An Alternative Oat-Containing, Ready-To-Use, Therapeutic Food Does Not Alter Intestinal Permeability or the 16S Ribosomal RNA Fecal Microbiome Configuration Among Children With Severe Malnutrition in Sierra Leone: A Randomized Controlled Trial.

Autor:	Hendrixson DT; Department of Pediatrics, University of Washington, Seattle, WA, USA., Naskidashvili N; Project Peanut Butter, Freetown, Sierra Leone., Stephenson KB; Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA., Laury ML; Genome Technology Access Center, Washington University in St Louis, St. Louis, MO, USA., Koroma AS; Ministry of Health and Sanitation, The Republic of Sierra Leone, Freetown, Sierra Leone., Manary MJ; Project Peanut Butter, Freetown, Sierra Leone.; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.; USDA Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2023 Jan 14; Vol. 152 (12), pp. 2744-2753.
DOI:	10.1093/jn/nxac207
Abstrakt:	Background: Previously, a novel oat ready-to-use therapeutic food (o-RUTF) resulted in improved recovery from severe acute malnutrition (SAM) when compared to a standard RUTF (s-RUTF). The o-RUTF contained 18% oat, while the s-RUTF has no cereal ingredients. Objectives: We determined the effects of o-RUTF on intestinal permeability, as measured by lactulose permeability, and the 16S ribosomal RNA (rRNA) fecal microbiome configuration of children with SAM. Methods: This was a prospective, randomized, double-blinded, controlled clinical trial. Sierra Leonean children aged 6-59 mo with SAM, defined by a midupper arm circumference < 11.5 cm, were randomized to receive o-RUTF or s-RUTF. All children received 7 d of amoxicillin per guidelines. Lactulose permeability testing and fecal 16S rRNA sequencing were performed at baseline and after 4 wk of therapy. The change in lactulose permeability was the primary outcome, while the fecal 16S rRNA configuration at 4 wk was a secondary outcome. Results: Of the 129 children enrolled, lactulose permeability testing was completed by 100 at baseline and 82 at week 4. After 4 wk of therapeutic feeding, there were no differences in lactulose permeability between the o-RUTF and s-RUTF groups (P = 0.84), and over half of children had increased lactulose permeability (50% s-RUTF compared with 58% o-RUTF, mean difference = -7.5%; 95% CI: -29.2, 15.2; P = 0.50). After 4 wk of feeding, there were no differences in the 16S rRNA configurations between the o-RUTF and s-RUTF groups (Permanova, 999 permutations; P = 0.648; pseudo-F = 0.581), nor were there differences in α or β diversity. Conclusions: Despite remarkably different compositions of o-RUTF and s-RUTF, no differences were identified in lactulose permeability or the fecal 16S rRNA configuration among children with SAM receiving these foods. These results suggest that the o-RUTF exerts its beneficial effects through mechanisms other than reducing intestinal permeability or altering the fecal 16S configuration. This trial was registered at clinicaltrials.gov as NCT04334538. (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)
Databáze:	MEDLINE
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