Gut Microbiome-Targeted Nutrition Interventions and Growth among Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Hammond Yaw Addae; Charles Apprey; Alexander Kwarteng

doi:10.1016/j.cdnut.2024.102085

Gut Microbiome-Targeted Nutrition Interventions and Growth among Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Curr Dev Nutr. 2024 Feb 14;8(3):102085. doi: 10.1016/j.cdnut.2024.102085. eCollection 2024 Mar.

Authors

Hammond Yaw Addae^{1

2}, Charles Apprey¹, Alexander Kwarteng^{1

3}

Affiliations

¹ Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
² Nursing Department, Nursing and Midwifery Training College, Kpembe, Ghana.
³ Kumasi Centre for Collaborative Research in Tropical Medicine, KNUST, Kumasi, Ghana.

Abstract

Background: Childhood malnutrition is a public health challenge of much interest and concern globally. However, a perturbed gut microbiome (GM) may limit some nutrition interventions' effects among healthy children with undernutrition.

Objectives: This review aimed to evaluate the effects of GM-targeted nutrition interventions on growth outcomes among children (0-59 mo) using published studies in low- and middle-income countries.

Methods: The methods were guided by the Cochrane methodology. The literature search was conducted to include articles published from inception to July 2023 in PubMed, Google Scholar, and Cochrane Databases. We identified and included 35 studies among 11,047 children. The analysis was conducted considering various growth parameters in the qualitative synthesis and weight gain (kg) in the meta-analysis.

Results: In the qualitative synthesis, 55.6% of prebiotics, 66.7% of probiotics, 71.4% of synbiotics, and 28.6% of "microbiome complementary feed" studies had significant effects on growth outcomes. Also, prebiotics had more studies with significant effects among healthy children, whereas probiotics, synbiotics, and "microbiome complementary feeds" had more studies with significant effects among children with undernutrition. Nineteen studies were included in the meta-analyses, of which 7 (36.8%) measured GM outcomes. The meta-analysis showed that prebiotics exhibited heterogeneity but had significant effects on weight in the intervention as compared with the control (mean difference [MD]: 0.14 kg; 95% CI: 0.02, 0.25; I² = 63%, P = 0.02; 4 studies, n = 932). Probiotics had significant effects on weight in the intervention (MD: 0.15 kg; 95% CI: 0.06, 0.25; I² = 42%, P = 0.05; 8 studies, n = 2437) as compared to the control. However, synbiotics (MD: 0.26 kg; 95% CI: -0.04, 0.56; I² = 41%, P = 0.17; 4 studies, n = 1896] and "microbiome complementary feed" (MD: -0.03 kg; 95% CI: -0.18, 0.11; I² = 0%, P = 0.60; 3 studies, n = 733] had no significant effects on weight in the intervention as compared with control.

Conclusions: Although probiotics and synbiotics may be effective at enhancing growth among children, the selection of interventions should be contingent upon health status.This trial was registered at www.crd.york.ac.uk/prospero/ as CRD42023434109.

Keywords: child gut microbiome; low- and middle-income countries; meta-analysis; microbiome-directed complementary feeds; nutrition intervention studies; probiotics; synbiotics; systematic review.