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Draft:Microbiota Directed Therapeutic Food

  • Comment: This appears to contain a fair bit of original research. Please seek help from WT:MED with writing this if the subject is notable. – bradv 03:04, 18 June 2023 (UTC)
  • Comment: I have requested review assistance from WikiProject Medicine. Roger (Dodger67) (talk) 20:58, 15 June 2023 (UTC)

Globally, the burden of malnutrition is still substantially high and it is the leading cause of death among children under five years of age [1]. According to the World Health Organization, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 37 million were overweight or living with obesity in 2022 [2]. Gut microbiota is closely linked to growth and development of young children [3][4]. Impaired configuration of gut microbial profile is a major contributor to the acute form of malnutrition. Dysbiosis of gut microbiota or immature gut microbial profile is a common phenomenon in children with acute and chronic undernutrition [1]. Existing therapeutic interventions are not designed to repair the altered composition of gut microbiota. Microbiota directed therapeutic foods are dietary formulations designed to modulate the gut microbiota of malnourished children. Microbiota directed therapeutic foods are found to be beneficial in improving the components of small intestinal microbiota.

Background

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Post-natal human development involves development of microbial communities in different parts of the body including the gut. Diets play a crucial role in the development of intestinal microbiota during early years of life[2]. The interactions between gut microbiome and molecules obtained from dietary ingredients are critical for optimal health. Recent evidence showed that childhood undernutrition characterized by impaired linear and ponderal growth is linked to defects in the development of gut microbiota[3]. Therefore, the treatment of malnutrition needs attention to develop approaches that will help to repair perturbed gut microbiota in undernourished children. The conventional therapeutic foods used to treat children with undernutrition were not developed taking into consideration the developmental biology of the gut microbiota. The microbiota directed therapeutic foods are developed to promote growth in malnourished children through durable repair of the gut microbiome profile.  

Microbiota Directed Therapeutic Foods

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The microbiota directed therapeutic foods are food formulations that are developed by locally available, culturally acceptable, and affordable dietary ingredients. The ingredients were selected based on commonly consumed complementary foods by children during their transition from breastfeeding to a fully weaned stage.

Composition

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The commonly used food ingredients to prepare microbiota directed therapeutic foods are chickpea flour, green banana (plantain), soybean flour, oat flour, millet flour, sweet potato, peanut, sugar, and soybean oil[4]. There is no universally accepted formulation for microbiota directed therapeutic foods. The compositions of microbiota-directed complementary food (MDCF)[5] and microbiota-directed ready to use supplementary food (MD-RUSF)[6] formulations are highlighted in the table.

Components MDCF (gm/100gm) MD-RUSF (gm/100gm)
Chickpea flour 10 --
Peanut flour 10 --
Soybean flour 8 --
Green banana (plantain) powder 19 --
Yolk powder -- 5
Oat flour -- 20
Millet flour -- 19.9
Corn flour -- 20.1
Powdered skimmed milk -- 16
Sugar 29.8 6
Lactose -- 6
Soybean oil 20 --
Sunflower oil -- 5.5
Linseed oil -- 0.9
Micronutrient premix 3.14 0.6

Delivery method

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The microbiota directed therapeutic foods are developed for children with acute malnutrition. Doses depend on age, calorie requirements, and status of malnutrition. Children with moderate acute malnutrition aged between 12 and 18 months received 50 gm daily in a trial conducted in Bangladesh. The formulation was administered orally in two daily servings for 3 months[7]

Effect on growth outcomes

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The intervention with microbiota directed therapeutic foods showed promise in improving the growth outcomes in malnourished children. The positive changes in weight-for-length and weight-for-age z scores were observed in children who received the formulation[8][9]. The receipt of microbiota directed therapeutic foods was also associated with the increase in plasma proteins known as mediators of bone growth and neurodevelopment[10]. The bacterial taxa linked to consumption with microbiota directed therapeutic foods were found to be positively correlated with weight-for-length z score in malnourished children[10]

