Gut power: Testing Innovations to Prevent Malnutrition

News article 22 Aug 2019

LSTM is partnering with the Children’s Investment Fund Foundation (CIFF) on a new £2 million project in Kenya. Our aim is to assess whether probiotics and prebiotics, given as supplements to young infants, may improve gut health through supporting the development of a healthy gut microbiome.

With undernutrition being responsible for an estimated 45% of child deaths globally, LSTM’s Professor Stephen Allen describes the importance of a healthy gut in alleviating malnutrition and preventing infections. “A healthy gut is critical for digesting and absorbing nutrients and protection against infection – especially in the young infant who is growing rapidly. Unfortunately, even in infants who are exclusively breasted, poor sanitation and hygiene and other environmental factors compromise healthy gut development. Breast milk is the main factor that encourages the growth of “friendly” gut bacteria that protect against harmful microbes. Our project aims to look at boosting these friendly bacteria as an extra defence against gut pathogens. Giving these as supplements up to the age of six months may lead to a healthier gut and in turn a healthier child less prone to malnutrition and infection. CIFF is a leader in addressing malnutrition in children and we are very excited to join forces with them on this project.”

As an independent philanthropic organisation, CIFF works with partners and governments to accelerate progress on improving children’s lives through evidence-based interventions that prevent and reduce severe acute malnutrition. Despite developments in research, it is still unclear what causes malnutrition and CIFF is delighted to be working with the LSTM on one of the many interventions that have shown promising results. By intervening earlier (less than six months), before the microbiome is well established in the gut, the project might see stronger, more positive results than previous gut-related interventions in malnutrition. If proven successful, this type of intervention could contribute towards saving the lives of the 3.1 million children lost each year to malnutrition.

The main types of friendly bacteria in healthy, breastfed babies are Bifidobacteria and Lactobacilli. These are often given as dietary supplements called “probiotics”. Probiotics have been tested in many people, including very small babies, and found to be safe. Another approach is to give the special sugars that support the growth of friendly bacteria – called “prebiotics”. The benefit might be greatest when a probiotic and a prebiotic are combined - called a “synbiotic”.

Working in partnership with the Kenya Medical Research Institute (KEMRI) in a 52-month project, we aim to recruit 600 newborn babies in Homa Bay county, western Kenya. Newborns will either be given one of two different synbiotics, a prebiotic alone or usual feeds without any supplement. The team will record growth and episodes of illness in all children as well as testing stool and heel/finger prick blood samples to look for biomarkers of gut health, inflammation and growth. All children will be followed-up to age 2 years.

“We must promote the healthy development of the body and brain to provide children with greater opportunities.” Continued Professor Allen: “If this initial intervention provides evidence that the supplements improve gut health and are acceptable to mothers, this would present exciting potential to subsequently assess impact on key clinical outcomes such as the prevention of malnutrition.”