Doctoral Dissertation Improvement: Dual Burden Life History Tradeoffs in the Exploration of Childhood Gut Immune Function and Overnutrition

儿童时期由于水质差和卫生条件不佳而经常受到肠道感染，往往会导致慢性营养不良和直线生长受限。然而，许多发展中国家现在正在经历饮食和疾病的转型，从频繁的营养不良和传染病转变为日益严重的营养过剩，高热量、高脂肪、低纤维的饮食，超重和肥胖率更高。这种感染和营养过剩的双重负担对儿童肠道健康和免疫功能的影响尚不清楚。博士生Kelly Houck(北卡罗来纳大学)在Amanda Thompson博士的指导下，利用专注于肠道微生物区系(负责肠道屏障功能、膳食纤维消化和免疫健康(炎症调节)的有益细菌菌落)的新兴研究领域，研究致病因素和饮食因素对儿童肠道免疫健康、生长和肥胖之间关系的影响。厄瓜多尔的加拉帕戈斯群岛是这项研究的重要地点，因为儿童既经历了由于缺乏清洁水而导致的高感染率，也经历了营养过剩，这可能是由于依赖从大陆运来的加工食品。研究人员将收集有关儿童饮食、病史和家庭特征的详细数据，并将使用血斑和粪便分析来测量生长和肥胖、家庭水质和肠道免疫功能。该项目测试了一种假设，即在双重负担环境中，同时接触病原体和营养过剩会导致肠道免疫功能失调，在营养过剩和感染之间产生一种新的协同效应，这可能会导致在这些人群中出现儿童发育迟缓和肥胖的矛盾模式。在经济发展和城市化正在迅速改变人类健康的发展中国家，迫切需要了解这些变化如何影响儿童的免疫功能和生长，以防止高感染率、发育迟缓和肥胖率。拟议的项目为厄瓜多尔的大学生和一名社区卫生工作者提供培训。这些结果将为肠道免疫激活对儿童发育和肥胖的影响提供原创性见解，并确定与加拉帕戈斯、厄瓜多尔和其他正在转型的非工业化人口相关的公共卫生教育和干预的重要目标。

Frequent intestinal infections due to poor water quality and inadequate sanitation during childhood often result in chronic malnutrition and linear growth restrictions. Many developing countries, however, are now undergoing diet and disease transitions, with a shift from frequent malnutrition and infectious disease to increasing overnutrition, with calorically-dense, high-fat, low-fiber diets, and higher rates of overweight and obesity. The impact of this dual burden of infection and overnutrition on childhood intestinal health and immune function remains unknown. Doctoral student Kelly Houck (University of North Carolina), with the guidance of Dr. Amanda Thompson, draws on the emerging field of study focusing on gut microbiota, the beneficial bacterial colonies responsible for intestinal barrier function, digestion of dietary fiber and immune health (inflammatory regulation), to examine the impact of pathogenic and dietary factors on the relationship between childhood gut immune health, growth and obesity. The Galápagos Islands of Ecuador are an important setting for this research as children experience both high infection rates due to the lack of clean water and overnutrition, likely due to the reliance on processed foods shipped from the mainland. Researchers will collect detailed data on the children's diet, illness history, and household characteristics, and will measure growth and adiposity, household water quality, and gut immune function using blood spot and fecal analyses. This project tests the hypothesis that in dual burden environments, concurrent pathogenic exposures and overnutrition contribute to gut immune dysregulation, creating a new synergism between overnutrition and infection that may be driving the paradoxical pattern of childhood stunting and obesity seen in such populations.In developing countries where economic development and urbanization are rapidly transforming human health, the need to understand how these changes are affecting childhood immune function and growth is urgent to prevent the high rates of infection, stunting and obesity. The proposed project offers training to university students and a community health worker in Ecuador. The results will provide original insights into the impacts of gut immune activation on childhood growth and obesity and identify important targets for public health education and interventions relevant to the Galapagos, Ecuador, and other non-industrialized populations undergoing transition.