Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.
Adv Nutr. 2021 Jun 1;12(3):969-979. doi: 10.1093/advances/nmaa146.
Child undernutrition is a major public health challenge that is persistent and disproportionately prevalent in low- and middle-income countries. Undernourished children face adverse health, economic, and social consequences that can be intergenerational. The first 1000 days of life, from conception until the child's second birthday, constitute the period of greatest vulnerability to undernutrition. The transition process from milk-based diets to solid, semi-solid, and soft food and liquids other than milk, referred to as complementary feeding (CF), occurs between the age of 6 mo and 2 y. CF practices that do not meet the WHO's guiding principles and are lacking in both quality and quantity increase susceptibility to undernutrition, restrict growth, and jeopardize child development and survival. The gut microbiota develops toward an adult-like configuration within the first 2-3 y of life. Recent studies suggest that significant changes in the gut microbial composition and functional capacity occur during the CF period, but these studies were conducted in high-income countries. Research in low- and middle-income countries, on the other hand, has implicated a disrupted gut microbiota in child undernutrition, and animal experiments reveal the potential for a causal relation. Given the growing body of evidence for a plausible role of the gut microbiota in the link between CF and undernutrition, microbiota-targeted complementary food may be a promising treatment modality for undernutrition management. The aims of this paper are to review the evidence for the relation between CF and undernutrition and to highlight the potential of the gut microbiota to be a promising target in this relation. Our summary of the current state of the knowledge in this area provides a foundation for future research and helps inform the design of interventions targeting the gut microbiota to combat child undernutrition and promote healthy growth.
儿童营养不足是一个主要的公共卫生挑战，在中低收入国家持续存在且不成比例地普遍存在。营养不足的儿童面临不良的健康、经济和社会后果，这些后果可能会代际传递。生命的前 1000 天，从受孕到儿童两岁生日，是最容易受到营养不足影响的时期。从基于牛奶的饮食过渡到固体、半固体和软食以及除牛奶以外的液体，即补充喂养（CF），发生在 6 个月至 2 岁之间。不符合世界卫生组织指导原则且在质量和数量上都不足的 CF 做法会增加营养不足的易感性，限制生长，并危及儿童的发育和生存。肠道微生物群在生命的头 2-3 年内朝着成人模式发展。最近的研究表明，在 CF 期间，肠道微生物组成和功能能力会发生显著变化，但这些研究是在高收入国家进行的。另一方面，在中低收入国家的研究表明，肠道微生物群的破坏与儿童营养不足有关，动物实验揭示了因果关系的可能性。鉴于越来越多的证据表明肠道微生物群在 CF 和营养不足之间的关联中可能发挥作用，针对肠道微生物群的补充食品可能是一种有前途的营养不足管理治疗方法。本文的目的是回顾 CF 与营养不足之间的关系的证据，并强调肠道微生物群在这一关系中具有成为有前途的靶点的潜力。我们对该领域当前知识状况的总结为未来的研究提供了基础，并有助于为针对肠道微生物群的干预措施的设计提供信息，以对抗儿童营养不足并促进健康成长。
