Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Abstract

OBJECTIVE: Children are vulnerable to diet inadequacies, which may affect immune function. Our objective was to determine if a follow-up formula (FUF) containing DHA, the prebiotics PDX and GOS, and yeast β-glucan affects incidence of respiratory infections and diarrheal disease in healthy children. METHODS: In a double-blind, randomized, controlled, prospective trial, 3-4 year old children were fed 3 servings per day of either a FUF with 25 mg DHA, 1.2 g PDX/GOS, and 8.7 mg yeast β-glucan per serving or an unfortified, cow’s milk-based beverage (control) for 28 weeks. Fecal and blood samples were collected to assess immune markers and iron/zinc status. Incidence of acute respiratory infections (ARI), diarrheal disease, and antibiotic treatment were obtained from medical records. RESULTS: The FUF group had fewer episodes and shorter duration of ARI (mean days [SE]; control = 4.3 [0.2]; FUF = 3.5 [0.2]; P = .007), less antibiotic use (n [%]; control = 21 [14%]; FUF = 8 [5%]; P = .01), and fewer missed days of day care due to illness. No diarrheal disease was diagnosed in either group. The FUF group had higher interleukin-10 and white blood cell count at the end of the study. There were no differences in hemoglobin, serum ferritin and zinc, or fecal secretory immunoglobulin A. CONCLUSIONS: Daily consumption of a FUF was associated with fewer episodes and shorter duration of ARI, as well as less antibiotic use. The children who consumed the FUF had increased interleukin-10 and white blood cells, suggesting an antiinflammatory mechanism and/or an increase of effector immune cells.

Similar Occurrence of Febrile Episodes Reported in Non-Atopic Children at Three to Five Years of Age after Prebiotics Supplemented Infant Formula

“…Recent studies showed influence of dietary micronutrient intake on the occurrence of infections. Most of these studies have been done in developing countries [19] in specific patient groups [20], or do not present data about infections [21]. It is difficult to extrapolate these study results to other populations.…”

Why Dietary Supplements?

“…7 In the study by Li et al, 5 it was 65% at study entry and 58% at study conclusion. This finding, along with the low ZWH inclusion criteria, suggests at least some of the children were malnourished at entry into the study, in which case supplements could be beneficial.…”

“…In the end, the article by Li et al 5 does not further understanding of how nutrients might reduce infections. The supplement simply had too many additions to allow one to discern which one or combination thereof had a desirable effect.…”

“…Information important to the interpretation of this report 5 is lacking. The reader needs to know actual weights of the children, how much of the milk or supplement was consumed, and the daily total caloric intake.…”

“…Although not well defined, 2 the quality of diets in young children is likely to have lasting effects on growth and development. 3,4 To discover if a nutritional supplement would decrease the number of infections and positively affect the immune system in healthy children, Li et al 5 fed children a follow-up formula to which docosahexaenoic acid, yeast b-glucan, and a prebiotic blend of polydextrose and galactooligosaccharides were added. They compared data from these children with a group who were fed cow' s milk in place of the supplemented formula.…”