Fermented Milk and Fermented Rice on the Appearance of Respiratory and Gastrointestinal Symptoms
Condition: Gastrointestinal Infections; Respiratory Infections
MeSH terms: Infections; Communicable Diseases; Respiratory Tract Infections
Study type: Interventional
Phase: Phase 3

Summary: 
      The respiratory and gastrointestinal infections are a very common problem with high morbidity
      in children. These conditions were due, in general, immaturity and all "inexperience" of the
      immune system, as well as to the particular anatomical structure and function of the
      respiratory and gastrointestinal tract still developing. This inevitably means that
      school-age children develop disease (as a result of infection) more easily than at later
      ages. The frequency and duration of these conditions implies a high discomfort and incur
      significant costs in relation to drug administration, the need for hospitalization, days of
      absence from school and work days lost by parents.

      Recently probiotics, defined as "microorganisms that prove able, once ingested in adequate
      amounts, exert beneficial functions for the body "have been proposed for the treatment of
      treatment of respiratory and gastrointestinal infections of childhood but only in recent
      years have been conducted controlled clinical trials that have conclusively proven
      effectiveness. All probiotics induce an immune response, the characteristics of which are
      related to the strain or the mixture of bacteria used. Recent studies have demonstrated
      positive effects of probiotics on the respiratory system, and in particular on the prevention
      and reduction of the severity of respiratory infections, probably mediated by an increase of
      cells that secrete Immunoglobulin A in bronchial mucosa. It 'been shown that probiotics can
      be a sure way to reduce the risk of early acute otitis media and the use of antibiotics for
      recurrent respiratory infections during the first year of life. Similar results were seen in
      a study conducted on a population of 326 children aged between 3 and 5 years, who found a
      decrease in the incidence of antibiotic use by over 65% and a reduction of days of absence of
      more than 25% among children treated with a probiotic. Many of the studied effects of
      probiotics, understandably, refer to the digestive system. These effects relate to both
      conditions paraphysiological (constipation) and more specifically in situations of illness.

      Most of the studies carried out in recent years has demonstrated the efficacy of specific
      probiotics in reducing the symptoms in the pediatric population affected by infectious
      gastroenteritis. Probiotics reduce the duration of infectious diarrhea by 0.7 days and reduce
      the frequency of diarrheal episodes in the first few hours.

      The microbiota on the other hand participates in the function of the mucosal barrier against
      the adhesion of pathogenic bacteria, crucial time for the start of the infectious process.

      When this barrier function is altered by chemical agents, by antigens or by stressors of
      different nature, may manifest intestinal disorders, sometimes due to the growth of bacteria
      pathogens. Numerous experimental data suggest that probiotics can contribute to the
      reinforcement of the activities of gut mucosal barrier, in particular aspects affecting the
      functionality of the intestinal epithelial cells or macrophages.

      More recently it has been shown that daily intake for 3 months of preparation with probiotics
      reduce the incidence and severity of the most common respiratory infections and limits the
      number of days of absence school children during the winter season.

      It's scientifically recognized as some probiotic effects can also be obtained with the use of
      inactivated bacteria or bacterial components isolated (eg bacterial DNA). It has been
      recently proposed a modified definition of probiotic products as "prepared bacterial cells or
      bacterial components that have a beneficial effect on the health and welfare of the host".

      Among these products "probiotic-like" fall ingredients object of this study: food ingredients
      (rice flour and skim milk) fermented, or in which has been made to grow a probiotic
      (Lactobacillus CBA-L74) that has been inactivated at the end of the fermentation process
      through a heat treatment. The benefits are attributable to bacterial components that remain
      in the final product (for example, DNA, cell wall, etc.) and factors produced during the
      fermentation (short chain fatty acids, bacterial proteins, etc.).

      The main effects of these bacterial components relate to the stimulation of the
      gastrointestinal tract associated lymphoid tissue (GALT), through interaction with the immune
      cells via Toll-like receptors.

      In addition, some components, such as proteins and peptides, may have a Bifidogenic activity
      and are available in the literature some studies that have demonstrated the ability of infant
      formula, milk-based fermented to reduce the severity of episodes of infectious diarrhea in
      children.

      With this data, the Commission of the European Society of Nutrition Gastroenterology,
      Hepatology and Pediatric Nutrition (ESPGHAN) has defined this type of products are not only
      safe but to determine a potential prebiotic effect and the reduction of the severity of
      episodes of infectious diarrhea.
    


Intervention name(s): fermented milk; fermented rice
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): fermented milk with Lactobacillus CBA-L74; fermented rice wit Lactobacillus CBA-L74
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: children, fermented milk fermented rice, gastrointestinal infections, respiratory infections