Brief Summary: Undernutrition is not simply caused by lack of nutritious food but also the ability to efficiently assimilate nutrients from diet where the gut microbiota plays a critical role enabling the host to maintain energy balance and overall health. Dysbiosis in the gut microbiota composition are now being causally linked to undernutrition, although current modalities of treatment do not encompass ways to address these challenges.

 Our study employs a modern take on nutritional interventions for the management of severe and moderate acute malnutrition by combining a nutritional and a microbiota targeted intervention not only to deliver sufficient calories but also to improve the gut microbiota composition for sustained health benefits even after cessation of the nutritional therapy.

 We intend to use a finger millet based dietary supplement which is rich in dietary fibers to improve gut microbiome composition and in turn overall energy balance in under 5 years old children with severe and moderate acute malnutrition, in comparison to a high-energy wheat based supplement with a much lower dietary fiber content.

 We will conduct randomised control trials to test the effect of a finger millet based dietary intervention on the gut microbiome and its impact on the nutritional status measured by anthropometry of undernourished children from Anganwadi schools in three different states.

 Both soluble and insoluble/non-digestible dietary fibers have a profound effect on the gut microbiota. Finger millets are a rich source of high-quality beneficial dietary fibers as well as polyphenols with anti-inflammatory properties. Use of finger millets should provide an avenue to correct underlying pathologies of undernutrition and help in establishing a more resilient process of energy assimilation through the harmonious action of microbial and host components in the gut.