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 严重的急性营养不良（SAM）是五岁以下儿童死亡的几乎一半的原因。在 印度尼西亚，山姆影响超过200万儿童，约有1％的人因缺乏 访问和覆盖范围。典型的SAM治疗包括现成的治疗食品（RUTF） 但是，立即显示出益处和降低死亡率，但是，恢复的儿童持续存在 不植物肠道微生物群，使它们容易感染和营养继电器以及风险 慢性代谢疾病后期。在肠道治疗的益生元食品上越来越重点 功能障碍，在SAM治疗和恢复过程中鲜为人知的是富含益生元食品的效率。 米麸含有益生元，对支持共生的有利变化越来越重要 微生物群和微生物群代谢。米麸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。引人入胜的动物发表和初步证据 人类支持大米麸皮会积极影响肠道微生物组和代谢组以保护 针对腹泻病并支持健康的生长。将注意力转移到改善SAM处理 具有创新的RUTF配方奶粉的儿童是含有大米麸皮的基础 随机对照试验（NCT05319717）。该RCT是SAM治疗期间对米麸的首次检查。 该提议的目的是检查在RUTF中添加大米麸的 恢复的儿童的菌群和代谢，可增强对促进感染的保护， 预防营养不良的缓解和促进血液代谢特征表明营养增强 吸收。假设是rutf +米麸的治疗将增加粪便微生物的多样性和 与对照RUTF相比，SAM儿童的干血点代谢组有利。 饮食中的米麸包含在 孩子们从山姆恢复过来。探索这一假设的两个提出的特定目的是1）确定 与对照RUTF相比 6-59岁儿童的SAM和2）检查和建立EED标记和代谢物谱。 与对照RUTF相比，与RUTF +米麸相关。米麸包纳入 预计RUTFS将成为本地，负担得起的解决方案，可以增强对微生物的保护 与营养不良中继有关的营养不良，粪便和血液分析的结果将显着 促进我们如何改善肠道导向的SAM治疗方法的全球知识。