Is there dietary macronutrient malabsorption in children with environmental enteropathy?

Area of Science:

• Pediatric Gastroenterology
• Nutritional Science
• Environmental Health

Background:

• Assessing gastro-intestinal tract (GIT) function in children non-invasively is challenging.
• Childhood environmental enteropathy (EE) is linked to growth faltering, malnutrition, and cognitive impairment.
• Malabsorption in EE is a critical factor connecting gut dysfunction to these adverse outcomes.

Purpose of the Study:

• To review mechanisms of macronutrient malabsorption in EE.
• To evaluate existing and potential non-invasive tests for measuring malabsorption in EE.
• To discuss the suitability of these tests for use in children with EE.

Main Methods:

• Narrative review of mechanistic and experimental studies.
• Examination of strengths and limitations of human experimental studies.
• Analysis of existing and potential tests for measuring malabsorption.

Main Results:

• Lactose and fat malabsorption are common in children with EE.
• Non-invasive breath tests using 13C-labeled substrates show potential for assessing carbohydrate, fat, and dipeptide malabsorption.
• Modified breath test protocols may be suitable for children with EE.

Conclusions:

• Non-invasive breath tests offer a viable method for assessing malabsorption in childhood EE.
• Further research should quantify macronutrient malabsorption and link it to functional outcomes in diverse settings.