Combating Malnutrition with MDCF-2

Malnutrition in children is a significant global health challenge, with problems such as stunting and wasting as the primary indicator. In 2020, about 22% of children-under-5 suffer from stunting, while 6.9% suffer from wasting. This problem is mainly caused by not enough nutrition provided since childhood. However, other than those health problems, malnutrition is also accompanied mainly by the immaturity of the gut microbiota. Hence, scientists suspect that nourishing them is also a way to help solve this problem.

The Impact of MDCF-2 on Malnourished Children

Gut microbiota helps the human body strengthen gut integrity or shape the intestinal epithelium, harvest energy, give protection against pathogens, and regulate host immunity. That is why not having enough microbiota is harmful to the human body. Multiple factors contribute to establishing the human gut microbiota during infancy, with diet as one of the main drivers.

Studies performed by researchers from Washington University School of Medicine— Prof. Gehrig together with Prof. Raman — showed that children with malnutrition might fail to thrive even after therapeutic intervention with standard commercial complementary foods. By going on that information, a new supplement was designed to promote helpful gut bacteria. This supplement, called microbiota-directed complementary food No. 2, or MDCF-2, contains a complex mixture of chickpea, banana, soy, and peanut flours and oils.

Chickpea, banana, oil, soy - ingredients in MDCF-2 (source: https://unsplash.com)

This supplement is used in Dhaka slums, Bangladesh, for about 120 malnourished toddlers. After three months of consuming it, the researchers weighed and measured the children, sampled their blood, and analyzed the bacteria in their feces. The results showed that MDCF-2 boosts blood components linked to growth — such as proteins needed for the proper development of bones, the nervous system, and the immune system — and resulted in a growth rate twice as high, measured by the change in a weight-to-length score.

The Idea Behind MDCF-2

Scientists started involving gut microbiota in malnutrition cure research after discovering its significant role in the said field. The initial research starts by transplanting microbial communities of healthy and malnourished children into weaned germ-free mice fed a diet representative of that consumed by the human donor. Results disclosed that compared with mice colonized with normally maturing microbiota from the healthy donors, animals harboring immature microbiota exhibited reduced rates of lean body mass gain, alterations in bone growth, and metabolic abnormalities.

Formulas that can steer microbiota into an age-appropriate and healthy stage were concocted. Lead formulations were subsequently tested in gnotobiotic piglets colonized with a defined consortium of age- and growth-discriminatory strains to test their biological effects. The final prototypes, one of them being MDCF-2, were administered to children with MAM, and its effects on the microbiota and host’s biological state were determined from the research.

Overview of therapeutic food discovery and testing (source: https://www.science.org/cms/)

The Laboratory Trial of MDCFs

MDCF-2 was first tested together with three other supplements, MDCF-1 — similar ingredients as MDCF-2 with an addition of milk powder, MDCF-3 — containing two lead ingredients (chickpea flour and soy flour), and RUSF — rice and lentil-based ready to use supplementary food with an addition of milk powder. RUSF is used as a control group because RUSF was not designed to change gut microbial community structure.

The effects of different MDCF formulations on biomarkers and mediators of bone and CNS development, plus NF-κB signaling (source: https://www.science.org/cms/)

The MDCF-2 treatment group induced changes in biological state accompanied by the increase in the relative abundances of several weaning phase taxa while the other treatment did not produce significant increases in any of the taxa in the model. This shows that MDCF-2 can help make proteins involved in linear growth, bone development, neurodevelopment, and immune function much better than any other supplement.

By taking MDCF-2, 21 types of beneficial bacteria actually increase in abundance which then results in enhanced growth in children to continue even after the treatment has ended. Right now, MDCF-2 is still made fresh by mothers and researchers so it is still hard to become a standard treatment. Scientists are thinking that all remaining challenges are mostly logistical, and as they continue to refine their formulation, a ‘cure’ for malnutrition is not so far ahead.

In Indonesia, 8.4 billion or 37,2% of kids suffer from stunting that prevents them from living a healthy and fulfilled life. To provide awareness of these issues, SBE UISC 2021 organized an event called SBEWARE with the theme of health education. The main event of SBEWARE will be held in October 2021 and currently, we open donations by collaborating with Save the Children in Indonesia to distribute supplements, nutritious food, and educate pregnant moms and healthcare workers regarding the importance of nutrition. You are more than welcomed to help donate at the following link below:

https://kitabisa.com/campaign/GiatGiziUntukNegeri

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References:

Beban Ganda Malnutrisi bagi Indonesia [WWW Document], n.d. URL https://www.worldbank.org/in/news/feature/2015/04/23/the-double-burden-of-malnutrition-in-indonesia (accessed 8.31.21).

Gehrig, J.L., Venkatesh, S., Chang, H.-W., Hibberd, M.C., Kung, V.L., Cheng, J., Chen, R.Y., Subramanian, S., Cowardin, C.A., Meier, M.F., O’Donnell, D., Talcott, M., Spears, L.D., Semenkovich, C.F., Henrissat, B., Giannone, R.J., Hettich, R.L., Ilkayeva, O., Muehlbauer, M., Newgard, C.B., Sawyer, C., Head, R.D., Rodionov, D.A., Arzamasov, A.A., Leyn, S.A., Osterman, A.L., Hossain, M.I., Islam, M., Choudhury, N., Sarker, S.A., Huq, S., Mahmud, I., Mostafa, I., Mahfuz, M., Barratt, M.J., Ahmed, T., Gordon, J.I., 2019. Effects of microbiota-directed foods in gnotobiotic animals and undernourished children. Science 365, eaau4732. https://doi.org/10.1126/science.aau4732

Mostafa, I., Nahar, N.N., Islam, Md.M., Huq, S., Mustafa, M., Barratt, M., Gordon, J.I., Ahmed, T., 2020. Proof-of-concept study of the efficacy of a microbiota-directed complementary food formulation (MDCF) for treating moderate acute malnutrition. BMC Public Health 20, 242. https://doi.org/10.1186/s12889-020-8330-8

Pennisi, E., 2021. Food supplements that alter gut bacteria could ‘cure’ malnutrition [WWW Document]. Sci. AAAS. URL https://www.sciencemag.org/news/2021/04/food-supplements-alter-gut-bacteria-could-cure-malnutrition (accessed 8.31.21).

Thursby, E., Juge, N., 2017. Introduction to the human gut microbiota. Biochem. J. 474, 1823–1836. https://doi.org/10.1042/BCJ20160510