Trial reportThe New England journal of medicine2021
A Microbiota-Directed Food Intervention for Undernourished Children.
5 registry-linked trialsOpen access · hybridAbstract readComparative StudyRandomized Controlled Trial
In one paragraph
Trial report in The New England journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 169 papers, 7 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
169citing papers in PubMed, 7 pooled it
25.1field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Microbiota-directed Complementary Food (MDCF) Trial
Development of Shelf-Stable, Locally-Sourced, Microbiota-Directed Complementary Foods for Children With Undernutrition
Multidimensional Evaluation of the Early Emergence of Executive Function and Emotional Regulation in Young Children in Bangladesh Using Nutritional and Psychosocial Intervention: A Pilot Study
Washed Microbiota Transplantation for Malnutrition
Early Life Diarrhoea Episode(s), Malnutrition, Environmental Enteric Dysfunction and Microbiome Trajectories From Birth Until 3 Years of Life ; The University of Zimbabwe Birth Cohort Study-2 (UZBCS-2)
Who cites it
169 citing papers in PubMed, 7 syntheses or guidelines pooled it, 279 citations in OpenAlex.
- Local Food Interventions for the Management of Moderate Acute Malnutrition (MAM) among Children Aged 6 to 59 Months: A Systematic Review and Non-inferiority Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2026Pooled it
- Pooled it
- Systematic review of associations between gut microbiome composition and stunting in under-five children.NPJ biofilms and microbiomes · 2024Pooled it
- Roles of the gut microbiome in weight management.Nature reviews. Microbiology · 2023Pooled it
- Impact of antibiotics on gut microbiome composition and resistome in the first years of life in low- to middle-income countries: A systematic review.PLoS medicine · 2023Pooled it
- Pooled it
- Probiotic Supplementation for Promotion of Growth in Children: A Systematic Review and Meta-Analysis.Nutrients · 2021Pooled it
- Trial
- Effect of Household Air Pollution on the Gut Microbiome and Virome of Adult Women Living in Uganda.Environmental health perspectives · 2026Trial
- Inclusion of stabilised rice bran in ready-to-use therapeutic food supports growth in Indonesian children with severe and moderate acute malnutrition: solutions to enhance health with alternative treatments (SEHAT), a double-blinded, randomised clinical trial.Journal of nutritional science · 2026Trial
- A Pilot Study of Enterade (VS001), an Oral Amino Acid Formulation, in Malnourished Bangladeshi Children with Environmental Enteric Dysfunction.The American journal of tropical medicine and hygiene · 2025Trial
- A microbiome-directed therapeutic food for children recovering from severe acute malnutrition.Science translational medicine · 2024Trial
- Three-arm clinical trial of improved flour targeting intestinal microbiota (MALINEA).Maternal & child nutrition · 2024Trial
- Faecal microbiota of schoolchildren is associated with nutritional status and markers of inflammation: a double-blinded cluster-randomized controlled trial using multi-micronutrient fortified rice.Nature communications · 2024Trial
- A microbiota-directed complementary food intervention in 12-18-month-old Bangladeshi children improves linear growth.EBioMedicine · 2024Trial
- Trial
- Gut microbiota shifts favorably with delivery of handwashing with soap and water treatment intervention in a prospective cohort (CHoBI7 trial).Journal of health, population, and nutrition · 2023Trial
- The putative role of the microbiota in the development of neuropsychiatric disorders following early childhood malnutrition.Gut microbes · 2026Review
- The JNK2-microbiome axis modulates gut barrier integrity through microbial acetate.Gut microbes · 2026Article
- Towards optimizing the host response to biotics: a report of an International Scientific Association for Probiotics and Prebiotics working group.Gut microbes · 2026Article
109 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
19 authors at 3 institutions in 3 countries.
Robert Y ChenFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Ishita MostafaFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Matthew C HibberdFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Subhasish DasFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Mustafa MahfuzFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Nurun N NailaFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
M Munirul IslamFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Sayeeda HuqFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
M Ashraful AlamFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).ORCID 0000-0003-1389-8510
Mahabub U ZamanFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Arjun S RamanFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Daniel WebberFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Cyrus ZhouFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Vinaik SundaresanFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Kazi AhsanFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Martin F MeierFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Michael J BarrattFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Tahmeed AhmedFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
Jeffrey I GordonFrom the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., M.C.H., A.S.R., D.W., C.Z., V.S., K.A., M.F.M., M.J.B., J.I.G.), and the Department of Pathology and Immunology (M.C.H., A.S.R., D.W., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; and the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (I.M., S.D., M.M., N.N.N., M.M.I., S.H., M.A.A., M.U.Z., T.A.).
