2013/01/30 by Michelle I. Smith, Tanya Yatsunenko, Mark Manary +16 · 1,199 citations
Biochemistry, Genetics and Molecular Biology · Medicine · Nursing · #Bioinformatics #Biology #Child Nutrition and Water Access #Concordance #Diet and metabolism studies #Feces #Gut microbiome #Gut microbiota and health #Immunology #Internal medicine #Kwashiorkor #Malnutrition #Medicine #Microbiology #Microbiome #Physiology #Severe Acute Malnutrition
paper · open access · doi:10.1126/science.1229000
published in Science 339(6119), 548-554 (American Association for the Advancement of Science)
openalex publication_date 2013/01/30 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/06
Kwashiorkor, an enigmatic form of severe acute malnutrition, is the consequence of inadequate nutrient intake plus additional environmental insults. To investigate the role of the gut microbiome, we studied 317 Malawian twin pairs during the first 3 years of life. During this time, half of the twin pairs remained well nourished, whereas 43% became discordant, and 7% manifested concordance for acute malnutrition. Both children in twin pairs discordant for kwashiorkor were treated with a peanut-based, ready-to-use therapeutic food (RUTF). Time-series metagenomic studies revealed that RUTF produced a transient maturation of metabolic functions in kwashiorkor gut microbiomes that regressed when administration of RUTF was stopped. Previously frozen fecal communities from several discordant pairs were each transplanted into gnotobiotic mice. The combination of Malawian diet and kwashiorkor microbiome produced marked weight loss in recipient mice, accompanied by perturbations in amino acid, carbohydrate, and intermediary metabolism that were only transiently ameliorated with RUTF. These findings implicate the gut microbiome as a causal factor in kwashiorkor.