Abstract
ABSTRACTBackgroundEggs are a rich source of nutrients important for brain development, including choline, riboflavin, vitamins B-6 and B-12, folate, zinc, protein, and DHA.ObjectiveOur objective was to evaluate the effect of the consumption of 1 egg per day over a 6-mo period on child development.MethodsIn the Mazira Project randomized controlled trial, 660 children aged 6–9 mo were randomly allocated into an intervention or control group. Eggs were provided to intervention households during twice-weekly home visits for 6 mo. Control households were visited at the same frequency. At enrollment, blinded assessors administered the Malawi Developmental Assessment Tool (MDAT), and 2 eye-tracking tasks using a Tobii-Pro X2–60 eye tracker: a visual paired comparison memory task and an Infant Orienting with Attention task. At endline, 6-mo later, blinded assessors administered the MDAT and eye-tracking tasks plus an additional elicited imitation memory task.ResultsAt endline, intervention and control groups did not significantly differ in any developmental score, with the exception that a smaller percentage of children were delayed in fine motor development in the intervention group (10.6%) compared with the control group (16.5%; prevalence ratio: 0.59, 95% CI: 0.38–0.91). Among 10 prespecified effect modifiers for the 8 primary developmental outcomes, we found 7 significant interactions demonstrating a consistent pattern that children who were less vulnerable, for example, those with higher household wealth and maternal education, showed positive effects of the intervention. Given multiple hypothesis testing, some findings may have been due to chance.ConclusionThe provision of 1 egg per day had no overall effect on child development in this population of children, however, some benefits may be seen among children in less vulnerable circumstances. This trial was registered at clinicaltrials.gov as NCT03385252.
Highlights
An estimated 149 million children are stunted and 250 million are estimated to be at risk of not fulfilling their developmental potential, partly due to inadequate dietary intake [1], which is especially likely to occur from the age of 6 to 24 mo, as children transition from exclusive breastfeeding to sharing household meals
The standardized mean difference in scores between groups is shown in Supplemental Figure 2 stratified for each significant effect modifier. In this randomized trial in Malawi, an intervention providing 1 egg per day to children for 6 mo during the early complementary feeding period did not affect motor, language, or personalsocial development, or memory development measured by an elicited imitation task
Indices of memory and attention derived from infant looking behavior using automated eye tracking did not show effects of the egg intervention
Summary
An estimated 149 million children are stunted and 250 million are estimated to be at risk of not fulfilling their developmental potential, partly due to inadequate dietary intake [1], which is especially likely to occur from the age of 6 to 24 mo, as children transition from exclusive breastfeeding to sharing household meals. During this complementary feeding period, infants require nutrient-dense foods to complement breast milk and support healthy growth and development.
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