An evolving perspective about the origins of childhood undernutrition and nutritional interventions that includes the gut microbiome

Abstract

The Sackler Institute for Nutrition Science and the World Health Organization (WHO) have worked together to formulate a research agenda for nutrition science. Undernutrition of children has profound effects on health, development, and achievement of full human capacity. Undernutrition is not simply caused by a lack of food, but results from a complex interplay of intra- and intergenerational factors. Representative preclinical models and comprehensive well-controlled longitudinal clinical studies are needed to further understand the contributions and the interrelationships among these factors and to develop interventions that are effective and durable. This paper summarizes work on mechanisms underlying the varied manifestations of childhood undernutrition and discusses current gaps in knowledge and challenges to our understanding of undernutrition and infection/immunity throughout the human life cycle, focusing on early childhood growth. It proposes a series of basic and clinical studies to address this global health challenge.

Keywords: environmental enteropathy; epigenetics; gnotobiotic mice; gut microbiota, nutrient-immune system interactions, gut barrier function; neurodevelopment and brain metabolism; stunting; undernutrition.

Figure 1

The determinants of stunting operate at multiple levels of causation.