Impacts of an egg intervention on nutrient adequacy among young Malawian children

Abstract

Eggs are a rich source of multiple nutrients that support child growth and development. Provision of eggs as a complementary food may improve dietary adequacy among young children at risk for undernutrition. Our objective was to test the impact of an egg intervention on the adequacy of total nutrient intakes and micronutrient density among 6-to 15-month-old Malawian children. Children 6 to 9 months old, living in Mangochi District, Malawi, were randomly assigned to the intervention group (n = 331) receiving an egg per day or a control group (n = 329) consuming their usual diet. Dietary intakes of macronutrients, vitamins and minerals were assessed using 24-h recalls at baseline, 3-month midline and 6-month endline, with repeat recalls in a subsample. Usual nutrient intake and micronutrient density distributions were modelled to estimate group means and prevalence of inadequacy. Group differences at midline and endline were tested using unequal variance t tests with bootstrapped standard errors. The egg intervention resulted in higher intakes of fat and protein and lower intakes of carbohydrates.The egg group had lower prevalence of inadequacy for selenium, vitamin A, riboflavin, vitamin B 5 , vitamin B 12 and choline. Micronutrient density inadequacy was lower in the egg group for vitamin A and choline at midline and endline, riboflavin at midline and vitamin B 5 at endline. Inadequacy of nutrient intakes or density remained highly prevalent in both groups for multiple micronutrients. Though the egg intervention increased intakes of protein and several micronutrients, total intakes and micronutrient density of multiple micronutrients remained far below recommendations.

Plasma Choline Concentration Was Not Increased After a 6-Month Egg Intervention in 6–9-Month-Old Malawian Children: Results from a Randomized Controlled Trial

“…Eggs were procured from a local distributor. On average, eggs weighed 53 g and provided 126 mg choline ( 9 ). Families in the control group were asked to feed the child his or her typical diet.…”

“…Families in the control group were asked to feed the child his or her typical diet. Descriptions of food and nutrient intakes for study participants have been published ( 9 , 11 ); generally, complementary diets were maize-based, with some inclusion of green leafy vegetables but limited intake of animal-source foods. Both groups received instruction on food hygiene and handwashing during home visits.…”

“…Eggs were reportedly consumed by 71% of children in the egg group on a 24-h dietary recall performed at the 6-mo follow-up ( 7 ). However, dietary recall data revealed inadequate intakes of several nutrients, including choline, even with frequent egg consumption ( 9 ). It is unclear whether the increase in choline intake in the Malawian trial was sufficient to improve plasma choline concentration.…”

Choline and docosahexaenoic acid during the first 1000 days and children’s health and development in low- and middle-income countries

“…Eight studies reported on child growth in LMICs ( Table 4 120–126 , 128 , 129 , 131 ). In Guinea-Bissau, the fortified supplement was associated with decreased WAZ, BMI for age, fat tissue accretion, and increased lean tissue accretion compared with the corn-soy blend among children younger than 4 years.…”

“… a Townships were not randomly selected. b Nutrient values were presented in separate manuscripts for the Lulun 126 and Mazira 131 Projects. c NEWSUP was a novel food supplement fortified with choline, DHA, and other nutrients, including polyphenols, chromium, and molybdenum.…”