Abstract
The Lulun Project, a randomized controlled trial conducted in 2015, found that one egg per day for 6 months during early complementary feeding reduced stunting by 47% and increased linear growth by 0.63 length‐for‐age Z (LAZ). This follow‐up cohort study (Lulun Project II) aimed to test whether the growth effect remained in the egg intervention group compared with the control group after approximately 2 years. Mothers or caregivers from the Lulun Project were recontacted and recruited for this study. Enumerators collected data on socio‐economic and demographic factors, 24‐hr frequency of dietary intakes, morbidities, and anthropometric measures of height, weight, and head circumference using World Health Organization protocols. Statistical analyses followed the same analytical plan as Lulun Project, applying generalized linear models and regression modelling to test group differences in height‐for‐age z (HAZ) from LAZ at Lulun Project endline, and structural equation modelling for mediation. One hundred thirty‐five mother–child dyads were included in Lulun II, with 11% losses to follow‐up from endline Lulun Project. Growth faltering across all children was evident with HAZ −2.07 ± 0.91 and a stunting prevelance of 50%. Regression modelling showed no difference between egg and control groups for the HAZ outcome and other anthropometric outcomes, and significant declines in HAZ from endline Lulun Project in the egg intervention are compared with control groups. Current dietary egg intake, however, was associated with reduced growth faltering in HAZ from Lulun Project endline to Lulun Project II, independent of group assignment and through mediation, explaining 8.8% of the total effect. Findings suggest the need for a longer intervention period and ongoing nutrition support to young children during early childhood.
Highlights
Animal source foods (ASF) provide crucial nutrients in highly bioavailable forms to young children during the complementary feeding period (Iannotti, 2018)
Lulun Project II was a follow‐up cohort study to the Lulun Project, an randomized controlled trial carried out in 2015 in Ecuador that found one egg per day for 6 months during early complementary feeding reduced stunting by 47%
The percentage of mothers or caregivers reporting ownership of poultry was significantly higher in the egg intervention group (76%) compared with the control group (56%; p = .02), a difference not observed in the Lulun Project
Summary
Animal source foods (ASF) provide crucial nutrients in highly bioavailable forms to young children during the complementary feeding period (Iannotti, 2018). These foods, long part of our evolutionary past, likely played a central role for increasing body and brain size at particular junctures in hominin history (Kuipers, Joordens, & Muskiet, 2012). Eggs may be relatively more affordable ASF depending on context and highly nutritious complementary food. The Lulun Project leveraged the opportunity to test the effects of introducing eggs early in the complementary feeding period on infant and young child growth
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