Featured article in the Winter 2019 Issue of Nutrition Close-Up; written by Jen Houchins, PhD, RD
Inadequate nutrition is responsible for stunted growth in approximately 25% of children worldwide and the cause of nearly half of deaths in children under five years of age.
In the context of the global focus to end hunger and ensure access to safe, nutritious and sufficient food, a recent Maternal and Child Nutrition supplement explores a unique opportunity to address stunting and malnutrition through improved access to and increased consumption of eggs. As stated by Lutter, “…eggs in the context of a healthy diet may be an efficient, sustainable, and scalable approach to improve maternal and child nutrition and rural development.”1
Stunting is a significant problem in children <5 years of age in Ecuador, and the Lulun (Kichwa word for egg) Project developed, implemented, and tested a social marketing strategy that helped to re-define the community’s understanding of infant nutrition and complementary feeding within a randomized controlled intervention trial.2 This project considered culturally based norms, values, and local expectations, and the food-based intervention of one egg per day reduced stunting by nearly 50% in infants 6 to 9 months of age.3 The impact of this intervention is illustrated not only by the significant impact on growth, but also with participant feedback, “The egg is truly effective, and it is good for our children. Thank you for promoting campaigns to help people to know more about the egg.”
Despite the high potential for eggs as a nutrition intervention in women and children, egg consumption is low in many parts of the world due to cultural, access and cost barriers. Data based on nationally representative surveys conducted between 2007 and 2010 for women who had given birth in the last 3 years indicate “egg consumption was strongly related to socioeconomic status in a dose-response fashion with women in the lowest wealth quintile eating the fewest eggs and those in the highest wealth quintile eating the most.”4 Similarly, “…the poorest families in low and lower middle income countries often rely on low-quality, plant-based diets consisting primarily of starchy staples, and novel approaches are needed to improve animal source foods availability and consumption in these settings.”5
Novel approaches to help improve access and consumption of eggs in women and children is not straight forward and varies based on local cultures. Dumas et al. piloted an intervention to establish egg production centers in rural Zambian communities to increase availability of eggs in the local food system. This program improved egg production and offers a novel approach to improving access to eggs, but “optimization… is needed to ensure that egg consumption translates to improved dietary quality, growth, and health.”5 Morris et al. separately concluded that there should be a focus on production practices that bring prices down significantly, allowing more poor households to access and consume eggs.6 A summary of key issues associated with small scale production indicates, “interdisciplinary research and development is required to ensure the long-term environmental and economic sustainability… that are a good fit with local circumstances.”7
The articles in this recent supplement illustrate that “eggs are one of our best tools to help end hunger, achieve food security, and improve nutrition.”6 However, access to eggs is not yet universal, and novel approaches are needed that address local cultures and circumstances. Importantly, sustainable nutrition includes evaluation of food and diet patterns not only in terms of health benefits, but also economic, social and environmental outcomes. We invite you to explore the most recent evidence of how eggs provide an opportunity to positively impact child and maternal nutrition, and all areas of sustainable nutrition.