Effects of lipid-based nutrient supplements on gut markers in stunted children: Secondary analysis of a randomised trial
Artikel i vetenskaplig tidskrift, 2025
Objectives: To examine the effects of lipid-based nutrient supplements (LNS) containing milk protein (MP) and/or whey permeate (WP) on markers of intestinal inflammation and enterocyte mass among stunted children. Furthermore, to explore whether gut status modifies effects of LNS on growth and micronutrient status. Methods: In a 2 × 2 factorial trial 12–59 months-old Ugandan children with stunting were randomized to four LNS formulations (100 g/day for 12 weeks) containing MP or soy protein and WP or maltodextrin, or to no supplementation. Linear mixed-effects models were used to explore faecal myeloperoxidase (f-MPO) and plasma citrulline (p-cit) as outcomes and modifiers of the intervention effects (ISRCTN13093195). Results: Of 750 children, mean ± SD age was 32.0 ± 11.7 months and height-for-age Z-score was −3.02 ± 0.74. Neither MP nor WP had effects on p-cit or f-MPO. f-MPO decreased over time among controls (ratio of change 0.54, 95% confidence interval [CI]: 0.35, 0.84), but not among those given LNS (0.99, 95% CI: 0.79, 1.23) (p = 0.016). In contrast, LNS had no effect on p-cit (p = 0.27). The effect of LNS on cobalamin (B12) status was reduced in children with p-cit <20 µmol/L; whereby there was 20% (95% CI: 2, 35) lower increase in plasma cobalamin and 59% (95% CI: 13, 125) smaller decrease in plasma methylmalonic acid. p-cit or f-MPO did not modify the effects of LNS on growth or other micronutrient markers. Conclusion: LNS had no effect on enterocyte mass and possibly increased intestinal inflammation. The effect of LNS on cobalamin status was reduced in those with low enterocyte mass.
cobalamin
malabsorption
stunting
environmental enteric dysfunction
citrulline
Författare
Hannah Pesu
Köpenhamns universitet
Joseph Mbabazi
Makerere University
Köpenhamns universitet
Rolland Mutumba
Makerere University
Köpenhamns universitet
Otto Savolainen
Chalmers, Life sciences, Infrastrukturer
Peter R. Johnsen
Köpenhamns universitet
Hanne Frøkiær
Köpenhamns universitet
Mette F. Olsen
Köpenhamns universitet
Rigshospitalet
Christian Mølgaard
Köpenhamns universitet
Kim F Michaelsen
Köpenhamns universitet
Christian Ritz
Syddansk Universitet
Suzanne Filteau
London School of Hygiene & Tropical Medicine
André Briend
Tampereen Yliopisto
Köpenhamns universitet
Ezekiel Mupere
Makerere University
Henrik Friis
Köpenhamns universitet
Benedikte Grenov
Köpenhamns universitet
Journal of Pediatric Gastroenterology and Nutrition
0277-2116 (ISSN) 1536-4801 (eISSN)
Vol. In PressÄmneskategorier (SSIF 2025)
Pediatrik
Näringslära och dietkunskap
DOI
10.1002/jpn3.70023