Animal-source foods (ASFs) can play an important role in curbing early child undernutrition, which, if left unaddressed, can affect physical development, the ability to fight off diseases, and economic potential as children grow into adulthood. ASFs also contain healthy fats and other nutrients associated with cognitive development. Recent research highlights the importance of ASFs to improve child growth and micronutrient status. Eggs in particular have been singled out for their many positive attributes such as nutritional value, low cost relative to other ASFs, and ease of preparation. A great source of protein, essential fatty acids, and choline, eggs also offer several unique immune properties in one efficient package.  Additionally, small-scale community or household chicken and egg production has the potential to provide income for households, thereby helping to alleviate poverty and food insecurity, though existing evidence of the effects on nutritionally vulnerable groups in low-income countries is minimal. 

In 2014, with funding from the Mathile Institute, several colleagues and I tested the effect of eggs introduced early in complementary feeding through the Lulun Project, a mixed-methods study conducted in Ecuador. During the six-month study, families with children aged six to nine months were provided fresh eggs and asked to feed one egg per day to their children. The mothers were also exposed to social marketing to promote the value of egg consumption for their children. This was the first-ever randomized-controlled study to link eggs to improved child nutrition.

We found that, at the end of six months, stunting was reduced in the “egg” group by 47 percent. While these conclusions were exciting, a recent follow-on study in Malawi supported through the Bill and Melinda Gates Foundation attempted to replicate these findings, but the take-home message was not as clear. The Mazira Project study found that while introducing similar interventions did increase egg consumption – and, therefore, lead to healthier diets – it did not result in a reduction in stunting in the egg group.  This may have been due to the high prevalence of fish consumption – another protein-rich food -- the difference in staple food availability (maize versus potato), and low baseline prevalence of stunting in Malawi compared to that in Ecuador. These conflicting findings in two very different contexts indicate the importance of conducting additional egg child nutrition research in settings where children do not have ready access to another high-quality protein source.  

Expanding on this research, last year RTI International self-funded a study to examine the knowledge, beliefs, and practices related to consuming eggs during pregnancy in Kenya, where we suspected that such consumption was not generally culturally accepted. Our study showed that egg consumption is low among pregnant women in Kenya and, while there are potential belief barriers, many see eggs as good for pregnant women. The families in our study saw health workers as a trusted source of nutrition information, indicating that interpersonal communication from health workers could lead to an increase in consumption. Cost was also seen as a barrier to higher consumption. Agricultural interventions that promote policies and practices to increase productivity could increase availability and lower prices to help address the cost constraints.

Despite eggs’ potential to be a game-changer for maternal and child nutrition, challenges to leveraging that potential remain. Although eggs are less expensive than other ASFs, they are still expensive relative to the equivalent calories from staple crops, which prevents access by the poor households who tend to need them the most. While several isolated pilot interventions promoting household poultry production to improve child egg consumption have been successful, many others have failed. Therefore, sustainable and scalable programs to improve small-scale community and household poultry production using a proven business approach have not been identified. In order to improve nutrition, when such programs are identified they also need to leverage existing platforms for social-behavior change communication to promote feeding eggs to children at around six months when complementary feeding begins. In doing so, we can clearly link development and nutrition outcomes to the benefit of resource-poor households.

Learn more:

• Iannotti et al., The Uncracked Potential of Eggs: https://www.ncbi.nlm.nih.gov/pubmed/24807641 (Open Access)
• Lulun Trial: https://www.ncbi.nlm.nih.gov/pubmed/28588101 (Open Access)
• Mazira Trial: https://www.ncbi.nlm.nih.gov/pubmed/31386106 (Open Access)
• Kenya Egg Study: https://www.ncbi.nlm.nih.gov/pubmed/31132879
• Maternal and Child Nutrition: Special Supplement on Eggs (2018) (11 publications, Open Access) https://onlinelibrary.wiley.com/toc/17408709/2018/14/S3