Abstract: Preterm babies are born with an immature intestine and are at higher risk for intestinal failure and needing for parenteral nutrition than full-term newborns. These babies show an altered intestinal microbiota, which may results of key importance for later health. However, there is a lack of information on effect of parenteral formulas upon the establishing infant microbiota. Moreover, the microbiota alterations present in preterm newborns have been related with an altered redox-potential which hinders the establishment of strict anaerobes. Thus, interventions aimed at reducing the oxidative stress in these infants, including those under parenteral nutrition, could also affect the intestinal microbiota composition. We assessed the effect upon the gut microbiota of the administration during 30 days of a lipid emulsion, containing ω3 polyunsaturated fatty acids and α-tocopherol, or a control emulsion containing soybean-bases lipids to parenterally-fed preterm newborns. In spite of its high antioxidant potential, the infants receiving the experimental fat emulsion showed a trend to increase of facultative anaerobes such as enterobacteria and specifically of Klebsiella. This study stresses the need of further work monitoring the impact of early-life parenteral nutrition on the establishment of the intestinal microbiota.

Keywords: Preterm infants, Parenteral nutrition, lipid emulsion, Antioxidants, Intestinal microbiota.

Abstract: Childhood undernutrition is a health crisis in the rapidly expanding informal settlements of low-income countries worldwide. Nearly half of Kenyan children in the Kibera settlement, in Nairobi, were reported to be stunted, indicating low height-for-age. Stunted children are at greater risk for poor cognitive and physical health outcomes in the long-term, problems that tend to be perpetuated in subsequent generations. Animal-source foods (ASF) supply a calorically dense source of micro- and macronutrients, and supplementation with ASF has been shown to improve linear growth and cognition. Correspondingly, increasing consumption of ASF by pregnant women and children has been proposed as a means to disrupt the intergenerational cycle of undernutrition caused by food insecurity. Household surveys indicate that consumption of ASF is low in urban slums, despite the availability of these foods in local markets. Here we review the studies addressing the role of ASF in the diets of the urban poor and identify knowledge gaps relevant to improving nutrition by increasing consumption of ASF. Based predominantly on studies in Kibera and greater Nairobi, these gaps include determining the minimal amount and frequency of dietary ASF to prevent stunting, defining how consumer preferences, markets, and income interact to impede or promote ASF consumption, and understanding the interaction between diet and both clinical and sub-clinical enteric disease on growth outcomes.

Keywords: Maternal health, Child malnutrition, Undernutrition, Food security, Informal urban settlements.