Healing through the gut: Microbiome-directed complementary food could benefit malnourished children, study reveals

18 Dec 2023 --- The bioactive glycans found in microbiome-directed complementary food (MDCF-2) for children with malnourishment are more effective at repairing the gut microbiome than the transitionally used therapeutic food, suggests a recent study conducted by researchers at the Washington University School of Medicine in St. Louis, US.

“We have identified bioactive elements of a microbiome-directed food,” says study lead Dr. Jeffrey I. Gordon, professor at the Washington University School of Medicine.

“These are naturally occurring carbohydrate structures that could, in theory, be recovered in large quantities from the byproduct streams of food manufacturing and be used to produce prebiotics. We also have identified the microbes that process these food components. In theory, there is potential for the organisms to be part of a therapeutic intervention in children completely lacking these beneficial gut microbes.”

The research builds upon the findings of an earlier clinical trial conducted by the same team in collaboration with the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh.

The gut health of children recovering from malnutrition has holistic health implications, studies show.Importance of gut bacteria in for children’s health
The study, published in the journal Nature, emphasizes the importance of understanding how specific food components are processed by bacterial strains to improve knowledge of how current treatments work and develop more effective formulations in the future. 

The researchers discovered a positive link between the presence of strains of the bacteria Prevotella copri in the gut of children affected by malnourishment and the age-appropriate growth of children. This link has been associated with the organism’s function in the metabolic pathways, using beneficial bioactive carbohydrate structures present in the MDCF-2.

They note that ensuring the gut health of children recovering from malnutrition has implications beyond gastrointestinal health. Blood tests administered on the children receiving MDCF-2 revealed higher levels of proteins vital for musculoskeletal growth and neurodevelopment and lower levels of proteins involved with inflammation in comparison to children receiving the traditional therapeutic food. 

“We performed extensive genomic analyses of fecal samples from these children,” says co-author Dr. Matthew C. Hibberd. “We know the identities of the bacteria that are responding to these food components and the metabolic capabilities these bacteria have and express in response to treatment. It turns out that many of the bacteria strongly associated with growth in children are enriched in pathways for carbohydrate metabolism.”

“Our work has demonstrated that a healthy microbial community in the gut is necessary for healthy growth,” adds Gordon. “Development of the gut microbial community in the first two years of life needs to be in sync with the development of the rest of the body, the other organ systems.”

He further explains that when this microbial community is incompletely formed, “simply giving more calories will not repair it.” Thus, the team is now seeking specific food components that nurture healthy gut microbial communities in hopes of repairing the gut microbial community that has become dysfunctional in children with malnutrition.

Tackling childhood malnutrition
In 2020, globally, 149 million children under five were estimated by the UN Children’s Fund to suffer from stunted growth, while 45 million exhibited wasting. Malnutrition further remains a leading cause in children under the age of five.

Earlier this month, UNICEF warned that more than one in ten children living in the conflict-affected regions of Burkina Faso are now facing acute malnutrition. 

While traditional therapeutic foods have been shown to reduce deaths, these fall short in addressing long-term events like metabolic issues, stunted growth, compromised immune function and hindered brain development.

The WHO and the Bill and Melinda Gates Foundation are supporting a large, multi-site clinical trial investigating MDCF-2, aiming to enroll 6,500 malnourished children in East and West Africa and South Asia.

These clinical trials in the two regions are anticipated to advance microbiome-directed therapeutics. 

Gordon underscores: “The upcoming clinical trials of MDCF-2 will test the generalizability of its effectiveness in malnourished children from six to 24 months of age with varying degrees of severity of malnutrition.”

“The results from these and other studies should help advance our understanding of how our microbes collaborate with our human cells and organs to influence developmental biology,” he concludes. “The results will also refine our approaches for the development of microbiome-directed therapeutics and help us develop new approaches for feeding our children to ensure the formation of healthy microbiomes during the first several years of postnatal life.”

By Milana Nikolova