News article

Malnutrition 'damages gut bacteria'

Posted:  Wednesday, June 11, 2014

The World Health Organization estimates that severe acute malnutrition diseases affects about 20 million children worldwide. Moderate acute malnutrition, a less serious form of the disease, is more prevalent in South and Central Asia, where it affects 30 million children. That also accounts for child malnutrition in India. In Bangladesh, more than 40% of children under five are affected by stunted growth.

Friendly gut microbes play a crucial role in extracting and using nutrients in food. It has been suggested that malnutrition damages this process. Childhood malnutrition can lead to long-term problems such as stunted growth, cognitive problems and weakened immune systems.

According to a study, child malnutrition has long-term effects on gut health that affect development even after treatment. As a part of the research, a team studied the gut health of malnourished children in Bangladesh. Writing in the journal Nature, they said that the bacterial make-up was not fully restored to normal after food supplements were given. They said that the finding might explain why children often fail to grow normally even after treatment.

In this study, a team at Washington University School of Medicine, St Louis, and the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladeshi, assessed 64 malnourished children aged from 6 to 20 months.

Malnourished children were either given Plumpy'Nut, an enriched peanut-based food that is the mainstay treatment for severe child malnutrition worldwide, or, Khichuri-Halwa, which is produced in Bangladesh and has rice and lentils as its main ingredients. Both types of food include milk powder and micronutrients such as iron.

The researchers took faecal samples from the children before they were given the foods and every three days for around two weeks, stopping when they reached a certain weight. Samples were then taken every month for four months. In 50 healthy children of the same age who were studied as a comparison, the gut developed normally.

The malnourished children gained weight but the make-up of the gut bacteria improved only temporarily. Once treatment was discontinued, it regressed to a more "immature" state.

Dr. Sathish Subramanian of Washington University said that the children who were malnourished had gut microbial communities that were not consistent with their chronological ages. He opined that the severity of a child's malnourishment was tied closely with the degree of immaturity of his or her gut microbial community and this immaturity could not be durably repaired with standard treatments. The study further suggested that children may fare better if they are given nutritional supplements for longer, or if they are given additional gut microbes.

Commenting on the study, Prof. Colin Hill of University College Cork, Ireland, said, “The findings are novel, unexpected and compelling, and show that purely nutritionally based interventions do not fully restore a mature gut microbiota in these children. In the future, we will recognise that restoring the health of the gut microbiota is an important precursor to restoring the health of the child.”