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Modifying gut integrity and microbiome in children with severe acute malnutrition using LEgume-Based Feeds [MIMBLE]: A pilot trial

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Title: Modifying gut integrity and microbiome in children with severe acute malnutrition using LEgume-Based Feeds [MIMBLE]: A pilot trial
Authors: Calder, N
Walsh, K
Olupot-Olupot, P
Ssenyondo, T
Muhindo, R
Brignardello, J
Wang, X
McKay, E
Morrison, D
Holmes, E
Frost, G
Maitland, K
Item Type: Journal Article
Abstract: Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025). Bifidobacterium relative abundance increases from day 7 (5.8% ± 8.6%) to day 28 (10.9% ± 8.7%) in CpF (corrected p = 1.000). Legume-enriched feeds support aspects of gut function and the microbiome. Trial registration PACTR201805003381361.
Issue Date: 18-May-2021
Date of Acceptance: 22-Apr-2021
URI: http://hdl.handle.net/10044/1/89483
DOI: 10.1016/j.xcrm.2021.100280
ISSN: 2666-3791
Publisher: Elsevier
Start Page: 1
End Page: 17
Journal / Book Title: Cell Reports Medicine
Volume: 2
Issue: 5
Copyright Statement: ª 2021 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Sponsor/Funder: Wellcome Trust
Wellcome Trust
Funder's Grant Number: 203077/C/16/Z
105603/Z/14/Z
Publication Status: Published
Online Publication Date: 2021-05-18
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Department of Infectious Diseases
Faculty of Medicine



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