4. Discussion
SECONDARY, MALNUTRITION, CHILD MALNUTRITION
This randomized controlled trial (RCT) was the first long-term intervention that provided 2 additional whole eggs per school day for 35 weeks, beginning in the first semester and continuing through the second semester in multiple regions of Thailand. We confirmed that this had a positive biological impact on adolescent growth, particularly improving stunting and underweight. This intervention was associated with improved biomarkers, including lipoproteins, microbiota, and healthy dietary patterns in children.The World Health Organization (WHO) reported a 22.9% prevalence of stunting (H/A Z < −2SD from the median of WHO child growth standards) among children under 5 years of age and a trend in child malnutrition that will be greater than 10 to 50% in Africa, the eastern Mediterranean, and Southeast Asia, including Thailand [This finding confirms an RCT that egg consumption significantly improved growth in young children [Furthermore, we found that egg supplementation improved the blood lipid profiles, including HDL-C levels [Regarding the structure of the gut microbiome after whole egg supplementation, we observed increased levels of This research has strengths which suggest that its findings may have important implications for public policy. First, this is a large-scale, one-year randomized controlled trial. We collected data from rural schoolchildren, including central, eastern, and western Thailand, homogenized by geographical and food patterns. Second, we used tools for the evaluation of food intake to achieve a high level of precision of nutrition data. Third, this study showed an important verified discovery that the fight against malnutrition, especially in low- and middle-income communities, could be achieved by using locally available high-quality proteins such as eggs, milk, and chicken. This also impacts healthier food choices and children’s behavior. However, there are some limitations of this study. First, whole egg consumption in the protein substitute and control groups on weekends and during school breaks is difficult to control. Second, the whole egg group and the protein substitute group had at least one secondary school class, suggesting that these may be confounding variables for anthropometric analysis. 