Impacts of an egg complementary feeding trial on energy intake and dietary diversity in Malawi

Chessa K Lutter, Bess L Caswell, Charles D Arnold, Lora L Iannotti, Kenneth Maleta, Raphael Chipatala, Elizabeth L Prado, Christine P Stewart, Chessa K Lutter, Bess L Caswell, Charles D Arnold, Lora L Iannotti, Kenneth Maleta, Raphael Chipatala, Elizabeth L Prado, Christine P Stewart

Abstract

Complementary feeding diets in low- and middle-income countries are generally inadequate to meet requirements for growth and development. Food-based interventions may prevent nutrient inadequacies provided that they do not displace other nutrient-rich foods. We conducted a randomized controlled trial in rural Malawi in which 660 children aged 6 to 9 months were provided an egg a day for 6 months or assigned to a control group. Dietary intake of complementary foods and drinks was assessed at baseline, 3-month midline and 6-month endline visits using a tablet-based multipass 24-h recall. Up to two repeat recalls were collected at each time point in a subsample of 100 children per treatment group. At midline and endline, usual energy intake from eggs was about 30 kcal/day higher in the egg group compared with controls (p < 0.0001). Compared with controls, children in the egg group were over nine times more likely to consume eggs at midline and endline. There was a comparable, but nonsignificant, greater total usual energy intake from complementary foods of 30 kcal/day at midline (p = 0.128) and 36 kcal/day at endline (p = 0.087). There also was a displacement of 7 kcal/day in legumes and nuts in children at endline (p = 0.059). At midline and endline, more than 80% of children in the egg group consumed a minimally diverse diet compared with 53% at midline and 60% at endline in the control group. This study illustrates that mothers in the egg group fed eggs to young children on a regular basis without substantial displacement of other complementary foods.

Trial registration: ClinicalTrials.gov NCT03385252.

Keywords: childhood diet; complementary feeding; complementary foods; dietary intake assessment; infant and child nutrition; randomized controlled trial.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Participant flow diagram. MUAC, mid‐upper arm circumference
FIGURE 2
FIGURE 2
Usual energy intake by food group at baseline, midline and endline. SSB, sugar‐sweetened beverages

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