An Egg Intervention Improves Ponderal But Not Linear Growth Among Infants 6–12 mo of Age in Rural Bangladesh

Abstract

BackgroundAnimal source foods are rich in multiple nutrients. Regular egg consumption may improve infant growth in low- and middle-income countries. ObjectivesTo assess the impact of daily egg consumption on linear growth among 6–12-mo olds in rural Bangladesh. MethodsWe conducted a 2 × 4 factorial cluster-randomized controlled trial allocating clusters (n = 566) to treatment for enteric pathogens or placebo and a daily egg, protein supplement, isocaloric supplement, or control. All arms received nutrition education. Here, we compare the effect of the egg intervention versus control on linear growth, a prespecified aim of the trial. Infants were enrolled at 3 mo. We measured length and weight at 6 and 12 mo and visited households weekly to distribute eggs and monitor compliance. We used linear regression models to compare 12-mo mean length, weight, and z-scores for length-for-age (LAZ), weight-for-length, and weight-for-age (WAZ), and log-binomial or robust Poisson regression to compare prevalence of stunting, wasting, and underweight between arms. We used generalized estimating equations to account for clustering and adjusted models for baseline measures of outcomes. ResultsWe enrolled 3051 infants (n = 283 clusters) across arms, with complete 6 and 12 mo anthropometry data from 1228 infants (n = 142 clusters) in the egg arm and 1109 infants (n = 141 clusters) in the control. At baseline, 18.5%, 6.0%, and 16.4% were stunted, wasted, and underweight, respectively. The intervention did not have a statistically significant effect on mean LAZ (β: 0.05, 95% confidence interval [CI]: −0.01, 0.10) or stunting prevalence (β: 0.98, 95% CI: 0.89, 1.13) at 12 mo. Mean weight (β: 0.07 kg, 95% CI: 0.02, 0.11) and WAZ (β: 0.06, 95% CI: 0.02, 0.11) were significantly higher in the egg compared with control arms. ConclusionsProvision of a daily egg for 6 mo to infants in rural Bangladesh improved ponderal but not linear growth. Trial registration numberNCT03683667, https://clinicaltrials.gov/ct2/show/NCT03683667.