- 30 million children worldwide suffer from moderate acute malnutrition.
- Lifelong problems from undernourishment include increased risks of diabetes and heart problems.
- New research shows that targeting the microbiome could help malnourished children grow up healthy.
According to the United Nations Food and Agriculture Organization, an estimated 815 million people — nearly 11 percent of the global population — suffer from chronic undernourishment. While the predominant number of them live in poor countries, some 11 million live in more developed nations. As the pandemic rages on and the effects of climate change continue, those numbers will continue to increase if there are no interventions.
A new study, published in The New England Journal of Medicine by an international team of researchers, investigates one potential solution that could address the 30 million children suffering from moderate acute malnutrition: target the microbiome.
Childhood undernourishment results in a variety of crippling lifelong effects: wasting and stunting (impaired growth and development), immune and metabolic dysfunction, and central nervous system problems top the list. With the pandemic predicted to increase childhood deaths from wasting by 20 percent, the team expresses urgency for this chronic problem.
Feeding the microbiota
For this randomized, controlled study, researchers recruited 118 children between the ages of 12 to 18 months. They split the recruits into two groups: 59 children were given an experimental diet (which they called microbiota-directed complementary food prototype, or MDCF-2), and the other 59 were given a control diet (which was ready-to-use supplementary food, or RUSF). All children lived in Mirpur, an impoverished region of Dhaka, Bangladesh.
Supplementation was given for three months followed by one month of monitoring. The team measured a total of 4,977 proteins and 209 bacterial taxa in fecal samples over the course of the project. Because they had previously observed that malnourished children have less advanced microbiome profiles than healthy children, the goal was to feed and encourage the growth of the bacterial community associated with normal childhood development.
During the first month, mothers brought their children to a regional healthcare center to feed them two daily servings of either MDCF-2 or RUSF. During the second month, one of those two feedings happened at home. By the third month, the children were fed at home. After three months, the children returned to their normal feeding routines and were tested one month later.
The group given MDCF-2 saw improvements in two of four key measurements: weight-for-length and weight-for-age. They also found an important improvement in terms of bodily inflammation. The authors wrote:
“By the end of MDCF-2 supplementation, children in the upper quartile had the largest increases in mediators of bone growth and CNS development and the largest decreases in effectors of inflammation. Together, these results provide evidence that mediators of bone growth, neurodevelopment, and inflammation distinguished the effects of the MDCF-2 nutritional intervention from that of RUSF.”
Undernourishment often results in metabolic reprogramming that predisposes children to develop cardiovascular issues, diabetes, and hypertension later in life. This is, in part, why they’re seeking early interventions focused on creating healthy microbial communities before such metabolic changes occur.
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