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.

项目概要 严重急性营养不良 (SAM) 是五岁以下儿童死亡中近一半的原因。在 印度尼西亚，SAM 影响了超过 200 万儿童，约 1% 的儿童由于缺乏 访问和覆盖范围。典型的 SAM 治疗包括即用型治疗食品 (RUTF)，其具有 已显示出立竿见影的效果并降低了死亡率，但康复后的儿童仍持续存在 肠道微生物群失调，使它们容易受到感染和营养不良复发以及患 晚年慢性代谢性疾病。益生元食品在肠道治疗中的应用受到越来越多的关注 SAM 治疗和恢复期间富含益生元的食物的功效知之甚少。 米糠含有益生元，对于支持共生菌的有利变化具有越来越重要的意义 微生物群和微生物代谢。米糠含有独特的生物活性植物化学物质、脂质和氨基 与其他谷物的麸皮相比，酸含量更高。来自动物的令人信服的已发表证据和初步证据 人类支持米糠对肠道微生物组和代谢组产生积极影响以提供保护 对抗腹泻疾病并支持健康成长。重点关注改善 SAM 治疗 儿童使用含有米糠的创新 RUTF 配方是正在进行的双盲、 随机对照试验（NCT05319717）。该随机对照试验是首次在 SAM 处理期间对米糠进行检查。 该提案的目的是研究在 RUTF 中添加米糠是否会导致以下变化： 恢复儿童的微生物群和新陈代谢，增强对肠道感染的保护， 预防营养不良复发并促进表明营养增强的血液代谢特征 吸收。假设 RUTF + 米糠处理会增加粪便微生物多样性， 与对照 RUTF 相比，可有利地调节 SAM 儿童的干血斑代谢组。 膳食中米糠的添加有望通过肠道微生物群调节氨基酸和脂质代谢 从 SAM 中康复的儿童。探索该假设的两个提议的具体目标是 1) 确定 与对照 RUTF 相比，SAM 治疗组中 RUTF + 米糠对肠道微生物群组成的影响 6-59 个月儿童的 SAM 和 2) 检查并建立 EED 标记物和代谢物概况 与对照 RUTF 相比，在 SAM 处理中使用 RUTF + 米糠进行治疗。米糠夹杂物 RUTF 预计将成为一种本地的、负担得起的解决方案，可以增强对微生物的保护 与营养不良复发相关的菌群失调，粪便和血液分析的结果将显着 增进我们对如何改善肠道导向 SAM 治疗的全球知识。