Malnourishment Research: icddr,b finds homemade solution

If you have a child who struggles to recover from malnourishment despite being well fed, here is some good news for you.

A team of scientists at the capital’s icddr,b says the situation could be caused due to the presence of immature bacteria in the stomach and it could be overcome by feeding children a low-cost, easy-to-obtain food supplement made from banana, soya, Chinese nuts and chickpea.

This supplement could be made at home just like the Oral Rehydration Solution (ORS) that saves millions of lives globally, according to the scientists.

In a decade-long research and clinical trial, they found that if the certain types of immature microbiota are fed with specific food combination, those get mature, resulting in the end of malnutrition in children. This could overcome stunting, improper brain development or wasting (low weight-for-height), they said.

This finding, first of its kind, has won the Breakthrough of the Year 2019 award by the American Association for the Advancement of Science (AAAS) journal. This finding is among the ten most significant developments in scientific research last year, said the journal. 

“The supplements performed well during a small trial, and larger scale clinical trials are now underway at the icddr,b to see how well the supplement works to end malnutrition in the children,” Dr Tahmeed Ahmed, senior director, nutrition and clinical services at the icddr,b, told The Daily Star.

Dr Tahmeed is the lead investigator in the team that includes Prof Geffrey Gordon of Washington University.

In Bangladesh, more than half the population suffers from malnutrition while severe acute malnutrition affects 450,000 children, and around two million children have moderate acute malnutrition, according to the icddr,b website.

A quarter of women are underweight while around 15 percent have short stature, which increases the risk of difficult childbirth and low-birth-weight infants.

Malnutrition is estimated to cost Bangladesh more than $1bn every year in lost productivity, the website says.

Globally, more than two billion people suffer from malnutrition.

Asked how their work began, Dr Tahmeed said, “We started research on the concept: if particular microbiota are responsible for obesity, then there might be particular microbiota responsible for wasting.”

With this concept, the icddr,b team compared stomach/gut microbiota of two group of children -- one of a Mirpur slum and another of severe malnourished children admitted to icddr,b.

The analysis showed the gut microbiota of the malnourished children are immature and less diverse than those of nourished children.

He said they chose children between 12 and 18 months as children from this age group are most vulnerable to malnutrition.

He, however, said the research outcome is also applicable to children of all age groups.

The team first pinpointed 15 types of bacteria that characterise a mature gut microbiome. It also identified blood markers, including proteins, that signal a recovery from the effects of malnutrition.

Dr Tahmeed said they then tested various combinations of food readily found in developing countries to see how the microbiome responded. The tests were carried out first in mice, then in pigs, and finally in a small group of malnourished children.

Milk powder and rice, standard components of food aid, did little to foster expansion of the key bacteria, but supplements containing chickpeas, bananas, and soy and peanut flours helped the microbiomes mature.

“For around eight years, we applied this food supplement on animals in a very sophisticated laboratory at Washington University,” Dr Tahmeed said.

Later, a short clinical trial at icddr,b proved children who received the supplements had more of the blood proteins and metabolites that are markers for normal growth.

“We are not dismissing the efficacy of traditional food supplement. Our study, however, proves a certain type of food combination is more effective,” Dr Tahmeed said.

“In near future, we hope we could provide a mechanism to the public domain to fight malnutrition, as it happened with ORS,” he added.