Abstract
Microbiota and its modification with specific probiotics in early life could provide long term health benefits. Probiotics and calcium strengthen intestinal integrity and may support linear growth. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. We re-enrolled 238 adolescents aged 11–18 years from 494 children 10-years after 6-months of supplementation with either low-lactose milk fortified with low levels of calcium (LC, ∼50 mg/day, n = 53/124), with regular levels of calcium (RC, ∼440 mg/day, n = 70/126), or with regular calcium + 5 x 108 CFU/day Lactobacillus reuteri DSM 17938 (Reuteri, n = 55/124), or regular calcium + 5 x 108 CFU/day L. casei CRL 431 (Casei, n = 60/120). Changes in height-for-age z-score (HAZ) and body mass index-for-age z-score (BMIZ) were determined from the end of intervention to re-enrollment. General linear models were used to assess the effects on HAZ and BMIZ of group, gender, living area, maternal education, family income, physical activity, diet quality, nutritional status, and gut integrity as determined by urinary lactulose/mannitol ratio (L:M). Adolescent mean age was 15.3 years, mean HAZ was − 1.11, mean BMIZ was − 0.2 and median L:M (n = 155) was 0.23. Changes in HAZ and BMIZ were not significantly different between Casei, Reuteri, LC compared to RC. However, a significant decrease in BMIZ was observed among female adolescents in the Casei compared to RC group (− 0.5 SD, 95% CI − 0.8 to − 0.003, p = 0.048). Childhood probiotic and calcium supplementation may therefore selectively affect female adolescents.Clinical trial registration: This follow-up study has been registered at www.clinicaltrials.gov, Registry name: Rina Agustina, Registration number: NCT04046289, First Registration Date 06/08/19. web link: https://www.clinicaltrials.gov/ct2/show/NCT04046289.
Highlights
Microbiota and its modification with specific probiotics in early life could provide long term health benefits
Enteropathy is common in low resource e nvironments[4] and is often associated with an elevated lactulose mannitol ratio (L:M) indicating poor gut integrity, which in turn is correlated with gut dysfunction and growth failure[5]
Probiotics and calcium are sometimes used as food additives to strengthen intestinal integrity and may support child g rowth[7,8]
Summary
Microbiota and its modification with specific probiotics in early life could provide long term health benefits. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. This study was a 10-year re-enrollment follow-up of a previous randomized double blind clinical trial of probiotics and calcium supplementation for 6 months in children 1–6 years of age by Agustina et al.[7]. The intervention showed significant positive effects on weight gain, linear growth velocity, and reduction in stunting prevalence by 10% in the Reuteri (Lactobacillus reuteri DSM 17938) group. This re-enrollment study aimed to identify long-term effects of probiotics and calcium supplementation in childhood on growth during adolescence
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