Dietary intake from complementary feeding is associated with intestinal barrier function and environmental enteropathy in Brazilian children from the MAL-ED cohort study

摘要

A child's diet contains nutrients and other substances that influence intestinal health. The present study aimed to evaluate the relations between complementary feeding, intestinal barrier function and environmental enteropathy (EE) in infants. Data from 233 children were obtained from the Brazilian site of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project cohort study. Habitual dietary intake from complementary feeding was estimated using seven 24-h dietary recalls, from 9 to 15 months of age. Intestinal barrier function was assessed using the lactulose-mannitol test (L-M), and EE was determined as a composite measure using faecal biomarkers concentrations - alpha-1-antitrypsin, myeloperoxidase (MPO) and neopterin (NEO) at 15 months of age. The nutrient adequacies explored the associations between dietary intake and the intestinal biomarkers. Children showed adequate nutrient intakes (with the exception of fibre), impaired intestinal barrier function and intestinal inflammation. There was a negative correlation between energy adequacy and L-M (rho = -0 center dot 19, P < 0 center dot 05) and between folate adequacy and NEO concentrations (rho = -0 center dot 21, P < 0 center dot 01). In addition, there was a positive correlation between thiamine adequacy and MPO concentration (rho = 0 center dot 22, P < 0 center dot 01) and between Ca adequacy and NEO concentration (rho = 0 center dot 23; P < 0 center dot 01). Multiple linear regression models showed that energy intakes were inversely associated with intestinal barrier function (beta = -0 center dot 19, P = 0 center dot 02), and fibre intake was inversely associated with the EE scores (beta = -0 center dot 20, P = 0 center dot 04). Findings suggest that dietary intake from complementary feeding is associated with decreased intestinal barrier function and EE in children.