Peer-reviewed article
Undernutrition and Intestinal Infections in Children: A Narrative Review.
Maria Clara da Cruz Carvalho, Samilly Albuquerque Ribeiro, Lélia Sales de Sousa, Aldo Ângelo Moreira Lima, Bruna Leal Lima Maciel ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This narrative review examines how intestinal infections and gut barrier dysfunction contribute to undernutrition in children under five worldwide. The research found strong links between specific pathogens like Shigella and Cryptosporidium and malnutrition, and showed that poor gut function reduces nutrient absorption. Undernutrition from intestinal infections can cause lasting damage including stunted growth, cognitive problems, and metabolic disease later in life. The review calls for better personalized nutrition treatments and more study of how the gut microbiome affects infection risk and nutrition.
Key points
- Enteric pathogens most frequently found in malnourished children include Shigella, enterotoxigenic E. coli, enteroaggregative E. coli, and Cryptosporidium
- Close relationship exists between intestinal infections (both diarrheal and non-diarrheal) and undernutrition
- Gastrointestinal barrier dysfunction reduces nutrient absorption and affects child development, linear growth, and weight
- The infection-undernutrition cycle has long-term consequences including cognitive deficits, poor growth, and metabolic diseases in adulthood
- Studies showed heterogeneous designs and age ranges but consistently demonstrated the infection-undernutrition relationship
Limitations
This is a narrative review synthesizing existing literature rather than reporting primary research findings, so it cannot definitively establish causation or provide precise effect sizes. The heterogeneity in study designs and population ages across included studies limits the strength of conclusions that can be drawn.
Abstract
Undernutrition affects thousands of children under five years old worldwide, and various factors are related to its onset, among which we highlight enteric infections and gastrointestinal barrier dysfunction. The cycle of intestinal infections and undernutrition has long-term consequences, such as cognitive deficits, poor growth, and metabolic diseases in adulthood. This review explores factors linked to childhood undernutrition, focusing on intestinal infections and markers of intestinal permeability that affect child development. This narrative review was conducted using Medline/PubMed, Web of Science, and Scopus, from July 2024 to March 2025. Studies involving children under five years old and addressing undernutrition, intestinal infections, or intestinal permeability markers were included. Exclusion criteria comprised studies without therapeutic focus, and books, case reports, or academic theses. No language restrictions were applied, and registration on global platforms was not required. Overall, the studies reported a close relationship between enteric pathogens, diarrheal and non-diarrheal stools, and undernutrition. Among the pathogens most frequently found in the feces of malnourished children were Shigella, enterotoxigenic Escherichia coli, enteroaggregative E. coli (EAEC), and Cryptosporidium. The studies also showed the relationship between gastrointestinal barrier function and undernutrition, with the deterioration of nutrient absorption and, consequently, repercussions on development, linear growth, and weight in children. Although the studies analyzed had different designs and heterogeneity in the age range of the studied children, it was possible to observe the relationship between the infection/undernutrition cycle. Future studies should optimize personalized nutrient-based therapies, assess long-term effects on gut health and growth, and explore the gut microbiome's role in enteric infection susceptibility and undernutrition.