Gut microbiota dysbiosis and probiotic interventions in childhood stunting: Mechanistic insights and therapeutic potential

Stunting remains a significant public health challenge, particularly in low- and middle-income countries, with long-term consequences for physical growth, cognitive development, and future economic productivity. Emerging evidence highlights the critical role of the gut microbiota in early life nutrition, immune development, and linear growth, offering new insights into the pathogenesis of stunting. Children with stunting often exhibit reduced microbial diversity, dysbiosis, and decreased production of beneficial metabolites such as short-chain fatty acids (SCFAs), which are essential for intestinal health and metabolic regulation. Probiotics, especially strains of Lactobacillus and Bifidobacterium, have shown promise in modulating gut microbiota composition, enhancing nutrient absorption, improving intestinal barrier function, and promoting growth outcomes in malnourished children. This review synthesizes the current evidence on the interplay between stunting, gut microbiota, and probiotic interventions, emphasizing their mechanistic links and therapeutic potential. We also discuss the challenges in implementing probiotics at scale, including strain-specific efficacy, variability in host responses, and the need for long-term clinical trials. Targeting the gut microbiota through probiotic supplementation may serve as a complementary strategy to conventional nutritional programs to prevent and mitigate childhood stunting. • Highlighted role of SCFAs in growth regulation and intestinal health • Demonstrated probiotics’ potential to improve growth in malnourished children • Revealed mechanisms by which probiotics enhance gut barrier and immunity