Effects of Long-Term Supplementation of Eggs on Growth, Biochemical Indices, and Microbiota of Rural Thai Primary School Children

SummaryO_ST_ABSBackgroundC_ST_ABSProtein-energy malnutrition is still problematic worldwide. It directly impacts growth and development, especially in children. We investigated the long-term effects of egg supplementation on the growth, biochemical indices, and microbiota of primary school children. MethodsA randomized controlled cluster study was carried out in six rural schools in Thailand. Participants were randomly assigned into three groups: 1) whole egg (WE) - consuming 10 additional eggs/week [n = 238], 2) protein substitute (PS) - consuming yolk-free egg substitute equivalent to 10 eggs/week [n = 200], and 3) control group (n= 197]). Demographic and biochemical indices, and microbiota composition were measured at weeks 0, 14, and 35. Findings635 students (8 to 14 years old) were recruited (51{middle dot}5% female). At baseline, 17% of the participants were underweight, 18% were stunted, and 13% were wasted. At week 35, compared to the control group, body weight and height increased significantly in WE (3{middle dot}6 {+/-} 23{middle dot}5 kg, P<0{middle dot}001 and 5{middle dot}1 {+/-} 23{middle dot}2 cm, P<0{middle dot}001). No significant differences in weight or height were observed between PS and Control. Prealbumin levels were higher (1{middle dot}5 {+/-} 8{middle dot}158{middle dot}6314 mg/dL, P<0{middle dot}001) in WE, but not in PS, compared to control. Significant decreases in total cholesterol, triglycerides, and LDL cholesterol were observed in the WE, but not in the PS groups. HDL cholesterol tended to increase in WE (0{middle dot}7 {+/-} 25{middle dot}2 mg/dL, ns). Neither the alpha nor beta diversity of the bacterial diversity was significantly different among all groups. After WE supplementation, the overall relative abundance of Bifidobacterium increased by 1{middle dot}28-fold as compared to baseline and the differential abundance analysis also indicated that Lachnospira increased significantly and Varibaculum decreased. InterpretationLong-term whole egg supplementation is an effective, feasible and low-cost intervention to reduce protein-energy malnutrition, particularly in low-middle-income countries. Whole egg supplementation improves growth and nutritional biomarkers, and positively impacts gut microbiota without adverse effects on blood cholesterol levels. FundingAgricultural Research Development Agency (ARDA) of Thailand (PRP6105022310, PRP6505030460).