Danielle McClanahan1, Andrew Yeh1, Brian Firek2, Stacey Zettle3, Matthew Rogers2, Richard Cheek2, Michelle V L Nguyen4, Christopher P Gayer4, Stacy G Wendell5, Steven J Mullett5, Michael J Morowitz1,2. 1. Department of Surgery, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA. 2. Division of Pediatric General and Thoracic Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. 3. Department of Clinical Nutrition, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. 4. Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 5. Health Sciences Core Research Facilities, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Abstract
BACKGROUND: Dietary intake sharply impacts the structure and function of the gut microbiota, which is important for childhood health. However, little is known about the microbiota of children who cannot eat by mouth. Standard enteral formulas for supplemental nutrition are low in fiber and high in processed sugars and are commonly associated with gastrointestinal side effects. In this pilot study, we examined the effects of plant-based enteral nutrition (PBEN) upon the gut bacteria of chronically ill children. METHODS: Ten children (median age 3.5 years, age range 2-8 years) dependent upon conventional enteral formula were transitioned to PBEN for 2 months. Microbial diversity within fecal samples collected before and after PBEN was assessed by 16S ribosomal RNA gene sequence analysis and was compared with rectal swabs from healthy children. Fecal short-chain fatty acids and bile acids were measured in parallel. RESULTS: Relative to control samples, fecal samples from study subjects were depleted of commensals (eg, Faecalibacterium) and enriched with pathogens (eg, Enterococcus). Postintervention samples from study subjects were more similar to healthy controls. Most subjects experienced PBEN-induced alterations in the gut microbiota, but these changes varied significantly across individuals. Clinical diaries indicated that PBEN was well tolerated, with improvement in symptoms noted in several subjects. CONCLUSION: Results from this pilot study suggest that PBEN is well tolerated and could improve the health of the microbiota in chronically ill children. This trial provides a rationale for systematic evaluation of PBEN in clinical trials of children who require supplemental nutrition.
BACKGROUND: Dietary intake sharply impacts the structure and function of the gut microbiota, which is important for childhood health. However, little is known about the microbiota of children who cannot eat by mouth. Standard enteral formulas for supplemental nutrition are low in fiber and high in processed sugars and are commonly associated with gastrointestinal side effects. In this pilot study, we examined the effects of plant-based enteral nutrition (PBEN) upon the gut bacteria of chronically ill children. METHODS: Ten children (median age 3.5 years, age range 2-8 years) dependent upon conventional enteral formula were transitioned to PBEN for 2 months. Microbial diversity within fecal samples collected before and after PBEN was assessed by 16S ribosomal RNA gene sequence analysis and was compared with rectal swabs from healthy children. Fecal short-chain fatty acids and bile acids were measured in parallel. RESULTS: Relative to control samples, fecal samples from study subjects were depleted of commensals (eg, Faecalibacterium) and enriched with pathogens (eg, Enterococcus). Postintervention samples from study subjects were more similar to healthy controls. Most subjects experienced PBEN-induced alterations in the gut microbiota, but these changes varied significantly across individuals. Clinical diaries indicated that PBEN was well tolerated, with improvement in symptoms noted in several subjects. CONCLUSION: Results from this pilot study suggest that PBEN is well tolerated and could improve the health of the microbiota in chronically ill children. This trial provides a rationale for systematic evaluation of PBEN in clinical trials of children who require supplemental nutrition.
Authors: Amy Y Spurlock; Teresa W Johnson; Ali Pritchett; Leah Pierce; Jenna Hussey; Kelly Johnson; Holly Carter; Stephen L Davidson; Manpreet S Mundi; Lisa Epp; Ryan T Hurt Journal: Nutr Clin Pract Date: 2021-08-31 Impact factor: 3.204
Authors: Gloria M Agudelo-Ochoa; Beatriz E Valdés-Duque; Nubia A Giraldo-Giraldo; Ana M Jaillier-Ramírez; Adriana Giraldo-Villa; Irene Acevedo-Castaño; Mónica A Yepes-Molina; Janeth Barbosa-Barbosa; Alfonso Benítez-Paéz Journal: Gut Microbes Date: 2020-01-10
Authors: Michelle L Manni; Victoria A Heinrich; Gregory J Buchan; James P O'Brien; Crystal Uvalle; Veronika Cechova; Adolf Koudelka; Dharti Ukani; Mohamad Rawas-Qalaji; Tim D Oury; Renee Hart; Madeline Ellgass; Steven J Mullett; Merritt L Fajt; Sally E Wenzel; Fernando Holguin; Bruce A Freeman; Stacy G Wendell Journal: Sci Rep Date: 2021-09-07 Impact factor: 4.379
Authors: Érica Patrícia Cunha Rosa Schmitz; Eliziane Costa da Silva; Ozeas de Lima Lins Filho; Margarida Maria de Castro Antunes; Kátia Galeão Brandt Journal: Rev Paul Pediatr Date: 2021-09-01