Intestinal permeability and inflammation mediate the association between nutrient density of complementary foods and biochemical measures of micronutrient status in young children: results from the mal-ed study

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dc.contributor.authorMaciel, Bruna Leal Lima
dc.contributor.authorMcCormick, Benjamin J. J.
dc.contributor.authorMurray-Kolb, Laura E.
dc.contributor.authorLee, Gwenyth O.
dc.contributor.authorSchulze, Kerry J.
dc.contributor.authorRoss, A. Catharine
dc.contributor.authorBauck, Aubrey
dc.contributor.authorLima, Aldo Ângelo Moreira
dc.contributor.authorKosek, Margaret N.
dc.contributor.authorSeidman, Jessica C.
dc.contributor.authorAmbikapathi, Ramya
dc.contributor.authorBose, Anuradha
dc.contributor.authorJohn, Sushil
dc.contributor.authorKang, Gagandeep
dc.contributor.authorTurab, Ali
dc.contributor.authorMduma, Estomih
dc.contributor.authorBessong, Pascal
dc.contributor.authorShrestra, Sanjaya
dc.contributor.authorAhmed, Tahmeed
dc.contributor.authorMahfuz, Mustafa
dc.date.accessioned2024-02-01T15:01:07Z
dc.date.available2024-02-01T15:01:07Z
dc.date.issued2019-10
dc.description.resumoBackground: Environmental enteric dysfunction (EED) is thought to increase the risk of micronutrient deficiencies, but few studies adjust for dietary intakes and systemic inflammation. Objective: We tested whether EED is associated with micronutrient deficiency risk independent of diet and systemic inflammation, and whether it mediates the relation between intake and micronutrient status. Methods: Using data from 1283 children in the MAL-ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) birth cohort we evaluated the risk of anemia, low retinol, zinc, and ferritin, and high transferrin receptor (TfR) at 15 mo. We characterized gut inflammation and permeability by myeloperoxidase (MPO), neopterin (NEO), and α-1- antitrypsin (AAT) concentrations from asymptomatic fecal samples averaged from 9 to 15 mo, and averaged the lactulose:mannitol ratio z-score (LMZ) at 9 and 15 mo. Nutrient intakes from complementary foods were quantified monthly from 9 to 15 mo and densities were averaged for analyses. α-1-Acid glycoprotein at 15 mo characterized systemic inflammation. Relations between variables were modeled using a Bayesian network. Results: A greater risk of anemia was associated with LMZ [1.15 (95% CI: 1.01, 1.31)] and MPO [1.16 (1.01, 1.34)]. A greater risk of low ferritin was associated with AAT [1.19 (1.03, 1.37)] and NEO [1.22 (1.04, 1.44)]. A greater risk of low retinol was associated with LMZ [1.24 (1.08, 1.45)]. However, MPO was associated with a lower risk of high transferrin receptor [0.86 (0.74, 0.98)], NEO with a lower risk of low retinol [0.75 (0.62, 0.89)], and AAT with a lower risk of low plasma zinc [0.83 (0.70, 0.99)]. Greater nutrient intake densities (vitamins A and B6, calcium, protein, and zinc) were negatively associated with EED. Inverse associations between nutrient densities and micronutrient deficiency largely disappeared after adjustment for EED, suggesting that EED mediates these associations. Conclusions: EED is independently associated with an increased risk of low ferritin, low retinol, and anemia. Greater nutrient density from complementary foods may reduce EED, and the control of micronutrient deficiencies may require control of EED. Am J Clin Nutr 2019;110:1015–1025pt_BR
dc.identifier.citationMCCORMICK, Benjamin J.J; MURRAY-KOLB, Laura E.; LEE, Gwenyth O.; SCHULZE, Kerry J.; ROSS, A. Catharine; BAUCK, Aubrey; LIMA, Aldo Ângelo Moreira; MACIEL, Bruna Leal Lima; KOSEK, Margaret N.; SEIDMAN, Jessica C.; AMBIKAPATHI, Ramya; BOSE, Anuradha; JOHN, Sushil; KANG, Gagandeep; TURAB, Ali; MDUMA, Estomih; BESSONG, Pascal; SHRESTRA, Sanjaya; AHMED, Tahmeed; MAHFUZ, Mustafa.. Intestinal permeability and inflammation mediate the association between nutrient density of complementary foods and biochemical measures of micronutrient status in young children: results from the mal-ed study. The American Journal Of Clinical Nutrition, [S.l.], v. 110, n. 4, p. 1015-1025, out. 2019. DOI: 10.1093/ajcn/nqz151. Disponível em: https://www.sciencedirect.com/science/article/pii/S000291652201276X?via%3Dihub. Acesso em: 29 jan. 2024.pt_BR
dc.identifier.doihttp://dx.doi.org/10.1093/ajcn/nqz151
dc.identifier.urihttps://repositorio.ufrn.br/handle/123456789/57469
dc.languageenpt_BR
dc.publisherAmerican Journal of Clinical Nutritionpt_BR
dc.rightsAttribution 3.0 Brazil*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/br/*
dc.subjectEnvironmental enteropathypt_BR
dc.subjectIntestinal barrier functionpt_BR
dc.subjectInflammationpt_BR
dc.subjectMicronutrient statuspt_BR
dc.subjectDietpt_BR
dc.titleIntestinal permeability and inflammation mediate the association between nutrient density of complementary foods and biochemical measures of micronutrient status in young children: results from the mal-ed studypt_BR
dc.typearticlept_BR

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