The Lulun Project

Location: Pastocalle, Ecuador

Collaborators: Brown School at Washington University in St. Louis, Universidad San Francisco de Quito, University of California Davis, Pan American Health Organization

Description: Eggs are a good source of nutrients for growth and development. We hypothesized that introducing eggs early during complementary feeding would improve child nutrition.

A randomized controlled trial was conducted in Cotopaxi Province, Ecuador, from March to December 2015. Children ages 6 to 9 months were randomly assigned to treatment (1 egg per day for 6 months [n = 83]) and control (no intervention [n = 80]) groups. Both arms received social marketing messages to encourage participation in the Lulun Project (lulun meaning “egg” in Kichwa). All households were visited once per week to monitor morbidity symptoms, distribute eggs, and monitor egg intakes (for egg group only). Baseline and end point outcome measures included anthropometry, dietary intake frequencies, and morbidity symptoms.

Key Findings:

• The egg intervention increased length-for-age z score by 0.63 and reduced stunting prevalence by 47%.
• The egg intervention increased plasma concentrations compared with control of the following biomarkers: choline, betaine, methionine, docosahexaenoic acid,  DMA, and TMAO.
• Generally accessible to vulnerable groups, eggs have the potential to contribute to global targets to reduce stunting.

Sponsors: The Mathile Institute for the Advancement of Human Nutriton, Bill & Melinda Gates Foundation

Publications

Eggs in early complementary feeding and child growth: A Randomized Controlled Trial. Iannotti L, Lutter C, Stewart C, Gallegos Riofrío C, Malo C, Reinhart G, Palacios A, Karp C, Chapnick M,  Cox K, Waters W. Pediatrics. 2017 Jun 7. doi: 10.1542/peds.2016-3459.

Eggs early in complementary feeding increased choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador. Iannotti L, Lutter C, Waters W, Gallegos Riofrío C, Malo C, Reinhart G, Palacios A, Karp C, Chapnick M,  Cox K, Aguirre S, Narvaez L, López F, Sidhu R, Kell P, Jiang X, Fujiwara H, Ory D, Young R, Stewart C. American Journal of Clinical Nutrition 2017 Dec; 106 (6):1482-1489.

The Lulun Project’s social marketing strategy in a trial to introduce eggs during complementary feeding in Ecuador. Gallegos-Riofrio C, Waters W., Miguel Salvador J., Carrasco A., Lutter C., Stewart C., Iannotti, L. 2018 Maternal Child Nutrition, 2018 Oct, 14(S3):e12700

Cracking the egg potential: understanding traditional knowledge, attitudes, and practices in a food-based complementary feeding intervention in highland Ecuador. Waters W, Gallegos C, Karp C, Lutter C, Stewart C, Iannotti L. Food and Nutrition Bulletin 2018 Jun;39 (2):206-218.