Malnutrition and Gut Microbiota in Children

Abstract

Malnutrition continues to threaten the lives of millions across the world, with children being hardest hit. Although inadequate access to food and infectious disease are the primary causes of childhood malnutrition, the gut microbiota may also contribute. This review considers the evidence on the role of diet in modifying the gut microbiota, and how the microbiota impacts childhood malnutrition. It is widely understood that the gut microbiota of children is influenced by diet, which, in turn, can impact child nutritional status. Additionally, diarrhoea, a major contributor to malnutrition, is induced by pathogenic elements of the gut microbiota. Diarrhoea leads to malabsorption of essential nutrients and reduced energy availability resulting in weight loss, which can lead to malnutrition. Alterations in gut microbiota of severe acute malnourished (SAM) children include increased Proteobacteria and decreased Bacteroides levels. Additionally, the gut microbiota of SAM children exhibits lower relative diversity compared with healthy children. Thus, the data indicate a link between gut microbiota and malnutrition in children, suggesting that treatment of childhood malnutrition should include measures that support a healthy gut microbiota. This could be of particular relevance in sub-Saharan Africa and Asia where prevalence of malnutrition remains a major threat to the lives of millions.

Dysbiosis in Children With Neurological Impairment and Long-Term Enteral Nutrition

“…The dysbiotic picture that emerges for these taxa is strongly reminiscent of what is repeatedly reported in the literature for children malnourished as a consequence of inadequate food intake, often coming from low-income Western African and Asian countries (42,43): the strong depletion of several gut obligate anaerobes belonging to Firmicutes, Bacteriodetes, and Actinobacteria; and the enrichment in aerotolerant taxa, many of which Proteobacteria, more competitive and starvation resistant, and able to metabolize broader classes of substrates, such as amino acids (44,45,52). As for the link to our results, it is to be noted that the depletion of Faecalibacterium was found to be the most highly discriminatory bacterial taxonomic biomarker to distinguish malnourished children from age-matched controls exhibiting healthy growth (42). The "anaerobic depletion" also encompasses Bifidobacterium, whose reduction has been described as one of the first steps in gut microbiota alterations associated with severe acute malnutrition (45).…”

“…Diet is a strong modifier of the GM and its gene content, especially in children, whose gut bacterial communities are subject to rapid changes. Strong evidence links the microbial composition of the gut to situations of malnourishment in children, due to the pivotal role in extracting and metabolizing dietary ingredients (42,43). Indeed, the composition and functional capacity of the gut microbiota appear to be altered in childhood undernutrition (44).…”

How does mode of delivery associate with double burden of malnutrition among mother–child dyads?: a trend analysis using Bangladesh demographic health surveys

“…It can be possibly explained by gut microbial alteration in small intestines among children due to CS delivery [ 24 ]. Less diversity in the intestinal microbiome among infants born by CS delivery results in inflammatory bowel disease and diarrhea that ultimately causes stunting and faltered physical and mental growth [ 29 , 30 ]. On top of that, overweight mothers are at a higher risk of CS delivery [ 31 ] and are associated with late initiation of breastfeeding [ 32 ].…”

Intestinal microbiota research from a global perspective

“…Increased exposure to pathogens affects microbiota composition through direct interaction and/or through inflammation [ 113 ]; inter-kingdom effects through non-bacterial species such as worms, protists, or fungi [ 114 ]; and exposure to drugs and antibiotics [ 88 ]. Global health disparities in infectious diseases [ 115 ], micronutrient deficiencies [ 116 ], caloric restriction [ 117 ], and undernutrition [ 118 , 119 ] have all been shown to have a profound effect on the microbiome and thus on geographic differences in the microbiota profile observed.…”