Probiotic Supplementation for Promotion of Growth in Children: A Systematic Review and Meta-Analysis.

Joseph Catania,Emily Tanner-Smith,Muizz Zaman,Joseph P Zackular,Aamer Imdad,Courtney Franceschi,Natasha G Pandit,Abigail Smith,Elizabeth Stone,Zulfiqar A Bhutta,Julie M Ehrlich

doi:10.3390/nu14010083

Abstract

Probiotics are commonly prescribed to promote a healthy gut microbiome in children. Our objective was to investigate the effects of probiotic supplementation on growth outcomes in children 0–59 months of age. We conducted a systematic review and meta-analysis which included randomized controlled trials (RCTs) that administered probiotics to children aged 0–59 months, with growth outcomes as a result. We completed a random-effects meta-analysis and calculated a pooled standardized mean difference (SMD) or relative risk (RR) and reported with a 95% confidence interval (CI). We included 79 RCTs, 54 from high-income countries (HIC), and 25 from low- and middle-income countries (LMIC). LMIC data showed that probiotics may have a small effect on weight (SMD: 0.26, 95% CI: 0.11–0.42, grade-certainty = low) and height (SMD 0.16, 95% CI: 0.06–0.25, grade-certainty = moderate). HIC data did not show any clinically meaningful effect on weight (SMD: 0.01, 95% CI: −0.04–0.05, grade-certainty = moderate), or height (SMD: −0.01, 95% CI: −0.06–0.04, grade-certainty = moderate). There was no evidence that probiotics affected the risk of adverse events. We conclude that in otherwise healthy children aged 0–59 months, probiotics may have a small but heterogenous effect on weight and height in LMIC but not in children from HIC.

Highlights

The role of gut microbiota in human health has been studied extensively in the recent past [1]
After screening the full text of 243 studies, we included 79 studies in our systematic review, of which 54 studies were from high-income countries, and 25 studies from low- and middle
The full text of 243 studies, we included 79 studies in our systematic review, of which 54 studies were from high-income countries, and 25 studies from low- and middleincome countries [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98]

Summary

Introduction

The role of gut microbiota in human health has been studied extensively in the recent past [1]. Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit to the host [8]. Prebiotics are a non-digestible food ingredient that benefit the host by stimulating the growth or activity of microorganisms indigenous to the human digestive tract [9]. A systematic review by Onubi et al assessed the effect of probiotics on growth in children in developing countries [12]. We aimed to systematically assess up-to-date evidence on the effects of probiotics supplementation on growth outcomes in children aged 0–59 months by following the methodological guidance of the Cochrane Collaboration

Objectives

Methods

Results

Conclusion