Eggs for Improving Nutrition, cognitive development and reducing linear growth retardation among Infants and young Children (ENRICH): Protocol of an egg supplementation trial among children aged 9-18 months in Hyderabad, India

Santosh Kumar Banjara, Sai Ram Challa*, Little Flower Augustine, Teena Dasi, Radhika Madhari, Sylvia Fernandez Rao, Ravindranadh Palika, Raghu Pullakhandam, Rajender Rao Kalashikam, Ramachandrappa Naveen Kumar, Dharani Pratyusha Palepu, Monica Chilumula, Kiruthika Selvaraj, Preethi Gopinath, Hilary Davies-Kershaw, Modou Lamin Jobarteh, Paul Haggarty, Claire Heffernan, Elaine Ferguson, Bharati Kulkarni

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Introduction Evidence on the impact of nutrient-rich animal source foods such as eggs for improving child growth and cognition is inconsistent. This study aims to examine the impact of an egg intervention in children, along with behaviour change communication (BCC) to the mother, on linear growth and cognition, and nutritional status in children aged 9-18 months. Methods and analysis A 9-month open-labelled randomised controlled trial will be conducted in three urban slums in Hyderabad, India, as a substudy of an observational cohort study (n=350) following pregnant women and their children until 18 months of age in a population at risk of stunting. The children born to women enrolled during the third trimester of pregnancy will be block randomised in a 1:4 ratio into the intervention (n=70) and control (n=280) groups. Children in the intervention group will be supplemented with one egg per day starting from 9 months until 18 months of age. BCC designed to enhance adherence to the intervention will be used. The control group will be a part of the observational cohort and will not receive any intervention from the study team. The primary outcome will be length-for-age z-scores, and the secondary outcomes will include cognition, blood biomarkers of nutritional status including fatty acid profile and epigenetic signatures linked with linear growth and cognition. Multivariate intention-to-treat analyses will be conducted to assess the effect of the intervention. Ethics and dissemination The study is approved by the Institutional ethics committees of ICMR-National Institute of Nutrition, Hyderabad, India and London School of Hygiene and Tropical Medicine, UK. The results will be published in peer-reviewed journals and disseminated to policy-makers. Findings will also be shared with study participants and community leaders.

Original languageEnglish
Article numbere001892
Number of pages8
JournalBMJ Paediatrics Open
Volume8
Issue numberSuppl 1
Early online date27 Feb 2024
DOIs
Publication statusPublished - 22 Mar 2024

Bibliographical note

SKB, SRC and BK: conceptualised, designed the study and wrote first draft. LFA, TD, DPP, MC, KS and PA: developed detailed protocols, planned data collection, critical input to manuscript. RM, HD-K, CH, SFR, RPullakhandam, RPalika, RRK, RNK, MLJ and PH: concept, design, critical inputs to manuscript.

Keywords

  • Child Psychiatry
  • Epidemiology
  • Growth
  • Health services research
  • Nutrition
  • protocols

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