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By - Danone Nutricia academy
This clinical summary explains and demonstrates the impact of environmental enteropathy on the reduced linear growth in preschool-age children.
Stunting, a reduced linear growth, is a prevalent health problem in children globally. An estimated 32% of preschool-age children in developing countries have a height-for-age z score (HAZ) < -2. Reduced growth in children could be attributed to inadequate nutrition and acute infection. However, evidence suggests that 20% to 80% of seemingly healthy individuals present with asymptomatic environmental enteropathy (EE), affecting intestinal nutrient absorption. Thus, EE-induced reduced intestinal integrity may significantly contribute to malnutrition and poor growth.
The clinical trial investigated the association of EE to linear growth faltering in preschool children.
Table 1. The study design.
|
Study type |
Single-center
randomized control trial |
|
Number of participants (N) |
418 children |
|
Study group |
§Treatment group: 100 mL of water containing lactulose (5 g) and mannitol (1 g). (n=418) |
|
Inclusion criteria |
Children with- §2- to
5-year-old §Primary
diet of maize and legumes §Documented
history of growth monitoring every 2 to 3 months since birth |
|
Exclusion criteria |
Children with- §Any
chronic debilitating illness (HIV infection or apparent congenital
abnormalities) §Evidence
of acute malnutrition §History or
presence of diarrhea or hematochezia |
|
Outcome measures |
§The
lactulose:mannitol ratio (L:M) §Urinary
excretion of lactulose and mannitol (as a percentage of the dose
administered) §Change in
HAZ |
HAZ: Height-for-age z score; HIV: Human immunodeficiency virus
Table 1 shows how EE is associated with reduced linear growth in preschool-age children.
|
Characteristics |
Mean ± SD (n%) |
|
Height-for-age z
score |
-2.8±1.1 |
|
Change in
weight-for-height, z score during three mo |
-0.22±0.50 |
|
L:M ratio |
0.2±0.2 |
|
L:M ratio >0.1 |
364 (87) |
|
L:M ratio <0.1 |
54
(13) |
|
L:M ratio 0.1-0.3 |
278 (67) |
|
L:M ratio >0.3 |
86
(21) |
Figure 1: Association between HAZ change and lactulose (%) excreted (A) and L:M (B).
This study demonstrated a distinct association between abnormal gut integrity and reduced linear growth in children. It can be explained by reduced nutrient absorption due to altered gut functioning leading to malnutrition and growth faltering.
For the use of healthcare professionals only, not for distribution to general public.
CVM code: 1639650295079
