More calories are not enough for malnutrition

New study: Intestinal bacteria play important role in malnutrition

01/02/2013

In Malawi even the youngest suffer from severe malnutrition. Many children do not receive anything to eat for days or only a little nutritious. However, a new study shows that increased calorie intake alone is not enough to stop malnutrition. Intestinal bacteria play an important role in Kwashiorkor, the disease due to malnutrition.

Severe malnutrition in children leads to emaciation, liver and skin damage
Malawi is one of the poorest countries in the world. According to the UN World Food Program, more than 40 percent of the population lives on less than a dollar a day. Of the 14 million people living in Malawi, around 1.6 million are threatened with hunger in rural areas. It ranks 171 out of 187 countries in the 2011 Human Development Index.

The typical food in Malawi consists mainly of corn, tomatoes and onions. But people often do not get anything to eat for days at a time. Especially in children, the disease Kwashiorkor, which is a form of protein energy malnutrition (PEM) due to severe malnutrition, develops early. Children with Kwashiorkor suffer from a bloated abdomen due to water retention, liver and skin damage and emaciation. However, the exact cause has not yet been clarified, write Michelle Smith and Tanya Yatsunenko from Washington University in St. Louis, Missouri, who were involved in the new study. Increased calorie intake alone is not enough to fight long-term malnutrition and the associated underweight, the study says. Intestinal bacteria play a decisive role in Kwashiorkor.

Standard therapy for malnutrition with peanut paste
The scientists accompanied 317 Malawi twin pairs in their first three years of life. Nearly half of the children developed at least one twin Kwashiorkor. For the study, the researchers examined stool samples from 22 pairs of twins, nine of whom were well-fed twins. As it turned out, there were large differences in the intestinal microbiota, which describes the totality of microorganisms in the gut. The twin pairs, one of whom suffered from malnutrition, were then given a special peanut paste, which is standard therapy at Kwashiorkor. This changed the composition of the gut microbiota of the children. It was noticeable, however, that "stool samples of the sick children again showed the old composition of the intestinal microbes, as soon as the peanut paste was discontinued".

Connection between intestinal bacteria and malnutrition
The scientists wanted to learn more about the relationship between intestinal bacteria and malnutrition. In experiments with mice, they used intestinal bacteria from three pairs of twins. It was found that two out of three groups of mice who received intestinal microbes from sick children lost weight if they ate Malawi's typical food. With normal mouse food, the animals did not lose weight. Peanut paste as food led to weight gain in all animals. „These findings imply that intestinal microbes are a causal factor in Kwashiorkor“, the researchers write in the journal „Science“.

„The results of the study are remarkable, "says an article accompanying the study by David Relman of the Stanford University School of Medicine in California. „They also give cause for hope, "because a better understanding of the relationships between gut bacteria and malnutrition could lead to new strategies, but it would be necessary" to study more people with kwashiorkor and other forms of malnutrition. "(Sb)

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Picture: Gerd Altmann