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Maternal balanced energy-protein supplementation reshapes the maternal gut microbiome and enhances carbohydrate metabolism in infants: a randomized controlled trial

Author

Listed:
  • Lishi Deng

    (Ghent University)

  • Steff Taelman

    (Ghent University
    Ghent University
    BioLizard nv)

  • Matthew R. Olm

    (Stanford University School of Medicine
    University of Colorado Boulder)

  • Laeticia Celine Toe

    (Ghent University
    Unité Nutrition et Maladies Métaboliques)

  • Eva Balini

    (BioLizard nv)

  • Lionel Olivier Ouédraogo

    (Ghent University
    Centre Muraz)

  • Yuri Bastos-Moreira

    (Ghent University
    Ghent University)

  • Alemayehu Argaw

    (Ghent University)

  • Kokeb Tesfamariam

    (Ghent University)

  • Erica D. Sonnenburg

    (Stanford University School of Medicine)

  • Giles T. Hanley-Cook

    (Ghent University)

  • Moctar Ouédraogo

    (Agence de Formation de Recherche et d’Expertise en Santé pour l’Afrique (AFRICSanté))

  • Rasmané Ganaba

    (Agence de Formation de Recherche et d’Expertise en Santé pour l’Afrique (AFRICSanté))

  • Wim Criekinge

    (Ghent University)

  • Lieven Huybregts

    (Ghent University
    International Food Policy Research Institute (IFPRI))

  • Michiel Stock

    (Ghent University)

  • Patrick Kolsteren

    (Ghent University)

  • Justin L. Sonnenburg

    (Stanford University School of Medicine
    Chan Zuckerberg Biohub
    Stanford University School of Medicine)

  • Carl Lachat

    (Ghent University)

  • Trenton Dailey-Chwalibóg

    (Ghent University
    Agence de Formation de Recherche et d’Expertise en Santé pour l’Afrique (AFRICSanté))

Abstract

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.

Suggested Citation

  • Lishi Deng & Steff Taelman & Matthew R. Olm & Laeticia Celine Toe & Eva Balini & Lionel Olivier Ouédraogo & Yuri Bastos-Moreira & Alemayehu Argaw & Kokeb Tesfamariam & Erica D. Sonnenburg & Giles T. H, 2025. "Maternal balanced energy-protein supplementation reshapes the maternal gut microbiome and enhances carbohydrate metabolism in infants: a randomized controlled trial," Nature Communications, Nature, vol. 16(1), pages 1-16, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57838-y
    DOI: 10.1038/s41467-025-57838-y
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    References listed on IDEAS

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