03 Sep New Systematic Review on Stunting and Gut Microbiota Reveals Deeper Relationship, MDCFs May Offer Solution

Center for Infectious Disease Research in Zambia (CIDRZ) Research Fellow and AIGHD PhD Fellow Mwelwa Chibuye (she/her) holds a specialist degree in Genetics and a Master’s degree in Epidemiology and Biostatistics. She is currently pursuing her PhD at the University of Amsterdam’s Department of Global Health under the supervision of Prof. Constance Schultsz and Dr. Vanessa Harris.

This systematic review was supported by the Schlumberger faculty for the Future Foundation and the ShigaPlexIM project, an EDCTP-funded endeavour which aims to develop a Shigella vaccine. You can learn more about ShigaPlexIM on their official website.

Mwelwa Chibuye sat down with AIGHD Communications for a short interview to discuss the findings of her recently published systematic review paper on the relationship between stunting and the gut microbiome. Stunting is the impaired growth and development that children experience due to poor nutrition, repeated infections, and inadequate psychosocial stimulation (Source: World Health Organization), while the gut microbiome is the collection of microorganisms living in the intestines that perform various metabolic, immune, and digestive functions. This video from the Washington Post describes the gut microbiome. You can find the full paper on Nature’s NPJ Biofilms and Microbiomes here: “Systematic review of associations between gut microbiome composition and stunting in under-five children.”

As a researcher, Mwelwa has worked closely with Zambian children, especially those with vulnerabilities such as living with HIV, orphanhood, repeated infections, and other co-morbidities. For the last five years, her work has centered on enteric diseases and child health. As part of her PhD research, she is investigating childhood stunting, the most prevalent form of childhood malnutrition. “Infectious diseases, poor nutrition, and genetics have traditionally been implicated in childhood stunting. But even when you improve all of these variables, you find that children still remain stunted, which means there are other underlying causes of stunting. This condition is particularly concerning because it can affect a child’s cognitive development and increase the risk of infectious diseases (including pneumonia and diarrhea), which in turn exacerbates the stunting.”

The motivation for the systematic review was to collect and analyze data from studies on stunting and the gut microbiome to determine the specific gut microbiome profiles of stunted children across different geographies.

Using the standard PICO (Population, Intervention, Comparison, Outcome) framework, Mwelwa dissected other studies that focused on children in developing populations. “There is some data, but it’s very limited, particularly for Africa,” Mwelwa noted. “On both gut microbiota studies and stunting studies based in Africa, there is a very limited collection of papers.” The studies reviewed also used a variety of methodologies and study populations. She pointed out that “… geographic regions, food, culture, and health systems all play a role in how the gut microbiome develops.” In her review, she found that no single bacterial taxon was consistently found in stunted children across all studies. However, stunted children exhibited dysbiosis, characterized by reduced microbial diversity and an overgrowth of pathogenic bacteria. This dysbiosis can often cause inflammation of the gut lining, impairing nutrient absorption and contributing to chronic inflammation, further exacerbating stunting. Some studies also reported an overgrowth of bacteria usually resident in the oropharyngeal tract in the gut of stunted children.

Finally, Mwelwa shared a few ideas on how we can utilize this research for affected communities. For example, the taxa reported in this review can be used to develop microbiota-directed complementary foods (MDCFs) for children in underserved communities to address stunting. These MDCFs are dietary supplements designed to support the growth of healthy microorganisms in the gut. Studies using this technology in severely malnourished children have shown very promising results. Meanwhile, for future research, she hopes this review outlines the knowledge gap and limitations of current studies on the gut microbiome and stunting, particularly in Africa. “We need more microbiome studies from Africa, with an African voice to speak for Africans; that way, you give more confidence to your governments to say, ‘This is something that your own people are doing,’ and hopefully convince African governments to fund microbiome research,” she continued. “I hope that it inspires more research on the gut microbiome in Africa.”

Concluding our short talk, Mwelwa emphasized that more research into the relationship between gut microbiota and stunting is needed, especially in Africa, where the burden is greatest. Building this body of knowledge will help inform the management of stunting, shape policy, and improve health outcomes for future generations of underserved African children.