Although nutritional interventions such as Ready to Use Therapeutic Foods (RUTF) have been effective in the management of severe acute malnutrition, the presence of growth failure among the world’s children suggests persistent chronic malnutrition and begs a better understanding of its pathophysiology. Globally, approximately 25% of all children less than 5 years of age demonstrate stunted growth or short for age. Many of these children also demonstrate cognitive delay and increased disease susceptibility.

A recent study published online in EBioMedicine provides new insights into the mechanisms of the problem. Researchers from Washington University School of Medicine, the Johns Hopkins University, University of Maryland, the National Institutes of Health, and the University of Malawi used a targeted metabolomic approach to measure serum amino acids, sphingolipids, glycerophospholipids, and other metabolites in 313 children, aged 12-59 months, residing in rural Malawi. Among the study patients, 62% were classified as short for age based on WHO criteria.

The findings showed that all such children had lower serum concentrations of all nine essential amino acids, conditionally essential amino acids, non-essential amino acids, and six different sphingolipids. In addition, all stunted children demonstrated alterations in serum glycerophospholipid concentrations.

The findings support the notion that children with a high risk of stunting may not be receiving an adequate dietary intake of essential amino acids and choline, an essential nutrient for the synthesis of sphingolipids and glycerophospholipids.The study paves the way for further research using similar methodology to determine more appropriate dietary management for these children.