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Title: Abnormal gut integrity is associated with reduced linear growth in rural Malawian children

item Weisz, Ariana - Washington University
item Manary, Micah - University Of California
item Stephenson, Kevin - Washington University
item Agapova, Sophia - Washington University
item Manary, Faith - Washington University
item Thakwalakwa, Chrissie - University Of Malawi
item Shulman, Robert - Children'S Nutrition Research Center (CNRC)
item Manary, Mark - Washington University

Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/17/2012
Publication Date: 12/1/2012
Citation: Weisz, A.J., Manary, M.J., Stephenson, K., Agapova, S., Manary, F.G., Thakwalakwa, C., Shulman, R.J., Manary, M.J. 2012. Abnormal gut integrity is associated with reduced linear growth in rural Malawian children. Journal of Pediatric Gastroenterology and Nutrition. 55(6):747-750.

Interpretive Summary: Children living in impoverished conditions do not grow properly. The poor growth appears to be related to more than just not having enough to eat. Our intestines normally act as a barrier to protect us from bad bacteria, viruses, and harmful foods. In this study, we found that these children also have a damaged intestinal barrier. The more severe the damage, the greater the problem the children had with growth. These results bring us closer to understanding why impoverished children do not grow properly.

Technical Abstract: The aim of the present study was to investigate the relation of environmental enteropathy, as measured by the dual sugar absorption test, to linear growth faltering in 2- to 5-year-old Malawian children. Dietary quality, food insecurity, anthropometry, and site-specific sugar testing were measured in 418 children, and anthropometry was reassessed 3 months later. A linear regression model predicting linear growth was created. Better growth was associated with less urinary lactulose excretion, more clean water usage, not sleeping with animals, and no previous history of malnutrition. Eighty-seven percent of children studied demonstrated evidence of environmental enteropathy. In conclusion, abnormal gut integrity is associated with reduced linear growth in a population of rural African preschool-age children.