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Microbiota-Directed Dietary Supplements Aids in Growth of Malnourished Kids

Childhood undernutrition is a global health challenge that produces impaired ponderal and linear growth (wasting and stunting), immune and metabolic dysfunction, altered development of the central nervous system (CNS), and other abnormalities. In a recent study, researchers have found that microbiota-directed dietary supplements have beneficial growth rates for young children with moderate...
Childhood undernutrition is a global health challenge that produces impaired ponderal and linear growth (wasting and stunting), immune and metabolic dysfunction, altered development of the central nervous system (CNS), and other abnormalities. In a recent study, researchers have found that microbiota-directed dietary supplements have beneficial growth rates for young children with moderate acute malnutrition. The research has been published in The NEW ENGLAND JOURNAL of MEDICINE on April 22, 2021.
In a previous study published in Nature, Dr Jeffrey Gordon and his team identified 15 bacterial taxa that can be used to describe normal development of the gut microbial community during the first 2 years of postnatal life in healthy members of birth cohorts in several countries designated as low or middle income. They developed several microbiota-directed complementary food (MDCF) prototypes. Upon evaluation, they noted that one of these formulations (MDCF-2) changed the microbiota to a composition similar to that of age-matched healthy Mirpur children and changed the levels of plasma proteins indicative of improved health status. In this present study, they reported the results of a larger study conducted over a longer period to compare the effects of MDCF-2 and RUSF on clinical endpoints.
The researchers included a total of 118 slum-dwelling Bangladeshi children with moderate acute malnutrition between the ages of 12 months and 18 months. They enrolled children in either microbiota-directed complementary food prototype (MDCF-2) (n=59) or a ready-to-use supplementary food (RUSF) (n=59). The caloric density of MDCF-2 is lower than that of RUSF (204 kcal vs. 247 kcal per 50-g daily dose).The supplements were administered twice daily for 3 months, followed by 1 month of monitoring. They obtained weight-for-length, weight-for-age, and length-for-age z scores and mid–upper-arm circumference values at baseline and every 2 weeks during the intervention period and at 4 months. They further compared the rate of change of these related phenotypes between baseline and 3 months and between baseline and 4 months. They also measured the levels of 4977 proteins in plasma and 209 bacterial taxa in fecal samples.
Key findings of the study were:
- Upon analysis, the researchers found that the MDCF-2 group had better outcomes than those in the RUSF group based on greater weekly growth in z scores, indicating faster growth rates.
- Upon examining the blood samples, they noted that 714 proteins were significantly altered after 3-month MDCF-2 supplementation, compared with 82 proteins having shown significant alterations in the RUSF group.
- They found that MDCF-2 was linked to the magnitude of change in levels of 70 plasma proteins and of 21 associated bacterial taxa that were positively correlated with the weight-for-length z score.
The authors concluded, "These findings provide support for MDCF-2 as a dietary supplement for young children with moderate acute malnutrition and provide insight into mechanisms by which this targeted manipulation of microbiota components may be linked to growth. "
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Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.