Examples

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References

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  1. ^ Blanton, Laura V.; Barratt, Michael J.; Charbonneau, Mark R.; Ahmed, Tahmeed; Gordon, Jeffrey I. (2016-06-24). "Childhood undernutrition, the gut microbiota, and microbiota-directed therapeutics". Science. 352 (6293): 1533. Bibcode:2016Sci...352.1533B. doi:10.1126/science.aad9359. ISSN 0036-8075. PMID 27339978. S2CID 19286774.
  2. ^ Laursen, Martin Frederik; Andersen, Louise B. B.; Michaelsen, Kim F.; Mølgaard, Christian; Trolle, Ellen; Bahl, Martin Iain; Licht, Tine Rask (2016-02-25). Suen, Garret (ed.). "Infant Gut Microbiota Development Is Driven by Transition to Family Foods Independent of Maternal Obesity". mSphere. 1 (1): e00069–15. doi:10.1128/mSphere.00069-15. ISSN 2379-5042. PMC 4863607. PMID 27303699.
  3. ^ Blanton, Laura V.; Barratt, Michael J.; Charbonneau, Mark R.; Ahmed, Tahmeed; Gordon, Jeffrey I. (2016-06-24). "Childhood undernutrition, the gut microbiota, and microbiota-directed therapeutics". Science. 352 (6293): 1533. Bibcode:2016Sci...352.1533B. doi:10.1126/science.aad9359. ISSN 0036-8075. PMID 27339978. S2CID 19286774.
  4. ^ Mostafa, Ishita; Fahim, Shah Mohammad; Das, Subhasish; Gazi, Md Amran; Hasan, Md. Mehedi; Saqeeb, Kazi Nazmus; Mahfuz, Mustafa; Lynn, Hannah B.; Barratt, Michael J.; Gordon, Jeffrey I.; Ahmed, Tahmeed (2022-07-01). "Developing shelf-stable Microbiota Directed Complementary Food (MDCF) prototypes for malnourished children: study protocol for a randomized, single-blinded, clinical study". BMC Pediatrics. 22 (1): 385. doi:10.1186/s12887-022-03436-6. ISSN 1471-2431. PMC 9247958. PMID 35778675.
  5. ^ Mostafa, Ishita; Nahar, Naila Nurun; Islam, Md. Munirul; Huq, Sayeeda; Mustafa, Mahfuz; Barratt, Michael; Gordon, Jeffrey I.; Ahmed, Tahmeed (2020-02-17). "Proof-of-concept study of the efficacy of a microbiota-directed complementary food formulation (MDCF) for treating moderate acute malnutrition". BMC Public Health. 20 (1): 242. doi:10.1186/s12889-020-8330-8. ISSN 1471-2458. PMC 7027293. PMID 32066412.
  6. ^ Liang, Shengnan; Wang, Song; Xu, Baofeng; Ping, Lijun; Evivie, Smith Etareri; Zhao, Lina; Chen, Qingxue; Li, Bailiang; Huo, Guicheng (2022-12-01). "Effects of microbiota-directed supplementary foods on gut microbiota in fecal colonized mice of healthy infants". Journal of Functional Foods. 99: 105346. doi:10.1016/j.jff.2022.105346. ISSN 1756-4646. S2CID 253832743.
  7. ^ Mostafa, Ishita; Nahar, Naila Nurun; Islam, Md. Munirul; Huq, Sayeeda; Mustafa, Mahfuz; Barratt, Michael; Gordon, Jeffrey I.; Ahmed, Tahmeed (2020-02-17). "Proof-of-concept study of the efficacy of a microbiota-directed complementary food formulation (MDCF) for treating moderate acute malnutrition". BMC Public Health. 20 (1): 242. doi:10.1186/s12889-020-8330-8. ISSN 1471-2458. PMC 7027293. PMID 32066412.
  8. ^ Mostafa, Ishita; Hibberd, Matthew C.; Hartman, Steven J.; Hafizur Rahman, Md Hasan; Mahfuz, Mustafa; Hasan, S.M. Tafsir; Ashorn, Per; Barratt, Michael J.; Ahmed, Tahmeed; Gordon, Jeffrey I. (June 2024). "A microbiota-directed complementary food intervention in 12–18-month-old Bangladeshi children improves linear growth". eBioMedicine. 104: 105166. doi:10.1016/j.ebiom.2024.105166. PMC 11179573. PMID 38833839.
  9. ^ "IUNS 22nd International Congress of Nutrition – Abstracts". Annals of Nutrition and Metabolism. 79 (Suppl. 1): 14–1172. 2023-08-03. doi:10.1159/000530786. ISSN 0250-6807. PMID 37536290.
  10. ^ a b Chen, Robert Y.; Mostafa, Ishita; Hibberd, Matthew C.; Das, Subhasish; Mahfuz, Mustafa; Naila, Nurun N.; Islam, M. Munirul; Huq, Sayeeda; Alam, M. Ashraful; Zaman, Mahabub U.; Raman, Arjun S.; Webber, Daniel; Zhou, Cyrus; Sundaresan, Vinaik; Ahsan, Kazi (2021-04-22). "A Microbiota-Directed Food Intervention for Undernourished Children". New England Journal of Medicine. 384 (16): 1517–1528. doi:10.1056/NEJMoa2023294. ISSN 0028-4793. PMC 7993600. PMID 33826814.
  11. ^ Gehrig, Jeanette L.; Venkatesh, Siddarth; Chang, Hao-Wei; Hibberd, Matthew C.; Kung, Vanderlene L.; Cheng, Jiye; Chen, Robert Y.; Subramanian, Sathish; Cowardin, Carrie A.; Meier, Martin F.; O’Donnell, David; Talcott, Michael; Spears, Larry D.; Semenkovich, Clay F.; Henrissat, Bernard (2019-07-12). "Effects of microbiota-directed foods in gnotobiotic animals and undernourished children". Science. 365 (6449): eaau4732. doi:10.1126/science.aau4732. ISSN 0036-8075. PMC 6683325. PMID 31296738.
  12. ^ Chen, Robert Y.; Mostafa, Ishita; Hibberd, Matthew C.; Das, Subhasish; Mahfuz, Mustafa; Naila, Nurun N.; Islam, M. Munirul; Huq, Sayeeda; Alam, M. Ashraful; Zaman, Mahabub U.; Raman, Arjun S.; Webber, Daniel; Zhou, Cyrus; Sundaresan, Vinaik; Ahsan, Kazi (2021-04-22). "A Microbiota-Directed Food Intervention for Undernourished Children". New England Journal of Medicine. 384 (16): 1517–1528. doi:10.1056/NEJMoa2023294. ISSN 0028-4793. PMC 7993600. PMID 33826814.
  13. ^ Liang, Shengnan; Wang, Song; Xu, Baofeng; Ping, Lijun; Evivie, Smith Etareri; Zhao, Lina; Chen, Qingxue; Li, Bailiang; Huo, Guicheng (2022-12-01). "Effects of microbiota-directed supplementary foods on gut microbiota in fecal colonized mice of healthy infants". Journal of Functional Foods. 99: 105346. doi:10.1016/j.jff.2022.105346. ISSN 1756-4646. S2CID 253832743.
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