Rice bran in ready-to-use therapeutic foods for microbiota-targeted treatment of childhood malnutrition

即用型治疗食品中的米糠用于针对儿童营养不良的微生物群治疗

• 批准号: 10750478
• 负责人: Elizabeth P Ryan
• 金额: $ 41.66万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-18 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10750478
• 关键词: 5 year old; Acute; Adolescent and Young Adult; Affect; Aftercare; Age; Amino Acids; Animals; Antioxidants; Biological Assay; Blood; Cereals; Cessation of life; Child; Child Malnutrition; Childhood; Chronic; Chronic Disease; Collection; Development; Diarrhea; Dietary Intervention; Double-Blind Method; Dryness; Enrollment; Enteral; Enzyme-Linked Immunosorbent Assay; Feces; Food; Food Supplements; Formulation; Freezing; Functional disorder; Funding; GLP-2; Growth; Gut Mucosa; Human; Impairment; Indonesia; Infant; Infection; Inflammation; Intake; Intervention; Intestinal permeability; Intestines; Investigation; Knowledge; Lactobacillus; Length; Life; Lipids; Malnutrition; Metabolic; Metabolic Diseases; Metabolism; Mucosal Immune Responses; Non-Insulin-Dependent Diabetes Mellitus; Norovirus; Nutrient; Nutritional; Pathway interactions; Phytochemical; Predisposition; Prevention; Prevotella; Probiotics; Publishing; Randomized, Controlled Trials; Recovery; Recurrence; Relapse; Research; Resistance; Rice; Risk; Rotavirus Infections; Salmonella; Shotguns; Spottings; Supplementation; Therapeutic Uses; Time; Tryptophan; Weaning; Weight; Weight Gain; alpha 1-Antitrypsin; arm; bacterial community; commensal microbes; comparison control; diarrheal disease; dietary; directed attention; dysbiosis; enteric infection; food insecurity; gut microbiome; gut microbiota; high risk; immunoregulation; improved; indexing; innovation; lipid metabolism; metabolic profile; metabolome; metabolomics; metagenomic sequencing; microbial; microbiota; mortality; nutrient absorption; pathogen; prebiotics; response; stool sample; targeted treatment; uptake

PROJECT SUMMARY Severe acute malnutrition (SAM) is the cause for nearly half of all child deaths under the age five. In Indonesia, SAM affects more than 2 million children and ~1% receive adequate treatment due to lack of access and coverage. Typical SAM treatment includes ready-to-use therapeutic foods (RUTF) which have shown immediate benefit and reduction in mortality rates, however, recovered children have persistent dysbiotic gut microbiota, leaving them susceptible to infection and malnutrition relapse as well as risk for chronic metabolic disease later in life. A growing focus has been placed on prebiotic foods in treatment of gut dysfunction, with little known regarding efficacy of prebiotic rich foods during SAM treatment and recovery. Rice bran contains prebiotics of growing significance to supporting favorable changes to commensal microbiota and microbiota metabolism. Rice Bran contains unique bioactive phytochemicals, lipids, and amino acids when compared to bran from other cereals. Compelling published and preliminary evidence from animals and humans support that rice bran positively influences the gut microbiome and metabolome for protection against diarrheal disease and supports healthy growth. Directed attention to improving SAM treatment of children with an innovative RUTF formulation containing rice bran is the basis for an ongoing double-blinded, randomized control trial (NCT05319717). This RCT is the first examination of rice bran during SAM treatment. The objective of this proposal is to examine whether the addition of rice bran to RUTFs results in changes to the recovering child’s microbiota and metabolism that provide enhanced protection against enteric infections, prevention of malnutrition relapse and promotion of blood metabolic profiles indicative of enhanced nutrient absorption. The hypothesis is that the RUTF + rice bran treatment will increase stool microbial diversity and favorably modulate the dried blood spot metabolome in SAM children when compared to a control RUTF. Dietary rice bran inclusion is expected to modulate both amino acid and lipid metabolism via gut microbiota in children recovered from SAM. Two proposed specific aims to explore this hypothesis are 1) Determine the effect of RUTF + rice bran on gut microbiota composition in the treatment of SAM compared to control RUTF in SAM in children ages 6-59 months and 2) Examine and establish EED marker and metabolite profiles associated with RUTF + rice bran in the treatment of SAM compared to control RUTF. Rice bran inclusion to RUTFs is anticipated to become a local, affordable solution that can enhance protection against microbial dysbiosis that is associated with malnutrition relapse, and results from stool and blood analysis will significantly advance our global knowledge of how to improve gut-directed SAM treatments.

项目摘要 严重急性营养不良是五岁以下儿童死亡的近一半原因。在 在印度尼西亚，SAM影响了200多万儿童，约1%的儿童因缺乏适当的治疗而接受治疗。 获取和覆盖。典型的SAM治疗包括即用型治疗食品（RUTF），其具有 然而，康复后的儿童仍持续受到 肠道微生物群失调，使他们容易感染和营养不良复发， 慢性代谢性疾病。益生元食品在肠道治疗中的作用越来越受到关注 在SAM治疗和恢复期间，关于富含益生元的食物的功效知之甚少。 米糠含有益生元的增长意义，以支持有利的变化， 微生物群和微生物群代谢。米糠含有独特的生物活性植物化学物质，脂质和氨基 酸相比，从其他谷物麸皮。令人信服的已发表和初步的动物证据 人类支持米糠对肠道微生物组和代谢组产生积极影响， 预防疟疾，促进健康成长。注意改善SAM治疗， 儿童与一个创新的RUTF配方含有米糠是一个正在进行的双盲， 随机对照试验（NCT 05319717）。该RCT是SAM处理期间对米糠的首次检查。 本提案的目的是研究在RUTFs中添加米糠是否会导致 恢复中的儿童的微生物群和新陈代谢提供增强的保护，防止肠道感染， 预防营养不良复发和促进指示营养增强的血液代谢谱 吸收。假设RUTF +米糠处理将增加粪便微生物多样性， 当与对照RUTF相比时，有利地调节SAM儿童中的干血斑代谢组。 预期膳食米糠包含物通过肠道微生物群调节氨基酸和脂质代谢， 孩子们从SAM中恢复过来。探索这一假设的两个建议的具体目标是：1）确定 与对照RUTF相比，RUTF +米糠对SAM处理中肠道微生物群组成的影响 SAM在6-59个月的儿童和2）检查和建立EED标志物和代谢物谱 与对照RUTF相比，SAM处理中RUTF +米糠相关。米糠内含物 RUTFs预计将成为一种当地的，负担得起的解决方案，可以加强对微生物的保护， 与营养不良复发相关的生态失调，粪便和血液分析的结果将显着 推进我们对如何改善肠道导向SAM治疗的全球知识。