Fascinating new research suggests malnutrition in children can be better treated by therapeutic foods designed to boost and repair the gut microbiome, instead of more traditional energy- and nutrition-maximized supplements. A clinical trial targeting malnourished children in Bangladesh revealed a newly developed therapeutic food is superior to conventional nutritional supplements.
"We found that children who are malnourished have incompletely formed gut microbial communities compared with their healthy counterparts," says senior author Jeffrey Gordon, explaining the origins of the research. "Therefore, we set about to design therapeutic foods to repair this immaturity and to determine whether such repair would restore healthy growth."
Current therapeutic foods designed to treat malnutrition certainly achieve the primary goal of keeping starving children alive. However, a barrage of other consequences of malnutrition are sadly unaffected by many of these therapeutic foods, such as stunted growth and an impaired immune system.
Prior research has revealed the gut microbiome of malnourished children does not develop to mature states similar to healthy children. Animal studies have also shown these immature microbial populations result in immune system and metabolic abnormalities. So the hypothesis was that developing therapeutic foods designed to foster a healthy microbiome environment should result in broader beneficial outcomes.
The first step in the research was to home in on the most effective array of food ingredients to repair the immature microbial communities of malnourished children. The scientists colonized a series of animals with gut microbiome communities from children in Bangladesh and a variety of different diets were then tested to ascertain what specifically would best improve the health and microbiome of the animals.
Three specific formulations were subsequently developed, and a human trial commenced in 63 Bangladeshi children. The subjects were between 12 and 18 months of age, and suffering from moderate acute malnutrition. Each child received twice-daily meals of either the conventional therapeutic food administered to malnourished children, or one of the three newly developed formulations.
After a month, one of the experimental food formulations was found to be significantly more effective in improving the children's metabolic markers and shifting their microbiome makeup closer to something seen in that of healthy children. The lead ingredients in the successful formulation were chick pea, soy, peanut and banana, as opposed to the more traditional rice- and lentil-based therapeutic food administered to malnourished children.
"There is uncertainty about what foods are best to administer during the period of complementary feeding – when children transition from exclusive milk feeding to solid foods," says Gordon. "Our studies were inspired by the notion that these commonly used, affordable, culturally acceptable complementary foods could contain ingredients coveted by key microbes that are underrepresented and underperforming in the gut microbiomes of malnourished children. These microbes were our therapeutic targets."
The new research follows on from other recently published work finding growth may be stimulated in preterm babies by focusing on improving microbiome deficiencies that affect metabolic processes. This growing body of evidence suggests fundamental development problems in infants and children may be effectively addressed by repairing the gut microbiome. Gordon compares this burgeoning field of science to a form of preventative medicine.
"We need to be effective stewards of the precious microbial resources of our children," he says. "If we are, the effects may be long-lived and herald a new dimension to preventive medicine – one that starts with their developing microbiomes."
Tahmeed Ahmed, lead on the Bangladeshi clinical trial, notes the work is ongoing, and the team aims to track the long-term effects of this new food formulation. The hope is that these improved metabolic biomarkers will actually manifest in improved physical growth and health as these children mature.
"A longer and larger clinical trial is currently underway at two sites in Bangladesh to see if the new Microbiome-Directed Complementary Food has sustained benefits," adds Ahmed. "This trial includes children with moderate malnutrition as well as children with severe malnutrition treated with conventional therapy but left with incompletely repaired microbiomes, stunting and various other growth impairments."
The new research was published in the journal Science.
Source: Washington University School of Medicine in St. Louis
