Early-life Gut Microbiome Assembly in Low- and Middle-Income Countries: Interactions Between Undernutrition, Infection, and Environmental Enteric Dysfunction

Mijić, Leon, Shaheen, Mishal, Chunga, Angeziwa, Kiu, Raymond and Hall, Lindsay J. ORCID: https://orcid.org/0000-0001-8938-5709 (2026) Early-life Gut Microbiome Assembly in Low- and Middle-Income Countries: Interactions Between Undernutrition, Infection, and Environmental Enteric Dysfunction. Gut Microbiology, 3. ISSN 3051-1720

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Abstract

The uninterrupted assembly of the early-life gut microbiome is central to growth, immune maturation, and resistance to infection. In low- and middle-income country (LMIC) settings, this process is often disrupted by nutritional inadequacy, high enteropathogen exposure, and health-system constraints, resulting in increased vulnerability to undernutrition and environmental enteric dysfunction (EED). These pressures interact bidirectionally as undernutrition and EED can impair intestinal barrier function and alter microbial composition and function, while recurrent infection and inflammation further reduce nutrient absorption and perpetuate microbiome perturbations. Here, we summarise current evidence on early-life microbiome assembly in LMIC settings, how wasting, stunting, micronutrient deficiencies and EED influence microbial community composition and function, how infection and microbiota perturbations reciprocally reinforce one another, and the implications of these interactions for microbiome-directed interventions. We highlight that nutritional rehabilitation alone may be insufficient when inflammation and enteropathy persist, whereas emerging microbiota-directed complementary foods and related microbiome-targeted approaches offer a mechanistically informed route to promoting microbiome maturation and improving growth outcomes. Finally, we outline key evidence gaps, particularly geographic under-representation and the limited availability of longitudinal, multi-omic studies, which constrain the development of generalisable diagnostics and scalable interventions.

Item Type:	Article
Uncontrolled Keywords:	sdg 2 - zero hunger,das not required, no data associated with output,2026 ,/dk/atira/pure/sustainabledevelopmentgoals/zero_hunger
Faculty \ School:	Faculty of Science > School of Biological Sciences Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:	https://linkinghub.elsevier.com/retrieve...
Depositing User:	LivePure Connector
Date Deposited:	15 Oct 2026 15:38
Last Modified:	18 Oct 2026 23:11
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104812
DOI:	10.1016/j.gutmic.2026.100020

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