Qian Jiafen, Fang Zongwei, Chang Sijie, Zeng Zhiwei, Zhang Jinhua
Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Eur J Clin Nutr. 2024 Oct 24. doi: 10.1038/s41430-024-01506-9.
Probiotics, prebiotics, and synbiotics, are hot topics of research and have been shown to improve the body's disease state and promote health. Analysis of whether infant formula containing probiotcs, prebiotics, synbiotics is beneficial to infant and child growth.
We systematically searched multiple electronic databases (PubMed, Web of Science, The Cochrane Library, Embase) to identify eligible studies published from 1966 to December 25, 2022. Included studies were randomized controlled trials (RCTs) studying the influence of milk powder containing probiotcs, prebiotics, synbiotics on infants and children's growth. RevMan 5.4 was used to analyze the data.
A total of 55 RCTs with a total sample size of 8868 participants met the inclusion criteria. Milk powder with probiotics, prebiotics, synbiotics does not significantly improve the growth of infants and children (Weight, height, BMI, and Head Circumference); The incidence of minor adverse events (OR 0.88, 95% CI 0.70-1.11 P = 0.28) and serious adverse events (OR 0.92, 95% CI 0.62-1.36 P = 0.67) was also comparable to the control group; The intestinal microbial diversity of infants consuming probiotcs, prebiotics, synbiotics supplemented formula was lower than that of infants consuming formula without probiotcs, prebiotics, synbiotics (SMD -0.88, 95% CI -1.66- -0.1 P = 0.03), but the abundance of individual beneficial flora was increased. (SMD 1.62, 95%CI 0.61-2.62 P = 0.002). In particular, the abundance of Lactobacillus (SMD 1.62, 95% CI 0.61-2.62 P = 0.002). For metabolites, synbiotics increased fecal antibody concentrations (SMD 0.47, 95% CI 0.08-0.86 P = 0.02), but fecal short-chain fatty acid concentrations remained balanced in both groups (SMD 0.05 95% CI -0.17-0.28 P = 0.64). Compared to the control group, infants who consumed formula with prebiotics had softer stools (SMD -1.47, 95% CI -2.23 to -0.7 P = 0.002) and lower stool pH (SMD -0.82, 95% CI -1.15- -0.5 P < 0.00001), there is also more frequency of bowel movements (SMD 0.27, 95% CI 0.09-0.44 P = 0.002).
Probiotcs, prebiotics, synbiotics supplemented formulas significantly increased abundance of individual probiotics, alter intestinal antibody secretion, and improve bowel movements. Incidence of adverse reactions did not differ between the two groups. So we can choose formula-supplemented probiotcs, prebiotics, synbiotics to maintain the intestinal health of infants.
益生菌、益生元及合生元是研究热点，已证实可改善机体疾病状态并促进健康。分析含益生菌、益生元及合生元的婴儿配方奶粉是否有利于婴幼儿生长。
我们系统检索了多个电子数据库（PubMed、Web of Science、Cochrane图书馆、Embase），以识别1966年至2022年12月25日发表的符合条件的研究。纳入研究为随机对照试验（RCT），研究含益生菌、益生元及合生元的奶粉对婴幼儿生长的影响。使用RevMan 5.4分析数据。
共有55项RCT符合纳入标准，总样本量为8868名参与者。含益生菌、益生元及合生元的奶粉对婴幼儿生长（体重、身高、BMI和头围）无显著改善；轻微不良事件（OR 0.88，95%CI 0.70 - 1.11，P = 0.28）和严重不良事件（OR 0.92，95%CI 0.62 - 1.36，P = 0.67）的发生率与对照组也相当；食用含益生菌、益生元及合生元配方奶粉的婴儿肠道微生物多样性低于食用不含益生菌、益生元及合生元配方奶粉的婴儿（SMD -0.88，95%CI -1.66 - -0.1，P = 0.03），但个别有益菌群的丰度增加（SMD 1.62，95%CI 0.61 - 2.62，P = 0.002）。特别是乳酸杆菌的丰度（SMD 1.62，95%CI 0.61 - 2.62，P = 0.002）。对于代谢产物，合生元增加了粪便抗体浓度（SMD 0.47，95%CI 0.08 - 0.86，P = 0.02），但两组粪便短链脂肪酸浓度保持平衡（SMD 0.05，95%CI -0.17 - 0.28，P = 0.64）。与对照组相比，食用含益生元配方奶粉的婴儿粪便更软（SMD -1.47，95%CI -2.23至 -0.7，P = 0.002），粪便pH值更低（SMD -0.82，95%CI -1.15 - -0.5，P < 0.00001），排便频率也更高（SMD 0.27，95%CI 0.09 - 0.44，P = 0.002）。
添加益生菌、益生元及合生元的配方奶粉显著增加了个别益生菌的丰度，改变了肠道抗体分泌，并改善了排便情况。两组不良反应发生率无差异。因此，我们可以选择添加益生菌、益生元及合生元的配方奶粉来维持婴儿的肠道健康。
