Gut microbiota profile of Indonesian stunted children and children with normal nutritional status

Abstract

The gut microbiota has been shown to play a role in energy metabolism of the host. Dysbiosis of the gut microbiota may predispose to obesity on the one hand, and stunting on the other. The aim of the study was to study the difference in gut microbiota composition of stunted Indonesian children and children of normal nutritional status between 3 and 5 years. Fecal samples and anthropometric measurements, in addition to economic and hygiene status were collected from 78 stunted children and 53 children with normal nutritional status in two regions in Banten and West Java provinces: Pandeglang and Sumedang, respectively. The gut microbiota composition was determined by sequencing amplicons of the V3-V4 region of the 16S rRNA gene. The composition was correlated to nutritional status and anthropometric parameters. Macronutrient intake was on average lower in stunted children, while energy-loss in the form of short-chain fatty acids (SCFA) and branched-chain fatty acids (BCFA) appeared to be higher in stunted children. In stunted children, at the phylum level the relative abundance of Bacteroidetes (44.4%) was significantly lower than in normal children (51.3%; p-value 2.55*10−4), while Firmicutes was significantly higher (45.7% vs. 39.8%; p-value 5.89*10−4). At the genus level, overall Prevotella 9 was the most abundant genus (average of 27%), and it was significantly lower in stunted children than in normal children (23.5% vs. 30.5%, respectively; q-value 0.059). Thirteen other genera were significantly different between stunted and normal children (q-value < 0.1), some of which were at low relative abundance and present in only a few children. Prevotella 9 positively correlated with height (in line with its higher relative abundance in normal children) and weight. In conclusion, Prevotella 9, which was the most abundant genus in the children, was significantly lower in stunted children. The abundance of Prevotella has been correlated with dietary fibre intake, which was lower in these stunted children. Since fibres are fermented by the gut microbiota into SCFA, and these SCFA are a source of energy for the host, increasing the proportion of Prevotella in stunted children may be of benefit. Whether this would prevent the occurrence of stunting or even has the potential to revert it, remains to be seen in follow up research.

Alterations in children’s sub-dominant gut microbiota by HIV infection and anti-retroviral therapy

“…The children in the HIV(+) group who resided in their own homes appeared to have poorer nutritional status than the children in other groups, which could be due to the uncontrolled diet and/or HIV infection [ 26 ]. Considering the influence of age and diet factors on the gut microbiota [ 7 , 21 , 22 , 33 , 56 – 58 ], we did not focus on comparing the gut microbiota between the groups, but highlighted the factors associated with the gut microbiota in each group. Second, the number of patients recruited in the present study was relatively small, which may limit the significance of our findings.…”

Differences in immune status and fecal SCFA between Indonesian stunted children and children with normal nutritional status

“…As expected, at the macronutrient level, intake for carbohydrate, fat, protein and energy was lower in stunted children than in children with normal nutritional status (Table 3). In our previous report, we calculated dietary fibre intake as well, which was also lower in stunted children (Table 3), although not significantly [13]. In the stunted children we reported a significant lower relative abundance (RA) of Prevotella 9 [13].…”

“…energy-loss as we discussed in our previous report on the gut microbiota profile of these children [13].…”

“…In our previous report, we calculated dietary fibre intake as well, which was also lower in stunted children (Table 3), although not significantly [13]. In the stunted children we reported a significant lower relative abundance (RA) of Prevotella 9 [13]. Prevotella has been correlated to dietary fibre intake [23], and hence the lower RA could be caused by the lower dietary fibre intake of the stunted children, although it should be mentioned that the food intake reported here, was based on a 24 h food recall.…”

“…These substances are pivotal for metabolic processes required to achieve an optimum level of physical growth and development. We recently showed that the gut microbiota composition of stunted children was different from that of children with normal nutritional status [13].…”