Why do some children who eat enough calories still end up stunted?

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Credit: Pirozzi/UNICEF

Even when given enough to eat, [malnourished children] end up shorter than their peers and are saddled with cognitive deficits, weakened immune systems and other long-term consequences that tax their brains and bodies alike. The result is a paradox that continues to vex researchers worldwide.

Some 150 million children under the age of 5 have stunted growth. “It’s perhaps the single most common nutritional problem that we see all over the world, and there is no single intervention that has worked,” said [researcher] Tahmeed Ahmed.

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With so many children imperiled by poor sanitation and food insecurity, it is unlikely that researchers will ever uncover a simple root cause for stunting, Dr. Ahmed said. But in a paper published [July 23] in The New England Journal of Medicine, a team led by Dr. Ahmed and Jeff Gordon, a microbiologist at Washington University in St. Louis, may have taken a crucial step toward understanding one driver behind the debilitating condition: the bacteria that reside within the small intestine, where most nutrients are absorbed.

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Certain members of this microbial community, the researchers found, may cause a cascade of inflammation in the gut that makes it harder for children to get the most out of their meals. Treatments that target these microbes for elimination — or perhaps foster friendlier strains — might someday help physicians rebuild the health of malnourished children.

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