Probiotic Supplementation Improves Short-Chain Fatty Acids Production in Malnourished Children: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to asses the impact of probiotic supplementation on short-chain fatty acids (SCFAs) production such as acetate, propionate, and butyrate in malnourished children. We hypothesize that probiotic supplementation would significanty improve SCFAs production in malnourished children. We conducted a comprehensive search in Scopus, PubMed, Google Scholar, Semantic Scholar, and Crossref up to February 2025. We included randomized controlled trials (RCTs) that involved children with undernutrition receiving probiotic supplementation. Risk of bias was assessed using the Cocrane risk-of-bias tool (RoB 2.0) and certainty of evidence was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Meta-analyses and meta-regressions were performed using R statistical software. A total of three RCTs involving 378 children were included in the analysis. Probiotic supplementation may improve overall SCFAs production in malnourished children, although the effect was not statistically significant for total SCFAs or for individual SCFAs such as acetate and propionate. However, a significant increase in butyrate levels was observed following probiotic supplementation (MD = 0.63, 95% CI: 0.14-1.12). Subgroup analyses showed no significant differences across SCFA types, indicating consistent effects of probiotics on SCFA profiles. Meta-regression analyses revealed that factors such as sample size, intervention duration, age, and dosage did not significantly moderate the outcomes. These findings suggest that probiotics may serve as a potential nutritional strategy for improving gut microbiota function in malnourished children.