Early life gut microbial and metabolic shifts reflected in stool consistency- a gut transit time proxy

Transit time, fluid intake, diet, and overall gut health influence stool consistency. However, the relationships between the gut metabolome (microbial metabolites) and stool consistency in infants and young children remain poorly understood. Here, we analyzed the metabolome and microbiota of 618 stool samples from children aged 2.5 months (n = 360), 6 months (n = 229), 14 months (n = 274), and 30 months (n = 169) from the FinnBrain Birth Cohort Study, and related these data to stool water content and parent-reported stool consistency. Breastfeeding showed the strongest association with both stool consistency and fecal water content. Concentrations of newly identified microbial bile acid amidates were associated with constipation and stool water content, while bile salt hydrolase, an enzyme involved in bile acid deconjugation and conjugation was predicted to be negatively associated with stool water content. In addition, short-chain fatty acids, particularly acetate, were positively associated with stool water content, whereas branched-chain short-chain fatty acids showed negative associations. These findings suggest that longer gut transit time permits more extensive microbial metabolism, including the transformation of bile acid amidates. We also found that microbial taxonomic richness, diversity, and community composition were primarily associated with stool water content, with only weak associations with stool consistency. Overall, our results highlight the importance of documenting stool consistency in fecal metabolomics and microbiome research, and provide new insights into how breastfeeding, microbial metabolism, and gut transit time shape early-life gut development.