EC Nutrition

Introduction: Pediatric malnutrition remains a global challenge with repercussions for growth, neurodevelopment, and immunity. The gut microbiota has emerged as a key determinant in the pathophysiology of malnutrition, integrating the axes of nutrition, immunity, and inflammation.

Objective: To synthesize recent advances on the role of the gut microbiota in pediatric malnutrition, highlighting pathophysiological mechanisms, therapeutic interventions, and perspectives in precision nutrition.
Methods: Narrative review of literature indexed in international databases (PubMed, Scopus, Web of Science, Cochrane Library) and institutional sources from 2018 to 2025, including clinical studies, animal models, and intervention trials.

Results: Recent findings demonstrate an immature microbiota in severely malnourished children, characterized by reduced bacterial diversity, depletion of Faecalibacterium and Bifidobacterium, and predominance of pro-inflammatory species. This dysbiosis correlates with growth faltering (stunting), environmental enteropathy, and systemic endotoxemia. Decreased production of short-chain fatty acids and impaired vitamin biosynthesis have also been documented. Innovative interventions such as microbiota-directed complementary foods (MDCF) and fecal microbiota transplantation show promise, albeit with context-dependent variability.

Conclusion: Integrating nutritional strategies with microbiome modulation is a promising pathway to address childhood malnutrition. The development of microbiome-based biomarkers and precision therapies opens new opportunities for prevention, early diagnosis, and effective treatment.

 Keywords: Pediatric Malnutrition; Gut Microbiota; Environmental Enteropathy; Stunting; Short-Chain Fatty Acids; Precision Nutrition, Probiotics

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