International Centre for Diarrhoeal Disease Research · BDMaine Farmland Trust · USWashington University in St. Louis · US
Funding
NATIONAL RESEARCH SERVICE AWARD-MEDICAL SCIENTISTT32GM007200 · NIGMS · WASHINGTON UNIVERSITY · PI YOKOYAMA, WAYNE M. · 1985 to 2024
$59.8MWashington University Nutrition Obesity Research CenterP30DK056341 · NIDDK · WASHINGTON UNIVERSITY · PI Dominic N Reeds · 1999 to 2026
$30.2MREGULATION OF GENE EXPRESSION - SMALL INTESTINER01DK030292 · NIDDK · WASHINGTON UNIVERSITY · PI JEFFREY I GORDON, ANDREI L OSTERMAN · 1986 to 2026
$6.5MREGULATION OF GENE EXPRESSION IN THE SMALL INTESTINER37DK030292 · NIDDK · WASHINGTON UNIVERSITY · PI GORDON, JEFFREY I · 1993 to 2015
$4.0MUnraveling the biological state of children with Environmental enteric dysfunctionF30DK124967 · NIDDK · WASHINGTON UNIVERSITY · PI CHEN, ROBERT YUZEN · 2020 to 2022
$115kNIDDK NIH HHS DK30292NIDDK NIH HHS F30 DK124967NIDDK NIH HHS P30 DK056341NIDDK NIH HHS R01 DK030292NIDDK NIH HHS R37 DK030292NIGMS NIH HHS T32 GM007200
Abstract
backgroundMore than 30 million children worldwide have moderate acute malnutrition. Current treatments have limited effectiveness, and much remains unknown about the pathogenesis of this condition. Children with moderate acute malnutrition have perturbed development of their gut microbiota.
methodsIn this study, we provided a microbiota-directed complementary food prototype (MDCF-2) or a ready-to-use supplementary food (RUSF) to 123 slum-dwelling Bangladeshi children with moderate acute malnutrition between the ages of 12 months and 18 months. The supplementation was given twice daily for 3 months, followed by 1 month of monitoring. We obtained weight-for-length, weight-for-age, and length-for-age z scores and mid-upper-arm circumference values at baseline and every 2 weeks during the intervention period and at 4 months. We compared the rate of change of these related phenotypes between baseline and 3 months and between baseline and 4 months. We also measured levels of 4977 proteins in plasma and 209 bacterial taxa in fecal samples.
resultsA total of 118 children (59 in each study group) completed the intervention. The rates of change in the weight-for-length and weight-for-age z scores are consistent with a benefit of MDCF-2 on growth over the course of the study, including the 1-month follow-up. Receipt of MDCF-2 was linked to the magnitude of change in levels of 70 plasma proteins and of 21 associated bacterial taxa that were positively correlated with the weight-for-length z score (P<0.001 for comparisons of both protein and bacterial taxa). These proteins included mediators of bone growth and neurodevelopment.
conclusionsThese findings provide support for MDCF-2 as a dietary supplement for young children with moderate acute malnutrition and provide insight into mechanisms by which this targeted manipulation of microbiota components may be linked to growth. (Supported by the Bill and Melinda Gates Foundation and the National Institutes of Health; ClinicalTrials.gov number, NCT04015999.).
Indexed as
Dietary SupplementsFood, FormulatedGastrointestinal MicrobiomeInfant Nutritional Physiological PhenomenaAnthropometryBangladeshBlood ProteinsBody WeightFecesFemaleGrowthHumansInfantMaleMalnutritionProteomeBlood ProteinsProteome
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NCT04015999ClinicalTrials.gov
NCT05094024ClinicalTrials.gov
NCT05629624ClinicalTrials.gov
NCT06447220ClinicalTrials.gov
NCT07195006ClinicalTrials.gov
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