Luận án tiến sĩ của NCS Nguyễn Lân

STUDY ABSTRACT

INTRODUCTION

Name of Author: Nguyen Lan       

Study title: “Effect of formula with pre-probiotic supplementation on nutritional status, infections and gastrointestinal microflora in children 6-12 months of age in Pho Yen district, Thai Nguyen province.”

Specification: Nutrition       Code: 62.72.03.03

Scientific instructors: Prof. PhD.Nguyen Gia Khanh, Ass. Prof. Nguyen Thi Lam

Traning institution: National institute of Nutrition, Viet Nam

CONTENT

Study Objectives and study subjects

Specific objectives:

1. To describe the breastfeeding situation, complementary feeding practices, feeding situation and morbidity of children aged from 5-6 months in Pho Yen district, Thai Nguyen province.

2. To assess the effect of formula milk supplemented with prebiotic or with synbiotic on nutritional status, infections and on gastrointestinal microflora in children 6-12 months of age during the 6 months intervention.

Study was carried on children of 6-12 months of age in Pho Yen district, Thai Nguyen province

Study methodology

Anthropometry:

Main findings and conclusion

1. Breastfeeding, complementary feeding and infections in studied location:

Breastfeeding practice and complementary feeding are inappropriate in studied location: 15.2% are breastfed after 24 hours after birth; more than 50% of mothers give different foods to children before first breastfeeding; nearly 90% of children are introduced to complementary foods under 4 months of age, and 0.7% within 5-6 months of age. Average age of children  to introduction of complementary foods are 3.4 months. The main reasons for early introduction to complementary feeding are: mother is busy (54.9%), mothers do not have enough breastmilk (16.9%), the common foods used for children are rice flour, commercial flour (70.3%), meat, fish, eggs (32.8%).  Child care practices are inappropriate in study location, the prevalence of infectious disease remains high: 5.3% of mothers breastfeed less when child got sick. The prevalence of diarrhea and ARI  within two weeks before the study was 21.7% and 27.6% respectively

2. Effect of formula with prebiotic and synbiotic on growth, gastrointestinal and respiratory infection and gastrointestinal microflora:

2.1. Growth of children:

- After 6 months intervention, Children in  prebiotic and synbiotic 1 have significantly higher weight gain compared to control group (2,6kg; 2,4kg vs 2,2 kg) (p<0,05). Children in synbiotic 1 have significantly higher height increment compared to control after 6 month intervention (p <0.05). Z-Score of weight for age (WAZ), height for age (HAZ), weight for length (WHZ) have no differences between study groups (p> 0.05).

2.2. Gastrointestinal and respiratory infections in children

Formula with prebiotic or synbiotic supplementation for breastfed children during 6 month intervention has no significant effect on the majority of symptoms of gastrointestinal and respiratory infection. The prevalence of flatulence in prebiotic and synbiotic 2 group are significantly lower compared to control group (1.7%, 9.1% vs 23.6%) (p <0.05), number of hard stools is significantly lower  in a synbiotic 1 group compared to the control, prebiotic and synbiotic  2 group  (0 vs 1 and 0, 0) (p <0.01).

2.3. Gastrointestinal microflora in children

Formula with prebiotic or synbiotic supplementation for breastfed children tends to increase the quantity and the ratio of beneficial bacteria Lactobacilli & Bifidobacteria to total  bacteria (for Bifidobacteria, the trend is not sustained), while reducing the number of total bacteria, number and ratio of some harmful bacteria total bacteria  such as Bacteroides and E. coli. Particularly, after 6 months intervention, the proportion of children with BB12 (+) and number of BB12 in synbiotic supplemented children group are significantly higher compared to 2 other  groups (43.8% and 66.7% vs 0%) and (1,47.107 and 1,85.107 vs 0) (p <0.05). Synbiotic 1 show a few more advantages to intestinal bacteria flora systems, although there was not really stable.

Practical implications and new contributions of the thesis

1. Testing new intervention approach in reducing gastro-intestinal and respiratory infections besides other nutrition interventions to improve the nutritional status of children in Vietnam.

2. The effects of prebiotic and synbiotic with 2 different doses of prebiotic on growth, gastrointestinal and respiratory infections and on gastro-intestinal microflora in  children of 6 - 12 months in Vietnam have been assessed

3. Research results show that supplemented B. lactis BB12 is able to survive and thrive in the gastro-intestinal tract in Vietnamese children during the 6-month intervention.