IMPACT OF NUTRITIONAL SUPPLEMENTATION ON ENVIRONMENTAL ENTERIC DYSFUNCTION (EED) IN CHILDREN LIVING IN RURAL AREAS: A SYSTEMATIC REVIEW.

Q2 Medicine
Arquivos de Gastroenterologia Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI:10.1590/S0004-2803.24612023-159
Rizky Abi Rachmadi, Yulia Ariani, Fatima Safira Alatas
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引用次数: 0

Abstract

Background: A staggering 99% of infant undernutrition mortality comes from Sub-Saharan Africa and South Asia. Despite multiple interventions focusing on nutrition adequacy, 2.7 million children worldwide remain associated with undernutrition-related mortality. The lack of impact from multiple interventions toward undernutrition reflects a strong reason to believe that EED is the missing link that sustains undernutrition in low-to-middle-income countries (LMICs). EED is a sub-clinical condition caused by repeated oral enteropathogenic and non-pathogenic fecal microbes exposure that causes intestinal villous malformation, multi-omics changes, chronic intestinal and systemic inflammation, and gut dysbiosis. EED impacts the absorptive capacity and the integrity of the gut, causing a cycle of undernutrition in children. There is currently no protocol for the diagnosis and treatment of EED, hence EED is widely believed to be highly prevalent and underdiagnosed in LMICs.

Objective: To our knowledge, this is the first systematic review to study the impact of nutritional interventions on EED. Previous studies yielded inconsistent results, hence the synthesis of this information is essential in attaining a deeper understanding of EED to formulate new targets of intervention against child undernutrition.

Methods: This systematic review is registered to PROSPERO (CRD42022363157) in accordance to PRISMA, using keywords referring to nutrient supplementation, EED, and child growth failure.

Results: Eleven articles were eligible for review, comprising randomized controlled trials performed mainly in the African continent, with a total of 5689 healthy children eligible for analysis.

Conclusion: The systematic review illustrates that nutritional interventions have a minimal impact on EED biomarkers and linear growth and reflects the importance of understanding better the mechanisms causing EED and its consequences. It appears that the anabolic contribution of nutrition intervention to child growth is negated by EED.

营养补充对农村地区儿童肠道环境功能紊乱(EED)的影响:系统综述。
背景:撒哈拉以南非洲和南亚地区的婴儿营养不良死亡率高达 99%。尽管采取了多种以营养充足为重点的干预措施,但全球仍有 270 万儿童因营养不良而死亡。多种干预措施对营养不良的影响不大,这充分说明我们有理由相信,EED 是中低收入国家(LMICs)营养不良问题赖以生存的缺失环节。EED 是一种亚临床症状,由反复口服肠道致病性和非致病性粪便微生物引起,会导致肠绒毛畸形、多组学变化、慢性肠道和全身炎症以及肠道菌群失调。EED 影响肠道的吸收能力和完整性,造成儿童营养不良的循环。目前还没有诊断和治疗 EED 的方案,因此人们普遍认为 EED 在低收入和中等收入国家非常普遍,而且诊断不足:据我们所知,这是第一篇研究营养干预对 EED 影响的系统性综述。以往的研究得出的结果并不一致,因此综合这些信息对于加深对 EED 的了解、制定针对儿童营养不良的新干预目标至关重要:本系统性综述根据 PRISMA 在 PROSPERO(CRD42022363157)上注册,使用的关键词包括营养素补充、EED 和儿童生长迟缓:有 11 篇文章符合审查条件,其中包括主要在非洲大陆进行的随机对照试验,共有 5689 名健康儿童符合分析条件:该系统性综述表明,营养干预对 EED 生物标志物和线性生长的影响微乎其微,这也反映了更好地了解 EED 的致病机制及其后果的重要性。营养干预对儿童生长的促进作用似乎被 EED 所抵消。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Arquivos de Gastroenterologia
Arquivos de Gastroenterologia Medicine-Gastroenterology
CiteScore
2.00
自引率
0.00%
发文量
109
审稿时长
9 weeks
期刊介绍: The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
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