الفهرس 
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Abstract
Background: Malnutrition in children is a global public health problem with wide implications. Malnourished children have increased risk of dying from infectious diseases, and it is estimated that malnutrition is the underlying cause of 45% of global deaths in children below 5 years of age. Prebiotic effect of honey has been observed in several monofloral honeys one of them is clover honey which used in this study. Honey is a prebiotic, containing non-digestible oligosaccharides and is Bifidogenic factor.
Aim of the Work: evaluating the role of honey supplementation (Egyptian clover honey) as a prebiotic on gut microbiota of malnourished children aged of 6 months to 3 years old.
Patients and Methods: This randomized single blinded case control prospective interventional study was conducted on forty infants and children of both sexes, aged 6 months to 3 years, with malnutrition recruited from the Nutrition Clinic of children Hospital, Ain Shams University, Egypt. The grading of malnutrition was based on WHO Z-Scores. Patients were randomly assigned following a simple randomization procedure (computerized random numbers) to malnourished children before honey intake group (group 1) and malnourished children after honey intake for 2 months (group 2). Each group consisted of 20 patients. An additional 20 healthy infants and children of matched age, sex and residency were recruited as a healthy control group (group 3).
Results: After honey intervention for 2 months There was a high statistically significant difference in (group 2) compared with the malnourished group (group 1) : increase in log count of Lactobacillus and Bifidolongum with p-value 0.000,increase in anthropometric measurements , WAZ, HAZ, MAZ and mid-arm circumference and height with p-value = 0.001 and 0.000 respectively. An increase was observed in the total caloric intake with p-value =0.000; decrease in the frequency of infection with p-value =0.000 and. However, there were non statistically significant differences in weight and WHZ in (group 2) in comparison with (group 1) with p value =0.930 and 0.620 respectively.
Conclusion: Honey consumption in a group of malnourished children resulted in positive effects: increased gut. microbiota (Lactobacillus and Bifidobacteria), decreased frequency of infections, Improved appetite with subsequent increase of total caloric intake and weight gain.