The number of infants who experienced more than three upper respiratory tract infections (URTIs) was 17 per cent less amongst those receiving formula containing a mixture of galacto- and fructo-oligosaccharides, according to findings published in Clinical Nutrition.
The study has been hailed as “a very important paper that adds positively to the prebiotics field” by prebiotic expert Professor Glenn Gibson from the University of Reading.
Prof. Gibson, who first coined the term 'prebiotic' in 1995 with Marcel Roberfroid from the Catholic University of Louvain (J. Nutr. Vol. 125, pp. 1401-1412), told NutraIngredients.com: “The impact of this research could be huge and has major implications for reducing gut infections when breast feeding is not possible.
“It is worth considering prebiotic use where infant diarrhoea is prevalent and may cause many fatalities, for example in under developed countries. Those involved in taking such decisions would be well advised to read this publication.”
The new study, led by Alfredo Guarino from the University of Naples, followed 342 infants participating in a prospective, randomised, placebo-controlled, open trial, partly funded by Numico Research in Germany.
The infants were randomly assigned to receive either a control formula, or a formula containing an additional mixture of galacto- and fructo-oligosaccharides (0.4 grams of prebiotic per 100 ml of formula, with a GOS – FOS ratio of 9:1).
Over the course of 12 months, the researchers documented that the incidence of gastroenteritis was lower in the prebiotic-supplemented formula group with only 0.12 episodes per child throughout the year, compared to 0.29 episodes per child in the control group.
Furthermore, the number of infants who experienced more than three episodes tended to be lower in group receiving the GOS/FOS-supplemented formula. This was reflected in a reduced number of children requiring multiple antibiotic courses.
“Prebiotic administration reduce intestinal and, possibly, respiratory infections in healthy infants during the first year of age,” concluded the researchers.
Commenting independently on the research, Professor Gibson told this website that the study “supports the inclusion of prebiotics into infant formulae and generates health promoting data s a result”.
“The use of prebiotics to infant formula is carried out in order to more closely simulate this effect during bottle feeding. The approach has been well used and seems efficacious. The health consequences of prebiotic use are more difficult to prove, but much new research has contributed well to this. One of the more important aspects for prebiotic use is the ability to reduce gastrointestinal infections.
“The study by Bruzzese et al. has been very well conducted (notably using a large population number) and generated very important data on the rational for using proven prebiotics in infant formula. The mechanism is likely explained by an increase in bifidobacteria and their concomitant anti-pathogen effects,” said Prof. Gibson.
“It is recognised that the gut microbiota of breast and formula fed infants differs in that health promoting genera such as the bifidobacteria predominate in the former. This explains, at least partly, the improved resistance to infections seen during breast feeding,” he added.
Breast versus bottle
Infant formula is a highly emotive area, with watchdogs keeping a close eye on companies' marketing tactics lest they drift towards promoting their products as preferable to breast feeding.
While it is agreed that breastfeeding is best, formulas are indispensable in cases where mothers are unable to feed their children - be it for health or logistical reasons. Mothers' desire to give their children the best possible start in life means that there is scope for fortification.
Research and product development on the ingredient side has centred on replicating the healthy profile of breast milk as far as possible.
Source: Clinical Nutrition Published online ahead of print, doi:10.1016/j.clnu.2009.01.008"A formula containing galacto- and fructo-oligosaccharides prevents intestinal and extra-intestinal infections: An observational study" Authors: E. Bruzzese, M. Volpicelli, V. Squeglia, D. Bruzzese, F. Salvini, M. Bisceglia, P. Lionetti, M. Cinquetti, G. Iacono, S. Amarri, A. Guarino