title: Probiotics Lactobacillus reuteri DSM 17938 and Lactobacillus casei CRL 431 modestly increase growth, but not iron and zinc status, among Indonesian children aged 1-6 years.
abstract: Probiotics and milk calcium may increase resistance to intestinal infection, but their effect on growth and iron and zinc status of Indonesian children is uncertain. We investigated the hypotheses that cow milk with added probiotics would improve growth and iron and zinc status of Indonesian children, whereas milk calcium alone would improve growth but reduce iron and zinc status. A 6-mo randomized trial was conducted in low-socioeconomic urban communities of Jakarta. Healthy children (n = 494) were randomly assigned to receive low-lactose milk with a low calcium content of ∼50 mg/d (LC; n = 124), a regular calcium content of ∼440 mg/d (RC group; n = 126), regular calcium with 5 × 10(8) CFU/d Lactobacillus casei CRL 431 (casei; n = 120), or regular calcium with 5 × 10(8) CFU/d Lactobacillus reuteri DSM 17938 (reuteri; n = 124). Growth, anemia, and iron and zinc status were assessed before and after the intervention. Compared with the RC group, the reuteri group had significantly greater weight gain [0.22 (95% CI: 0.02, 0.42) kg], weight-for-age Z-score (WAZ) changes [0.09 (95% CI: 0.01, 0.17)], and monthly weight [0.03 (95% CI: 0.002, 0.05) kg/mo] and height [0.03 (95% CI: 0.01, 0.05) cm/mo] velocities. Casei significantly increased monthly weight velocity [0.03 (95% CI: 0.001, 0.05) kg/mo], but not height. However, the changes in underweight, stunting, anemia prevalence, and iron and zinc status were similar between groups. In conclusion, L. reuteri DSM 17938 modestly improved growth by increasing weight gain, WAZ changes, and weight and height velocity, whereas L. casei CRL 431 modestly improved weight velocity. Independent from probiotics supplementation, regular milk calcium did not affect growth or iron and zinc status.
authors.affiliation: Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Jakarta, Indonesia. dr.rinaagustina@gmail.com
authors.forename: Rina
authors.initials: R
authors.lastname: Agustina
authors.forename: Ingeborg M J
authors.initials: IM
authors.lastname: Bovee-Oudenhoven
authors.forename: Widjaja
authors.initials: W
authors.lastname: Lukito
authors.forename: Umi
authors.initials: U
authors.lastname: Fahmida
authors.forename: Ondine
authors.initials: O
authors.lastname: van de Rest
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
authors.forename: Agus
authors.initials: A
authors.lastname: Firmansyah
authors.forename: Ratna
authors.initials: R
authors.lastname: Wulanti
authors.forename: Ruud
authors.initials: R
authors.lastname: Albers
authors.forename: Ellen G H M
authors.initials: EG
authors.lastname: van den Heuvel
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D000818:Animals; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000097:blood; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D019587:Dietary Supplements; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D019266:Iron, Dietary / Q000008:administration & dosage / Q000097:blood*; D007780:Lacticaseibacillus casei; D052200:Limosilactobacillus reuteri; D008297:Male; D008892:Milk / Q000737:chemistry; D009752:Nutritional Status; D015995:Prevalence; D019936:Probiotics / Q000008:administration & dosage*; D012959:Socioeconomic Factors; D015430:Weight Gain; D015032:Zinc / Q000008:administration & dosage / Q000097:blood*
chemical_list: D002136:Calcium, Dietary; D019266:Iron, Dietary; D015032:Zinc