EFFECTS OF PROBIOTICS ON CHILD GROWTH - A Systematic Review

1. EFFECTS OF PROBIOTICS ON CHILD GROWTH - A Systematic Review By: Onubi, Ojochenemi Joy MBBS, MSc International Health and Management

2. OUTLINE • Introduction • Aim and Objectives • Methods • Results • Conclusion and Recommendations • References

3. INTRODUCTION • Optimal child growth is important for children reach their full cognitive and social potential • Under-nutrition in children is manifested as underweight, stunting and wasting. • In 2011, the WHO estimated that globally, 25% of under-five children are under-nourished 18% are under-weight while 28% are stunted. The majority of these children reside in Africa and Asia .

4. CAUSES AND CONSEQUENCES OF UNDER-NUTRITION

5. UNDER-NUTRITION AND MDGs • MDG 1: Eradicate extreme poverty and hunger – some improvement • MDGs 2, 3, 4, 5, 6 • In Guatemala and Zimbabwe, food supplementation during early childhood improved schooling in men and women • height-for-age: 1 Z score was associated with an 8% increase in income in Brazil and Guatemala as well as with an increase of 0·27 household assets in India

6. PROBIOTICS • Probiotics are live micro-organisms which confer a health benefit on the host when they are consumed in adequate amounts. • The dietary intake of probiotics may lead to improved growth in children and therefore help in reducing the prevalence and magnitude of under-nutrition.

7. PROBIOTICS AND GROWTH PROBIOTICS GROWTH

8. AIM AND OBJECTIVES • Aim: To systematically review the available evidence on the effects of probiotics on the growth of children. • Objectives: • i) To determine the effect of probiotics on the growth of healthy young children • ii) To determine the effect of probiotics on the growth of undernourished children

9. METHODS • Three electronic databases were searched using inclusion and exclusion criteria MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials • Reference lists were also searched. • Outcome measure was change in growth- weight, height/length • Analysis was by a narrative synthesis of results

10. RESULTS • Eleven studies were included in the review - Seven healthy children studies - four under-nourished children studies • The studies varied in type and quantity of probiotics, duration of interventions, characteristics of participants and units of outcome measurement. • Four studies found that probiotics lead to an increase in growth of children

11. Figure 1: Effects of Probiotics on weight gain of healthy children

12. Figure 2: Probiotics and weight gain in undernourished children

13. RESULTS Contd • Consistent improvement in growth of children in low income settings • Availability and cost: Use of locally sourced, cheap probiotic substance • Acceptance • Adverse effects

14. CONCLUSION AND RECOMMENDATIONS • The dietary intake of probiotics seems to be effective in improving the growth of children in developing countries. • May contribute to the pace of achieving MDGs • However, there is a need for more quality research studies on the effects of probiotics on growth- different probiotics, age groups, settings, explore local sources

15. REFERENCES • Thomas DW, Greer FR, Bhatia JJS, Abrams SA, Daniels SR, Schneider MB, et al... Clinical report - Probiotics and prebiotics in pediatrics. Pediatrics 2010 December 2010;126(6):1217-1231 • Braegger C, Chmielewska A, Decsi T, Kolacek S, Mihatsch W, Moreno L, et al... Supplementation of infant formula with probiotics and/or prebiotics: A systematic review and comment by the ESPGHAN committee on nutrition. J PediatrGastroenterolNutr 2011 February 2011;52(2):238-250 • Steenhout PG, Rochat F, Hager C. The effect of bifidobacteriumlactis on the growth of infants: A pooled analysis of randomized controlled studies. Annals of Nutrition and Metabolism 2009 December 2009;55(4):334-340.

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