;9(7):669. doi: 10.3390/nu9070669.
Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool.
To investigate the efficacy of dietary supplementation with cow's skim milk fermented with the probiotic CBA L74 in reducing CIDs in children attending day care or preschool. 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 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. 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%, < 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%, < 0.01). PPA showed that the proportion of children presenting ≥1 acute gastroenteritis (AGE) was significantly lower in group A (18% vs. 40%, < 0.05). The ARD for the occurrence of ≥1 AGE was -22% (95% CI: -37% to -6%, < 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%, < 0.05), corresponding to an ARD of -23% (95% CI: -40% to -7%, < 0.01). Significant changes in innate and acquired immunity biomarkers were observed only in subjects in group A. Dietary supplementation with cow's skim milk fermented with CBA L74 is an efficient strategy in preventing CIDs in children.
有人提出发酵食品可预防日托或幼儿园儿童的常见传染病（CID）。
研究补充含益生菌CBA L74发酵的脱脂牛奶饮食对减少日托或幼儿园儿童CID的效果。对健康儿童（12 - 48个月）进行多中心、随机、双盲、安慰剂对照试验，在冬季，这些儿童每日食用7克含CBA L74发酵的脱脂牛奶（A组）或安慰剂（麦芽糊精，B组）并接受日托或上幼儿园。主要结局是在3个月随访期间经历≥1次CID发作的儿童比例。还监测了先天免疫（α - 和β - 防御素、cathelicidin）和获得性免疫（分泌型IgA）的粪便生物标志物。共有126名儿童（71名男性，占56%）完成研究，平均（标准差）年龄为33（9）个月，A组66名，B组60名。在意向性分析中，A组出现≥1次CID的儿童比例为60%，B组为83%，绝对风险差异（ARD）为 - 23%（95%置信区间： - 37%至 - 9%，P < 0.01）。在符合方案分析（PPA）中，A组出现≥1次CID的儿童比例为18%，B组为40%，绝对风险差异（ARD）为 - 22%（95%置信区间： - 37%至 - 6%，P < 0.01）。PPA显示，A组出现≥1次急性胃肠炎（AGE）的儿童比例显著更低（18%对40%，P < 0.05）。A组≥1次AGE发生的ARD为 - 22%（95%置信区间： - 37%至 - 6%，P < 0.01）。在PPA中关于出现≥1次上呼吸道感染（URTI）的儿童比例也有类似发现，A组显著更低（51%对74%，P < 0.05），绝对风险差异为 - 23%（95%置信区间： - 40%至 - 7%，P < 0.01）。仅在A组受试者中观察到先天和获得性免疫生物标志物有显著变化。补充含CBA L74发酵的脱脂牛奶饮食是预防儿童CID的有效策略。
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