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Session: Diet-Gut Microbiome Interactions in Health and Disease (Oral 19)

(OR19-01-24) A Microbiota-Directed Complementary Food Intervention in 12-18-Month-Old Bangladeshi Children Improves Linear Growth

Monday, July 1, 2024
8:00 AM – 8:12 AM CT
Location:  W184
Objectives: Globally, stunting affects ~150 million children under the age of five while wasting affects nearly 50 million. Current interventions have had limited effectiveness in ameliorating the long-term sequelae of undernutrition including stunting, cognitive deficits and immune dysfunction. Disrupted postnatal development of the gut microbiota has been linked to the pathogenesis of undernutrition, providing potentially new treatment approaches.

Methods: 124 Bangladeshi children with moderate acute malnutrition (MAM) enrolled at 12-18-months-of-age in a previously reported 3-month randomized controlled trial of a microbiota-directed complementary food (MDCF-2) designed to repair their impaired microbial community development, were followed for two years. Weight and length/height were monitored by anthropometry, the abundances of bacterial strains were assessed by quantifying metagenome-assembled genomes (MAGs) in serially-collected fecal samples, and levels of growth-associated proteins were measured in plasma.

Results: Children who received MDCF-2 were significantly less stunted during follow-up than those who received a standard ready-to-use supplementary food (RUSF) [Mean (95% CI) LAZ difference=0.18 (-0.16, 0.52) at 12 months]. Superior anthropometric responses to MDCF-2 were associated with elevated fecal abundances of Agathobacter faecis, Blautia massiliensis, Lachnospira and Dialister, and significantly increased levels (linear model; q < 0.1) of a group of 38 plasma proteins including IGF-1, neurotrophin receptor NTRK2, and multiple proteins linked to musculoskeletal accretion and CNS development that persisted for 6-months post-intervention.

Conclusions: A 3-month intervention with MDCF-2 in Bangladeshi children with MAM that produced previously reported significant improvements in WLZ compared to RUSF during intervention, also produced superior linear growth during follow-up. These results provide evidence that future clinical studies of supplementary foods for undernutrition should incorporate ingredients that sponsor healthy microbiota-host co-development.

Funding Sources: Bill and Melinda Gates Foundation