A new way to combat childhood undernutrition?

In recent years it has become clear that children suffering from malnutrition at an early age do not always fully recover even when they are given a better diet.

This indicates that childhood undernutrition is not related to nutritious diet alone. Research carried out at icddr,b and elsewhere suggests that incomplete recovery may be linked to abnormalities in the microbial communities that live in the gut – known as the gut microbiota.

 Infographic: Science Journal

“Our intestine harbours millions of such bacteria most of which can only be identified through complex DNA and RNA-based sequencing techniques,” says Dr Tahmeed Ahmed, senior director of nutrition and clinical services at icddr,b.

The latest insights into undernutrition has been published in a review in the prestigious journal Science, co-authored by Dr Ahmed and Professor Jeffrey Gordon, an internationally renowned researcher based at Washington University, St Louis, USA.

icddr,b's research is providing important new insight into the impact of undernutrition – findings that could one day transform how undernutrition is treated. “We have shown that the microbiota is immature and defective in children suffering from acute malnutrition,” adds Dr Ahmed.


Mothers at icddr,b's Nutrition Rehabilitation Unit learn preparing therapeutic foods from local ingredients. Photo: Shehzad Noorani / icddr,b

Just as children grow and develop new skills as they get older, so the communities of bacteria in the gut change over time. It appears that these changes are important to health. When children are undernourished, development of their microbiota may be impaired.

Crucially, treatment for undernutrition may not lead to full recovery of the microbiota, affecting the children’s ability to absorb nutrients and respond to oral vaccines in the future.

These new insights suggest a novel therapeutic approach – targeting the gut’s microbial communities to combat undernutrition. “This new approach would include treating the children with therapeutic foods and microbial interventions in order to sustainably repair the gut microbiota, leading to healthy growth in children,” says Dr Ahmed.


UN Secretary General Mr Ban Ki-moon in his 2011 visit to icddr,b learns from Dr Tahmeed Ahmed about treating acute malnutrition with therapeutic foods made from local ingredients. Photo: Shumon Ahmed / icddr,b

Undernutrition contributes to more than 40% of deaths worldwide among children under the age of 5, while acute malnutrition affects more than 50 million children.

Studies have established that damage done to the gut microbiota due to childhood undernutrition can impair skeletal, immunological and intellectual development in children in the long run.

According to the new review, national policy formulation regarding nutritional recommendation for children should consider the interrelationship between food, the gut microbiota and healthy growth.

Broader societal considerations such as educating women about microbiota and health, and incorporating knowledge of food ingredients that promote healthy microbiota into child-rearing practices could also help.