Modifying Gut Integrity and Microbiome in children with severe acute malnutrition using LEgume-Based Feeds [MIMBLE]: A pilot trial

Calder, N. et al. (2021) Modifying Gut Integrity and Microbiome in children with severe acute malnutrition using LEgume-Based Feeds [MIMBLE]: A pilot trial. Cell Reports Medicine, 2(5), 100280. (doi: 10.1016/j.xcrm.2021.100280)

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Abstract

Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025). Bifidobacterium relative abundance increases from day 7 (5.8% ± 8.6%) to day 28 (10.9% ± 8.7%) in CpF (corrected p = 1.000). Legume-enriched feeds support aspects of gut function and the microbiome. Trial registration PACTR201805003381361.

Item Type:Articles
Additional Information:This study is funded by a fellowship award to N.C. from the Wellcome Trust Institutional Strategic Support Fund (grant code 105603/Z/14/Z). Support for the trial management [KEMRI Wellcome Trust Programme East African Overseas Programme Award (2016) from the Wellcome Trust 203077/Z/16/Z])
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McKay, Mrs Eleanor and Morrison, Professor Douglas
Creator Roles:
McKay, E.Investigation
Morrison, D.Formal analysis, Investigation, Writing – review and editing
Authors: Calder, N., Walsh, K., Olupot-Olupot, P., Ssenyondo, T., Muhindo, R., Mpoya, A., Brignardello, J., Wang, X., McKay, E., Morrison, D., Holmes, E., Frost, G., and Maitland, K.
College/School:College of Science and Engineering > Scottish Universities Environmental Research Centre
Journal Name:Cell Reports Medicine
Publisher:Cell Press
ISSN:2666-3791
ISSN (Online):2666-3791
Published Online:18 May 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Cell Reports Medicine 2(5): 100280
Publisher Policy:Reproduced under a Creative Commons licence

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