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Background <p>This study employs a network meta-analysis to compare the effectiveness of multiple nutritional supplements in preventing childhood respiratory infections.</p> Methods <p>Systematically searched PubMed, Embase, Cochrane Library, Web of Science from their inception to 1 September 2025. Included studies were randomized controlled trials evaluating nutritional supplements for preventing respiratory infections in children under 18 years old. The primary outcome was the incidence of respiratory infections. Traditional meta-analysis and Bayesian network meta-analysis were conducted using random-effects models to calculate odds ratios (OR) and their 95% credible intervals (CrI). The cumulative sorted rank curve area (SUCRA) was used to rank the efficacy of each intervention. The Cochrane risk of bias tool was applied to assess the quality of included studies.</p> Results <p>A total of 19 articles involving 11,576 children were included. Direct comparison meta-analysis showed no statistically significant differences between low-dose vitamin D, vitamin A, vitamin A combined with zinc, zinc, and placebo. Network meta-analysis formed a closed-loop network, and local inconsistency tests revealed no significant differences in either direct or indirect comparisons. The league table indicated a trend toward reduced risk of childhood respiratory infections with high-dose vitamin D (HVD) compared to placebo [OR = 0.76, 95% CrI (0.61, 0.94)]. The cumulative ordered probability (SUCRA) for each intervention was: HVD (82.44%) &gt; LVD (64.81%) &gt; Iron (57.2%) &gt; VA_Zinc (54.56%) &gt; Probiotics (52.49%) &gt; Zinc (42.5%) &gt; VA (23.31%).</p> Conclusion <p>This study indicates that among the various nutritional interventions included, HVD demonstrated the greatest potential effect in preventing respiratory infections in children. Direct comparison meta-analyses revealed no statistically significant differences between LVD, VA, VA_Zinc, zinc, and placebo. A network meta-analysis further supported these findings, with league table and SUCRA rankings indicating HVD may offer the optimal efficacy among all interventions.</p> Clinical registration number <p>Not applicable.</p>

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Comparative efficacy of nutritional supplements for the prevention of respiratory tract infections in children: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月16日

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  • Yanmin Xing,
  • Dongdong Huang,
  • Lele Niu,
  • Ying Liu

摘要

Background

This study employs a network meta-analysis to compare the effectiveness of multiple nutritional supplements in preventing childhood respiratory infections.

Methods

Systematically searched PubMed, Embase, Cochrane Library, Web of Science from their inception to 1 September 2025. Included studies were randomized controlled trials evaluating nutritional supplements for preventing respiratory infections in children under 18 years old. The primary outcome was the incidence of respiratory infections. Traditional meta-analysis and Bayesian network meta-analysis were conducted using random-effects models to calculate odds ratios (OR) and their 95% credible intervals (CrI). The cumulative sorted rank curve area (SUCRA) was used to rank the efficacy of each intervention. The Cochrane risk of bias tool was applied to assess the quality of included studies.

Results

A total of 19 articles involving 11,576 children were included. Direct comparison meta-analysis showed no statistically significant differences between low-dose vitamin D, vitamin A, vitamin A combined with zinc, zinc, and placebo. Network meta-analysis formed a closed-loop network, and local inconsistency tests revealed no significant differences in either direct or indirect comparisons. The league table indicated a trend toward reduced risk of childhood respiratory infections with high-dose vitamin D (HVD) compared to placebo [OR = 0.76, 95% CrI (0.61, 0.94)]. The cumulative ordered probability (SUCRA) for each intervention was: HVD (82.44%) > LVD (64.81%) > Iron (57.2%) > VA_Zinc (54.56%) > Probiotics (52.49%) > Zinc (42.5%) > VA (23.31%).

Conclusion

This study indicates that among the various nutritional interventions included, HVD demonstrated the greatest potential effect in preventing respiratory infections in children. Direct comparison meta-analyses revealed no statistically significant differences between LVD, VA, VA_Zinc, zinc, and placebo. A network meta-analysis further supported these findings, with league table and SUCRA rankings indicating HVD may offer the optimal efficacy among all interventions.

Clinical registration number

Not applicable.