Probiotics May Not Help Treat Severe Malnutrition

But reduced outpatient mortality warrants further investigation
By Jane Parry
HealthDay Reporter

FRIDAY, July 10 (HealthDay News) -- Adding probiotics and prebiotics to ready-to-use high-energy food to treat African children with severe, acute malnutrition does not improve outcomes, according to a study published in the July 11 issue of The Lancet.

Marko Kerac, of the Centre for International Health and Development in London, and colleagues conducted a study of 795 Malawian children aged 5 to 168 months, of whom 399 were randomized to receive ready-to-use therapeutic food with the probiotic/prebiotic supplement Synbiotic2000 Forte, while 396 received the food alone. The treatment continued for a median of 33 days.

The two groups achieved similar nutritional cure rates, with 53.9 percent of the intervention group achieving weight for height of more than 80 percent of the target median on two consecutive outpatient visits, compared to 51.3 percent for the control group, the investigators found. Although mortality, weight gain, time to cure and prevalence of clinical symptoms were similar in the groups, there was a possible trend toward reduced outpatient mortality in the intervention group, the researchers discovered.

"An observation of reduced mortality in Synbiotic outpatients is important to explore in future studies," the authors write. "We cannot rule out bias, confounding, or chance. An effect is, however, biologically plausible. Enteropathy associated with severe acute malnutrition is an especially important problem that might be addressed by probiotics, which makes them also useful to other less severe but more prevalent forms of acute malnutrition."

One co-author is an unpaid director of Valid Nutrition, a charity that makes ready-to-use therapeutic food in developing countries.

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