Protein and fermentable fibre for gut health: The 'critical unanswered questions' in undernutrition

The college's Centre for Translational Nutrition and Food Research is undertaking a project aiming to lead multi-national, multi-disciplinary initiatives to address undernutrition in low-middle income countries by improving gut function.  

In a blog post to promote the college’s work, Dr Aaron Lett, a research and teaching fellow, and Professor Gary Frost, head Nutrition Research in the Department of Medicine, point out that current expert recommendations are only aimed at correcting nutrition as opposed to restoring and maintaining gut function.

Undernutrition and the gut: a crucial component​

“We believe there are a number of critical unanswered questions regarding the role of the gut in undernutrition, which if answered could significantly improve the effective management and prevention of undernutrition,”​ they write.

"The intestine is crucial for digestion and absorption of foods and nutrients. However, in undernutrition the structure and function of the intestine becomes impaired. ​

"To make this worse, the gut’s ability to function properly is  self-perpetuating, with impaired ability to digest food and absorb nutrients exacerbating the condition. ​

"The only way to fix this is to focus on restoring and maintaining gut function – however current expert recommendations are only aimed at correcting nutrition and not restoring and maintaining gut function."​

The academic goes on to say that the answer to improving gut health is the increased consumption of fermentable carbohydrates and protein!

The academics point out that the gut microbiota of children with undernutrition is immature and lacks bacterial diversity. However, fermentable carbohydrates – fermented by the gut microbiota – can have a positive influence, resulting in improvements in gut and nutritional health.

The post continues: "Current undernutrition treatments which consist of ready-to-use therapeutic foods, do not address the gut’s need for fermentable carbohydrates."​

"Protein, or more specifically amino acids, are needed for normal gut function and even more so to restore gut function. They are also critical for child growth and health. Unfortunately, dietary intake of essential amino acids is insufficient in children with undernutrition."​

Societal shift​

The group believes legumes are key to getting more of these nutrients into diets. He says they are rich in the fermentable carbohydrates, protein, minerals and phytochemicals in a food structure which delivers these nutrients to appropriate sites in the gut.

However, many interventions are required in order to boost legume consumption.

They write: “We need to empower consumers to create demand that will influence governmental policy on agricultural production. School and community based-feeding programmes should include a nutrition education component to further raise awareness of the value of legumes for a balanced diet.​

"Creating appealing, convenient and affordable legume-based recipes and products is an essential step in maintaining levels of legume consumption and their associated health benefits.​

“Farmers need incentives and improved legume value chains. Legume varieties can be optimised for better nutrition and climate resilience to accelerate progress towards global nutrition, health targets and as an investment in the human capital development of countries.”​

HUNGer​

Imperial's project is named 'Health outcomes in Undernutrition: the role of Nutrients, Gut dysfunction and the gut microbiome' (HUNGer).

Within the HUNGer consortium, field sites in India, Kenya, Zambia and Zimbabwe and their local population expertise will be utilised to investigate a number of aspects, including:

• The effects of fermentable carbohydrates on gut health 
• The effects of protein and amino acids on gut health
• The effects and how to increase legume intake through Nigeria’s National School Feeding programme
• Agricultural considerations
• How to maintain and improve legume food chains and promote investment in the human capital