Nutrition: Towards a better understanding of childhood malnutrition

A potential cause of environmental enteropathy (EE), a disorder widely recognized to be a major contributor to childhood malnutrition, has been described in a paper published in Nature Communications. The authors create the first animal model of the disease and find evidence that both diet and microbes combine to change the mouse small intestine to match the features of EE in humans.

Malnutrition is a significant worldwide health issue, causing 20% of all deaths in children under five. EE is a chronic inflammatory disease of the small intestine, which is poorly understood and thought by some to be the reason behind the poor success rate (less than a third) of therapeutic interventions in malnourished children. In addition, no animal model of the disease exists so understanding its cause and progression, in addition to testing potential therapeutics, has been difficult.

Brett Finlay and colleagues now create a mouse model of the disease and show that the consumption of a moderately malnourished diet by young mouse pups, in combination with repeated oral exposure to fecal-associated bacteria (replicating conditions of poor sanitation and hygiene), induces the symptoms of the disease in the mice. When the authors then fed the mouse pups a normal diet for 21 days, their growth was stunted by an average of 30% and they showed problems with the uptake of proteins and an increase in permeability of the small intestine. The findings indicate that the malnourished diet altered the ecosystem of the small intestine and permitted colonisation by environmentally acquired microbes. Further research is necessary to determine the exact mechanism in mice and to uncover whether this also applies to children suffering from EE.