Maternal balanced energy-protein supplementation reshapes the maternal gut microbiome and enhances carbohydrate metabolism in infants: a randomized controlled trial
Balanced energy-protein (BEP) supplementation during pregnancy and lactation can improve birth outcomes and infant growth, with the gut microbiome as a potential mediator. The MISAME-III randomized controlled trial (ClinicalTrial.gov: NCT03533712) assessed the effect of BEP supplementation, provided during pregnancy and the first six months of lactation, on small-for-gestational age prevalence and length-for-age Z-scores at six months in rural Burkina Faso. Nested within MISAME-III, this sub-study examines the impact of BEP supplementation on maternal and infant gut microbiomes and their mediating role in birth outcomes and infant growth. A total of 152 mother-infant dyads (n = 71 intervention, n = 81 control) were included for metagenomic sequencing, with stool samples collected at the second and third trimesters, and at 1-2 and 5-6 months postpartum. BEP supplementation significantly altered maternal gut microbiome diversity, composition, and function, particularly those with immune-modulatory properties. Pathways linked to lipopolysaccharide biosynthesis were depleted and the species Bacteroides fragilis was enriched in BEP-supplemented mothers. Maternal BEP supplementation also accelerated infant microbiome changes and enhanced carbohydrate metabolism. Causal mediation analyses identified specific taxa mediating the effect of BEP on birth outcomes and infant growth. These findings suggest that maternal supplementation modulates gut microbiome composition and influences early-life development in resource-limited settings.
Authors
- Matthew R. Olm (ORCID: https://orcid.org/0000-0001-5540-350X)
- Rasmané Ganaba (ORCID: https://orcid.org/0000-0001-7401-9546)
- Wim Van Criekinge (ORCID: https://orcid.org/0000-0003-2971-5539)
- Alemayehu Argaw (ORCID: https://orcid.org/0000-0003-3982-5408)
- Lionel Olivier Ouédraogo (ORCID: https://orcid.org/0000-0002-2729-6994)
- Patrick Kolsteren (ORCID: https://orcid.org/0000-0002-0504-2205)
- Giles Hanley‐Cook (ORCID: https://orcid.org/0000-0001-9907-594X)
- Lieven Huybregts (ORCID: https://orcid.org/0000-0002-3068-2853)
- Erica Dutil Sonnenburg (ORCID: https://orcid.org/0000-0001-8379-005X)
- Carl K. Lachat (ORCID: https://orcid.org/0000-0002-1389-8855)
- Steff Taelman (ORCID: https://orcid.org/0000-0002-2685-4130)
- Trenton Dailey-Chwalibóg (ORCID: https://orcid.org/0000-0002-8204-4925)
- Laéticia Céline Toe (ORCID: https://orcid.org/0000-0002-4615-5388)
- Moctar Ouédraogo (ORCID: https://orcid.org/0000-0002-1521-0532)
- Michiel Stock (ORCID: https://orcid.org/0000-0003-0903-6061)
- Yuri Bastos-Moreira (ORCID: https://orcid.org/0000-0003-0880-1462)
- Eva Balini
- Lishi Deng (ORCID: https://orcid.org/0000-0001-9802-5078)
- Justin L. Sonnenburg (ORCID: https://orcid.org/0000-0003-2299-6817)
- Kokeb Tesfamariam
Institutions
- International Food Policy Research Institute (US)
- University of Colorado Boulder (US)
- Ghent University (BE)
- Chan Zuckerberg Initiative (United States) (US)
- AFRICSanté (BF)
- Centre Muraz (BF)
- Institut de Recherche en Sciences de la Santé (BF)
- Stanford University (US)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-03-18
- DOI
- https://doi.org/10.1038/s41467-025-57838-y
- Citations
- 4
- Primary Topic
- Infant Nutrition and Health
- Type
- article
- Field-Weighted Citation Impact
- 4.48
Funders
- Bill and Melinda Gates Foundation
- Agentschap Innoveren en Ondernemen
- China Scholarship Council
- National Institutes of Health
- University of California, San Diego