Ending malnutrition

Mark Katzman

A study of young twins living in Malawi showed that intestinal bacteria play a key role in malnutrition. Center: Jeffrey Gordon, MD, is senior author.

International leaders in addressing childhood malnutrition, Washington University researchers are working to devise innovative solutions.

Jeffrey Gordon, MD, the Dr. Robert J. Glaser Distinguished University Professor and director of the Center for Genome Sciences and Systems Biology, leads an international team of scientists trying to understand how gut microbes (the “microbiota”) help determine nutritional status.

Recent study findings point to a role for the microbiota in childhood malnutrition. The research, published in the journal Science, involves 317 sets of twins in Malawi followed from birth to age 3.

Childhood malnutrition is all too common, and scientists wonder why some children are afflicted but not others, even those in the same household who eat the same foods. Gordon and his team focused on twin pairs in which one child remained healthy and the other became malnourished. This ‘discordance’ occurred equally in fraternal and identical twins, suggesting an underlying factor besides human genetics. So the team turned to the microbiota.

Therapeutic food interventions reduced mortality in children with severe undernutrition, but healthy growth was not completely restored and proper neurodevelopment lagged.

The team found that the microbiota of malnourished children appeared immature. Therapeutic foods helped, but once they were stopped, the immature state reappeared.

By transplanting microbiota from twins into formerly sterile mice, the researchers showed that the combination of immature microbiota from a malnourished child and a Malawian diet produced disease in recipient animals; this was not the case when mice received a healthy child’s microbiota.

Their work provides a microbial view of human postnatal development and suggests that healthy growth requires a properly maturing microbiota. An important implication is that prolonged food-based interventions and/or addition of gut microbes may be needed for durable repair of microbiota immaturity in childhood malnutrition and improved clinical outcomes.

“With support of the Bill & Melinda Gates Foundation, we are studying the gut microbiota in malnourished children living in other low-income countries, and working to develop new types of safe, effective interventions to treat and ultimately prevent this devastating disease,” Gordon said.