title: Microbiome, growth retardation and metabolism: are they related?
abstract: BACKGROUND
  Despite an improvement in food security and the delivery of nutritional supplements to children living in impoverished parts of the world, poor growth is still highly prevalent. Given that the microbiome is related to both nutrient absorption, as well as overweight/obesity, it may play a central role in limiting or modifying normal growth processes while contributing to chronic disease risks.
  
  
  OBJECTIVE
  The objective of this paper is to describe normal growth processes, the role of the microbiome in supporting or disrupting normal growth processes, and its potential impact on long-term health.
  
  
  METHODS
  A literature search of relevant human and laboratory research on growth, microbiome and the relationship between poor growth and chronic diseases was conducted. This review focuses on potential mechanisms that implicate the microbiome as a mediator of poor growth and later metabolic outcomes. In this relationship, attention was given to the potential for gastrointestinal infections to disrupt the microbiome.
  
  
  RESULTS
  Based on the studies reviewed, it is clear that exposure to infections disturbs both intestinal functioning as well as normal growth and changes in the microbiome may influence micronutrient availability and metabolic processes.
  
  
  CONCLUSIONS
  The microbiome may play a significant role in limiting human growth, but little is known about changes in the microbiome during periods of undernutrition. Thus, it is of great scientific and public health importance to improve the understanding of how the microbiome changes during nutrient deprivation. To best address the issue of the double burden and poor growth in low-income countries, research is warranted to advance the knowledge of the long-term role of the microbiome in the health of children exposed to undernutrition.
authors.affiliation: a Department of Nutritional Sciences and the New Jersey Institute for Food, Nutrition, and Health , Rutgers, the State University of New Jersey , New Brunswick , NJ , USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hoffman
authors.affiliation: b Department of Health Sciences , VU University , Amsterdam , The Netherlands.
authors.forename: Maiza
authors.initials: M
authors.lastname: Campos-Ponce
authors.affiliation: c Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences , University of São Paulo , São Paulo, SP , Brazil.|d School of Arts, Science and Humanities , University of São Paulo , São Paulo, SP , Brazil.
authors.forename: Carla R
authors.initials: CR
authors.lastname: Taddei
authors.affiliation: b Department of Health Sciences , VU University , Amsterdam , The Netherlands.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Doak
mesh_terms: D006128:Growth; D006801:Humans; D008660:Metabolism; D064307:Microbiota
keywords: Microbiome; chronic disease; growth; metabolism; stunting