Consumption of an experimental young child formula containing L. reuteri DSM 17938 and GOS synbiotic improves musculoskeletal development in toddlers via modulation of microbiota composition and function.
Key Findings
Results
Children receiving EYCF showed increased tibia speed of sound compared to control milk at both 3 and 6 months.
182 Filipino children aged 2-3 years were randomized to EYCF (n=91) or minimally fortified control milk (CM; n=91) for 6 months.
Tibia speed of sound was the primary outcome measure.
Improvements in tibia speed of sound were observed at both the 3-month and 6-month timepoints in the EYCF group compared to CM.
The trial was randomized and double-blind, conducted as a controlled trial (ClinicalTrials.gov NCT04799028).
Results
EYCF consumption remodeled stool microbiome composition, with enrichment of L. reuteri and higher bifidobacteria presence compared to control.
Gut microbiota was assessed by shotgun metagenomics.
The EYCF group showed enrichment of L. reuteri DSM 17938 relative to the CM group.
Higher bifidobacteria presence was observed in the EYCF group compared to the CM group.
Microbiome compositional changes were associated with stool metabolomic alterations.
Results
Increased L. reuteri abundance after 6 months of EYCF consumption was associated with higher bone quality and muscle strength.
L. reuteri abundance was quantified via shotgun metagenomics at 6 months.
Association was observed between L. reuteri abundance and tibia speed of sound (bone quality).
Association was also observed between L. reuteri abundance and muscle strength outcomes.
Muscle strength was a secondary outcome of the trial.
Results
Stool metabolomics identified 45 metabolites modulated by EYCF consumption that were associated with microbiome compositional changes, including enrichment of tryptophan and indole metabolism.
Metabolomic analysis was performed on stool samples.
45 metabolites were modulated by EYCF consumption.
These metabolite changes were associated with microbiome compositional changes.
Notable enrichment was observed in tryptophan and indole metabolic pathways in the EYCF group.
Methods
The study assessed multiple secondary outcomes including muscle strength, blood vitamin D levels, bone turnover markers, fecal calcium fatty acid soaps, and gastrointestinal tolerance.
Secondary outcomes included muscle strength, blood vitamin D levels, bone turnover markers, gut microbiota, fecal calcium fatty acid soaps, and gastrointestinal tolerance.
The intervention period was 6 months.
Participants were Filipino children aged 2-3 years.
The EYCF contained a combination of Limosilactobacillus reuteri DSM 17938 and galacto-oligosaccharides (GOS) as a synbiotic.
Conclusions
The results provide insights into gut-musculoskeletal crosstalk during early life, with the synbiotic combination mediating musculoskeletal benefits through microbiota modulation.
The mechanism of musculoskeletal improvement was linked to modulation of microbiota composition and function.
Tryptophan and indole metabolism pathways were identified as potentially mediating the gut-musculoskeletal axis.
Both bone and muscle development were improved, suggesting a broader musculoskeletal effect.
The authors describe these findings as providing insights on 'gut-musculoskeletal crosstalk during early life.'
Bonnet N, Capeding M, Siegwald L, Garcia-Garcera M, Desgeorges T, Tytgat H, et al.. (2026). A young child formula with Limosilactobacillus reuteri and GOS modulates gut microbiome and enhances bone and muscle development: a randomized trial.. Nature communications. https://doi.org/10.1038/s41467-025-66930-2