title: Effect of nucleotides on diarrhea and immune responses in healthy term infants in Taiwan.
abstract: OBJECTIVE
  The aim of this study was to compare the effects of an infant formula fortified with nucleotides (NF) with those of a control formula (CF) on the incidence of diarrhea, respiratory tract infections (RTIs), and immune responses in healthy term infants.
  
  
  METHODS
  This 12-month, double-blind study was conducted on 1- to 7-day-old infants randomized to receive NF or CF exclusively until 12 weeks of age, and fed the assigned formula with solid food until 12 months. NF was supplemented with 72 mg/L of nucleotides, based on the total potentially available nucleotide content of human milk. Subjects were evaluated within 1 week of birth, at 4 weeks, and every 4 weeks thereafter until 48 weeks of age. The primary outcome variable was the incidence of diarrhea. Secondary variables included RTIs, serum immunoglobulin concentrations, and response to hepatitis B vaccine.
  
  
  RESULTS
  Compared with subjects fed CF (n = 170), those fed NF (n = 166) had a trend toward reduced risk of diarrhea from 8 to 48 weeks of age and a significantly lower risk of 25.4% (P = 0.05) between 8 and 28 weeks. NF subjects had significantly higher serum immunoglobulin A concentrations ( P < 0.05) throughout the 48-week study. The NF group had an increased risk of upper RTIs, the same incidence of lower RTIs, and the same antibody response to hepatitis B vaccination as the CF group, based on one-sided tests. Growth was normal in both groups, and no adverse events were considered to be formula-related.
  
  
  CONCLUSIONS
  Healthy term infants from 8 to 28 weeks of life are less likely to experience diarrhea and have higher serum immunoglobulin A concentrations with NF compared with formula without added nucleotides.
authors.affiliation: College of Medicine, Catholic Fu-Jen University, Department of Pediatric, Cardinal tien Hospital, Kaohsiung Hsien, Taiwan.
authors.forename: Kuo-Inn Tsou
authors.initials: KI
authors.lastname: Yau
authors.forename: Chung-Bin
authors.initials: CB
authors.lastname: Huang
authors.forename: Walter
authors.initials: W
authors.lastname: Chen
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Yi-Hong
authors.initials: YH
authors.lastname: Chou
authors.forename: Fu-Yuan
authors.initials: FY
authors.lastname: Huang
authors.forename: Ka Em
authors.initials: KE
authors.lastname: Kua
authors.forename: Nancy
authors.initials: N
authors.lastname: Chen
authors.forename: Maggie
authors.initials: M
authors.lastname: McCue
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Alarcon
authors.forename: Randy L
authors.initials: RL
authors.lastname: Tressler
authors.forename: Gail M
authors.initials: GM
authors.lastname: Comer
authors.forename: Geraldine
authors.initials: G
authors.lastname: Baggs
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Merritt
authors.forename: Marc L
authors.initials: ML
authors.lastname: Masor
mesh_terms: D001903:Bottle Feeding; D003967:Diarrhea / Q000178:diet therapy*; D004311:Double-Blind Method; D005260:Female; D005527:Food, Fortified; D006510:Hepatitis B Antibodies / Q000097:blood; D006801:Humans; D007107:Immune System; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology*; D007225:Infant Food; D007231:Infant, Newborn; D008297:Male; D009711:Nucleotides / Q000276:immunology* / Q000627:therapeutic use*; D012016:Reference Values; D012141:Respiratory Tract Infections / Q000276:immunology*; D013624:Taiwan
chemical_list: D006510:Hepatitis B Antibodies; D007136:Immunoglobulins; D009711:Nucleotides