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April 22, 2021 VOL. 384 NO. 16 1517-1528

A Microbiota-Directed Food Intervention for Undernourished Children

By Robert Chen
From Washington University School of Medicine, St. Louis.

More than 30 million children worldwide have moderate acute malnutrition. Current treatments have limited effectiveness, and much remains unknown about the pathogenesis of this condition. Children with moderate acute malnutrition have perturbed development of their gut microbiota. These investigators describe the results of a randomized feeding study that tested the effects of a microbiota-directed complementary food (MDCF-2) against an existing supplementary food (RUSF) on four measures of growth in 123 Bangladeshi children between the ages of 12 months and 18 months who had moderate acute malnutrition. The dietary supplement was given twice daily for 3 months, followed by 1 month of monitoring. The rates of change in the weight-for-length and weight-for-age z scores are consistent with a benefit of MDCF-2 on growth over the course of the study, including the 1-month follow-up. Receipt of 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. These proteins included mediators of bone growth and neurodevelopment. 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 of the affected children.

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