More calories are not enough for malnutrition

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New study: intestinal bacteria play an important role in malnutrition

In Malawi, the youngest suffer from severe malnutrition. Many children are given nothing to eat or little food for days. However, according to a new study, increased calorie intake alone is not enough to end malnutrition. Gut bacteria are said to play an important role in Kwashiorkor, the malnutrition disease.

Severe malnutrition in children leads to emaciation, liver and skin damage Malawi is one of the poorest countries in the world. According to the United Nations 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 in rural areas are at risk of starvation. The country 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 often people don't get anything to eat for days. Especially in children, the disease Kwashiorkor develops early, which is a form of protein energy malnutrition (PEM) due to severe malnutrition. Children with Kwashiorkor suffer from a bloated stomach 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. According to the study, an increased calorie intake alone is not enough to combat malnutrition and the associated underweight in the long term. Gut bacteria therefore play a crucial role in Kwashiorkor.

Standard Therapy for Malnutrition with Peanut Paste The scientists accompanied 317 Malawian twins in their first three years of life. Almost 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 which were well-fed twins. As it turned out, there were big differences in the gut microbiota, which describes the entirety of the microorganisms in the gut. The twin couples, one of whom suffered from malnutrition, then received a special peanut paste, which is part of the standard therapy at Kwashiorkor. This changed the composition of the children's gut microbiota. What was striking, however, was that "stool samples from the sick children once again showed the old composition of the intestinal microbes as soon as the peanut paste was discontinued".

Relationship 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 in the animals. It was found that two out of three groups of mice that had received intestinal microbes from sick children lost weight if they ate the food typical of Malawi. The animals did not lose weight with normal mouse food. Peanut paste as feed led to weight gain in all animals. "These findings imply that intestinal microbes are a causal factor in Kwashiorkor," the researchers write in the scientific journal Science.

"The results of the study are remarkable," said a companion article to the study by David Relman of Stanford University School of Medicine in California. "They also give cause for hope." After all, new strategies could be derived from a better understanding of the relationships between intestinal bacteria and malnutrition. However, it was necessary to "examine more people with kwashiorkor and other forms of malnutrition". (sb)

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