Effect of infant formula supplemented with prebiotics and probiotics on incidence of respiratory tract infections: A systematic review and meta-analysis of randomized clinical trials

Kamil Rashidi; Mina Darand; Nazila Garousi; Azadeh Dehghani; Shahab Alizadeh

doi:10.1016/j.ctim.2021.102795

Effect of infant formula supplemented with prebiotics and probiotics on incidence of respiratory tract infections: A systematic review and meta-analysis of randomized clinical trials

Complement Ther Med. 2021 Dec:63:102795. doi: 10.1016/j.ctim.2021.102795. Epub 2021 Nov 30.

Authors

Kamil Rashidi¹, Mina Darand², Nazila Garousi³, Azadeh Dehghani⁴, Shahab Alizadeh⁵

Affiliations

¹ Department of Food Sciences and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: kamilrashidi@yahoo.com.
² Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mdarand@gmail.com.
³ Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: garousinazila70@gmail.com.
⁴ Nutrition Research Center, Department of Community Nutrition, faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: azadehdehghani68@yahoo.com.
⁵ Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address: sh_alizadeh@razi.tums.ac.ir.

PMID: 34861367
DOI: 10.1016/j.ctim.2021.102795

Abstract

Background: Previous investigations have proposed that the consumption of infant formula supplemented with prebiotics, probiotics and synbiotics (PRO-formula) may have protective impacts on respiratory tract infections (RTIs). Nevertheless, the findings of studies are contradictory. This meta-analysis aimed to explore the influence of PRO-formula on RTIs in infants by pooling randomized controlled trials (RCTs).

Methods: To obtain eligible RCTs, Scopus and PubMed databases were systematically searched from their inception to November 2020. A random-effects model was applied to pool the relative risks (RR) and corresponding 95% confidence intervals (CI) for RTIs following consumption of PRO-formula.

Results: A total of 15 RCTs, with a total sample size of 3805 participants (1957 for intervention and 1848 for placebo), were included in the present meta-analysis. In the overall analysis, in comparison to placebo, consumption of PRO-formula had a significant protective impact against RTIs (RR = 0.89, 95%CI: 0.82-0.97) in infants, with a remarkable evidence of heterogeneity across studies (I2 = 61.4%, P < 0.001). In the meta-regression analysis, the effect of PRO-formula on RTIs was not modified by the follow-up duration. No evidence for publication bias was detected.

Conclusions: Administration of PRO-formula may be a potential approach for the prevention of respiratory tract infections in infants.

Keywords: Formula; Meta-analysis; Prebiotics; Probiotics; Respiratory tract infections; Synbiotics.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Humans
Incidence
Infant
Infant Formula
Prebiotics
Probiotics* / therapeutic use
Randomized Controlled Trials as Topic
Respiratory Tract Infections* / drug therapy
Respiratory Tract Infections* / prevention & control
Synbiotics*

Substances

Prebiotics