A combination of Bifidobacterium breve M-16V and Danone’s Immunofortis-branded mix of galacto and fructooligosaccharide prebiotics was also associated with 20 percent reductions in the prevalence of 'frequent wheezing' in children with atopic dermatitis (AD), compared with placebo, according to findings published in the journal Allergy.
AD, also known as eczema, is one of the first signs of allergy during the early days of life and is said to be due to delayed development of the immune system. It is a common inflammatory skin disorder, which occurs in early childhood and may persist into adult life. According to the American Academy of Dermatologists, it affects between 10 to 20 per cent of all infants, but almost half of these kids will 'grow out' of eczema between the ages of five and 15.
According to a Swedish study from 2000, 40 percent of kids with eczema will develop asthma later in childhood (Allergy, Vol. 55, pp. 240-245).
New findings from the Synbad study group in the Netherlands indicate that daily supplements with probiotics and prebiotics – the mixture being called synbiotic – may prevent asthma-like symptoms in children with eczema. The study was sponsored by Danone Research – Centre for Specialised Nutrition.
“To our knowledge, no previous studies on the efficacy of probiotics, prebiotics or synbiotics in children with AD have also explored a possible preventive effect on asthma-like symptoms in these children,” wrote the researchers, led by Leontien van der Aa from the Department of Pediatric Respiratory Medicine and Allergy at Emma Children’s Hospital in Amsterdam.
“The infants included in our study will be followed up to age 5–6, when they are old enough for lung function tests and bronchial hyper-responsiveness measurements, to determine whether this synbiotic mixture also prevents the development of asthma,” they added.
According to the FAO/WHO, probiotics are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host". Prebiotics are "nondigestible substances that provide a beneficial physiological effect on the host by selectively stimulating the favourable growth or activity of a limited number of indigenous bacteria". Synbiotics are a combination of the two.
Dr van der Aa her co-workers recruited 90 infants with AD and under seven months of age, and randomly assigned them to receive infant formula with or without the B. breve M-16V (Morinaga Milk Industry Co., Japan) at a dose of 1.3 billion colony forming units per 100 ml plus the GOS/FOS mix (90%:10%). The experimental period last for 12 weeks.
One year after the study, data was available for 75 children, and this showed that the absolute risk of asthma symptoms 'frequent wheezing' and 'wheezing and/or noisy breathing apart from colds' were 20 and 28 percent lower, respectively, in the synbiotic group, compared with the placebo group.
Furthermore, 20 percent fewer children were using asthma medication in the synbiotic group, compared with the placebo group.
“The underlying mechanism of the lower prevalence of asthma-like symptoms in the synbiotic group is not yet fully understood,” explained the researchers. “It is known that asthma-like symptoms are often related to respiratory infections [and] [s]ynbiotics have been shown to decrease the number of respiratory infections. Therefore, a hypothesis could be that, in our study, synbiotics reduced the prevalence of asthma-like symptoms by lowering the respiratory infection rate.”
However, the researchers did not measure the incidence of respiratory infections during the 1-year follow-up period, and no differences between infection rates were observed during the 12-week of direct intervention.
Dr van der Aa and her co-workers added that larger clinical studies with the same synbiotic mixture are needed to confirm their findings.
Yet more proof
Commenting independently on the study, Glenn Gibson, Professor of Food Microbial Sciences at the University of Reading in the UK and a world leader in prebiotic research, told NutraIngredients-USA that, although the authors state that a larger trial is required, 90 persons recruited is already impressive.
"There is a clear effect of synbiotic administration on reduced allergy and associated symptoms (wheezing, noisy breathing). Given the study design there is no doubt to me that this was due to elevated gut bifidobacteria which would occur with this particular synbiotic," said Prof Gibson.
"It is yet more proof that increasing these bacteria does have health advantages, and backs up the research of many other published articles in this regard. This is a scientific fact that, stunningly, is constantly refuted by the EFSA NDA panel who would no doubt turn a subjective blind eye to such convincing data as is presented here," he added.
EFSA and Immunofortis
Last year, the European Food Safety Authority’s (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA) issued a negative opinion regarding Danone’s Immunofortis prebiotic formula for the claim that the formula could “naturally strengthen the baby’s immune system”.
The opinion provoked a strong response from Christian Neu, president of Danone Baby Nutrition (DBN), who said EFSA’s health claim assessment methodologies are threatening the reputation of the scientific peer-review process and sections of the medical fraternity.
“This goes beyond the interests of DBN,” Neu wrote in a 22-page defence of DBN’s Immunofortis prebiotic formula-based, infant immunity claim in March 2010. “It also regards the effect of this public opinion on the reputation of the external scientists which worked directly on, or peer-reviewed the science. Likewise, it affects the reputation of the community of medical advisors who support the health effects of the mixture referred to above [Immunofortis].”
To read more on Danone’s defense, please click here. EFSA’s unit head of the NDA panel subsequently wrote a five-page letter to the European Commission’s Basil Mathioudakis defending the initial opinion handed to Danone. To read more about EFSA’s response, please click here.
February 2011, Volume 66, Issue 2, pages 170–177
“Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis”
Authors: L. B. van der Aa, W. M. C. van Aalderen, H. S. A. Heymans, J. Henk Sillevis Smitt, A. J. Nauta, L. M. J. Knippels, K. Ben Amor, A. B. Sprikkelman, the Synbad Study Group