Physical measurements, such as weight for height, scored relative to a reference population are indispensable tools in the assessment and treatment of undernutrition. But Subramanian et al. have charted a different path - one in which the milestones are microbial - for young children living in the Mirpur urban slum of Dhaka, Bangladesh. By surveying the bacterial communities in faecal samples from 50 well-nourished subjects, the authors defined two indicators of gut-microbiota maturation: relative microbiota maturity and a microbiota-for-age Z-score. Compared with healthy children, malnourished children showed significant microbiota immaturity. In the 2-3 months following treatment, the children's microbiota-maturation scores improved; however, after this period, much of this catch-up maturation was lost. The approach presented by the authors could be used to develop standards across the globe, and then to monitor gut colonization during early childhood, as an early-warning system for microbiotas that are falling 'off track'. Nature 510, 417-421 (2014).
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