Scientist - News - 22-07-2009:

Probiotics and malnutrition
Beintema, Nienke

Probiotics do not improve the treatment of severe malnutrition. British research in Malawi showed no beneficial effect, other than a non-significant observation of reduced mortality. The authors recommend further research.

Severe acute malnutrition affects 13 million children worldwide and causes 1 to 2 million deaths every year. Researchers from the College of Medicine Malawi and the University College London Centre for International Health and Development studied whether probiotics could support nutritional treatment of malnutrition. The research, which was funded by the British Department for International Development (DfID), was published in the famous medical journal The Lancet on 11 July.

Pre- and probiotics
The researchers studied 795 malnourished, Malawian children aged 5 months to 14 years and enrolled them in a double-blind, randomised, placebo-controlled trial. They first stabilised the children’s condition with milk-based supplements. The children were then randomly assigned to ready-to-use therapeutic food either with or without Synbiotic2000 Forte, a supplement that contains both prebiotic fibres and lactic acid bacteria. The treatment lasted on average 33 days. The researchers measured the children’s weight gain, length, death, time to cure, and prevalence of clinical symptoms such as diarrhoea, fever, and respiratory problems.
The study showed that there was no significant difference between the two groups. In the probiotics group, 53.9 percent of children were cured of their malnutrition within the study period, versus 51.3 percent in the control group. The other health measures showed no differences either, apart from a non-significant trend towards reduced mortality in the probiotic group. "This finding", write the authors, "might be caused by bias, confounding, or chance, but is biologically plausible. It has potential for public health impact, and should be explored in future studies."
The researchers found that overall outcomes were worse in HIV-infected children, but that among these, there were no differences between the experimental and control groups. This finding is important, as the authors note, as probiotics are under scrutiny for potential adverse effects in people with challenged immune function.

More information:
Article in The Lancet