Prebiotics and Microbiota Composition and Functionality in Rural Burkinabe Infants
|Growth Retardation Infant Morbidity||Dietary Supplement: Fortified lipid based nutrient supplement Dietary Supplement: lipid based nutrient supplement|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant, Care Provider, Investigator
Primary Purpose: Prevention
|Official Title:||Effect of Supplementation With LNS Fortified With a Mixture of FOS and Inulin on Gut Microbiota Diversity and Functionality and Its Repercussion on Growth and Morbidity During Infancy in Rural Burkina Faso|
- Fecal microbiota range-weighted richness [ Time Frame: 6 months ]Composition of fecal microbiota will be determined by Illumina sequencing from which range-weighted richness will be calculated
- Mean concentration of short-chain fatty acids in stool [ Time Frame: 6 months ]Concentration of short-chain fatty acids (acetate, butyrate and propionate) will be measured by Gas Chromatography
- Frequency of digestive intolerance symptoms (flatulence, abdominal pain, regurgitation, vomiting, or diarrhea) [ Time Frame: once every week during the first month of supplementation ]Digestive intolerance symptoms will be recalled.
- Stool consistency [ Time Frame: Once every week during the first month of supplementation ]Stool consistency will be recalled
- Stool frequency per day [ Time Frame: 6 months ]Stool frequency per day will be recalled.
- Mean stool pH [ Time Frame: once every week during the first month of supplementation ]Stool pH will be measured once a week with pH sticks by a study nurse
- Calprotectin concentration in stool [ Time Frame: at inclusion, 3 months and 6months after inclusion ]Concentration of calprotectin will be measured by ELISA
- Infant linear growth velocity [ Time Frame: once a month during 6 months ]Linear growth velocity will be determined using the difference between 2 length measures over the follow up time in months and expressed in millimeters/ month
- Infant ponderal growth velocity [ Time Frame: once a month during 6 months ]Ponderal growth velocity will be determined using the difference between 2 weight measures over the follow up time in month and expressed in grams/ month. Infant's weight will be measured at inclusion and once a month during 6 months
- Cumulative morbidity [ Time Frame: Starting from inclusion, weekly during a follow-up of 6 months ]Cumulative morbidity of (malaria, gastro-intestinal tract infection, acute respiratory tract infection, acute otitis) will be assessed one a week by a study nurse
- Infant's intestinal permeability [ Time Frame: at inclusion, 3 months and 6 months after inclusion ]Intestinal permeability will be assessed using a mannitol-lactulose test
- Residual fecal microbiota range-weighted richness [ Time Frame: 3 months and 6 months ]Composition of fecal microbiota will be determined by Illumina sequencing, from which range-weighted richness will be calculated
- Residual concentration of short-chain fatty acids in stool [ Time Frame: 3 months and 6 months ]Concentration of short chain fatty acids (acetate, butyrate and propionate) will be measured by Gas Chromatography
|Study Start Date:||March 2016|
|Estimated Study Completion Date:||October 2017|
|Estimated Primary Completion Date:||October 2017 (Final data collection date for primary outcome measure)|
Experimental: Fortified lipid based nutrient supplement
lipid based nutrient supplement (Nutributter) fortified with fructo-oligosaccharides and inulin
Dietary Supplement: Fortified lipid based nutrient supplement
6 months intervention: participant will take a daily dose of 20g supplement. The product contains 3 g of a mixture (1:1) of inulin and fructan-oligosaccharide
Active Comparator: lipid based nutrient supplement
lipid based nutrient supplement (Nutributter)
Dietary Supplement: lipid based nutrient supplement
Dietary Supplement: lipid based nutrient supplement (Nutributter) 6 months intervention: participant will take a daily dose of 20g supplement.
No Intervention: non intervention group
This group will not be supplemented
The central role of gut microbiota in immunity and nutritional homeostasis is now acknowledged, albeit not fully understood. Gut microbiota composition imbalances have been found in malnourished children, which were not restored by nutritional interventions as currently conducted. Therefore, the necessity to design more complete nutritional interventions that include gut health has been advised by expert committees.
Prebiotics are compound that selectively enhance the growth of beneficial gut bacteria. They have been recommended and used in infant formula and weaning cereals resulting in gut microbiota resembling that of breastfed infants in formula fed infants in developed countries. A healthy gut microbiota was shown to be associated with enhanced growth patterns and decreased morbidity in children in developed countries. Evidence of such outcome is lacking in developing countries, yet such results would be particularly valuable for children from these settings, living in rather poor sanitary conditions in an environment characterized with high infectious disease load, conditions that mostly explain the high prevalence of chronic malnutrition. This study aims to assess the effect of a 6 months' supplementation with a lipid based nutrient supplement fortified with fructo-oligosaccharides and inulin on microbiota diversity and functionality in rural Burkinabe infants, and to explore its subsequent effects on linear growth velocity and morbidity.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02716935
|Bobo-Dioulasso, Houet, Burkina Faso, 01 BP 545|