Can Gut Bacteria Help Malnourished Children Grow?

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Researchers have tested a new dietary supplement that can restore the gut bacteria in malnourished children and help them gain weight.

The World Health Organization (WHO) defines malnutrition as ‘deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. Approximately 45% of deaths in children under 5 years of age occurs because of undernutrition. Along with affecting growth, childhood undernutrition also causes immunologic, metabolic, and neurological abnormalities. Moreover, the gut bacteria in malnourished children do not mature and change with age. Compared to healthy children, their gut microbiome appears ‘stunted’ or ‘younger’.

First, to test the effects of this stunted gut microbiome on a child’s development, the team of researchers transplanted malnourished children’s fecal samples into mice. As expected, the mice showed a decreasing rate of weight gain and bone growth. Researchers also noted metabolic dysfunction in the animals. This led the team to wonder whether certain food can repair this stunted gut microbiome and possibly help children grow.

The team then tested multiple combinations of locally available foods from Dhaka, Bangladesh and tested its effects on gut microbiome in animal models. Along with the changes in growth. They compared three of these formulations to an existing ready-to-use supplementary food (RUSF) in a small trial involving malnourished children living in slums located in Dhaka.

One particular microbiota-directed complementary food, MDCF-2, showed promising results. Thus, researchers aimed to conduct a larger study for studying its effects.

Dietary Supplement Supports Growth

According to WHO, moderate acute malnutrition is a weight-for-length measurement that is 2 or 3 standard deviations below the median. Whereas severe acute malnutrition is more than 3 standard deviations below the median weight-for-length value. Current therapeutic interventions for moderate and severe malnutrition do not target gut bacteria.

Researchers recruited 118 Bangladeshi children with moderate acute malnutrition between the ages of 12 and 18 months. The children either received RUSF, or the new dietary supplement, MDCF-2 twice daily for three months; followed by a month of monitoring. The team collected weight-for-length, weight-for-age, length-for-age, and mid–upper-arm circumference values every 2 weeks during the study. And at the one-month follow-up. The researchers also measured levels of proteins in the blood and the presence of bacteria in faecal samples. These proteins included mediators of bone growth and neurodevelopment.

Although RUSF is higher in calories, kids given MDCF showed a higher weight gain and grew faster. Moreover, children who received MDCF had higher levels of proteins that are associated with bone growth and neurological development. The team also noted 21 types of bacteria across the children in the study. These bacteria are positively linked to changes in growth.

The study provides support for the use of MDCF as a dietary supplement in children with moderate acute malnutrition.


Chen, Robert Y., et al. “A Microbiota-Directed Food Intervention for Undernourished Children.” New England Journal of Medicine, vol. 384, no. 16, 2021, pp. 1517–1528., doi:10.1056/nejmoa2023294.


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