Guideline / position statementindependent cross-checkabstract checked★ key study I-EGG-103 in-depth review
WHO: young children should eat meat, fish or eggs every day
WHO Guideline for complementary feeding of infants and young children 6-23 months of age
Overview
World Health Organization. WHO (guideline, ISBN 978-92-4-008186-4) 2023
WHO recommends daily animal-source foods such as meat, fish or eggs for children aged 6-23 months.
Does the study support the specific claim? No · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Set global recommendations for complementary feeding.
- How was the study done?
Systematic reviews, dietary modelling, GRADE.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Daily meat, fish or eggs recommended; removing all animal foods creates iron, zinc and B12 gaps; removing only eggs does not.
- How large was the observed effect?
Egg RCTs: no significant pooled effect on growth.
- What do the results mean in everyday life?
Eggs are a good, but not irreplaceable, food for small children; the danger is cutting many protein foods at once.
- What are the study's limitations?
Low-certainty evidence for most outcomes.
- What does it say about Elawady's specific claim?
Contradicts a ban on eggs for children, especially combined with other restrictions.
- Do the results apply to Germany and Europe?
Global.
- What can explicitly not be concluded from this study?
It does not test the Tayebat diet itself.
Scientific in-depth review
1. Full reference
- Authors
- World Health Organization
- Journal
- WHO (guideline, ISBN 978-92-4-008186-4)
- Year
- 2023
- Identifier
- Verification
- verified – WHO publication page and guideline PDF (iris.who.int) fetched 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
WHO guideline; declarations of interest are listed in the guideline annex (not reviewed in detail).
2. Research question
How should infants and young children aged 6-23 months be fed in addition to milk?
3. Study design and population
- Study design
- Guideline / position statement – WHO guideline based on commissioned systematic reviews, dietary modelling and GRADE (Guideline Development Group)
- Population
Infants and young children 6-23 months in low-, middle- and high-income countries
- Country
Global
- Period
Published 16 October 2023
- Sample size
Not applicable (guideline)
- Inclusion and exclusion criteria
not detailed in abstract
4. Methods and endpoints
- Exposure / intervention
Animal-source foods including meat, fish and eggs; other food groups
- Comparator
Diets without these foods
- Endpoints
Growth, anaemia, nutrient adequacy
- Statistical methods
GRADE; dietary modelling of nutrient gaps
5. Actual results
- Results
Recommendation 4a: animal source foods, including meat, fish or eggs, should be consumed daily (strong recommendation, low-certainty evidence). Evidence summary: two RCTs giving 1 egg/day for 6 months showed no effect on WAZ (MD 0.15 [0.00, 0.30]), HAZ (MD 0.06 [-0.10, 0.22]) or WHZ (MD -0.10 [-0.24, 0.04]) (low to very low certainty). Dietary modelling: all best-case diets included beef, lamb, game, liver or small fish; excluding meat, poultry, fish and eggs created gaps in iron, zinc and vitamin B12; excluding only eggs did not change intakes of these nutrients.
- Absolute risks
not reported
- Authors' conclusion
Infants and young children should consume a diverse diet; animal source foods should be eaten daily.
6. Strengths
- Global normative guideline with systematic reviews and GRADE
- Includes dietary modelling for nutrient gaps
7. Weaknesses
- Low or very low certainty for most outcomes
- Only relevant sections (Recommendation 4, evidence summary on animal source foods, certainty, allergy remarks) were read, not the full 96-page document
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- low
- Rationale
WHO GRC-approved guideline process.
9. Assessment of the statistical interpretation
Pooled egg RCTs show no growth effect; benefit of eggs lies mainly in nutrient density and dietary diversity.
10. Relevance to the specific claim
Eggs are listed among recommended daily animal-source foods for young children. At the same time, the modelling shows that excluding eggs alone does not create nutrient gaps when meat and fish are eaten; gaps arise when meat, poultry, fish and eggs are all excluded. This fairly limits the safety concern to combined restrictions.
11. Independent contrary findings
Egg-only RCTs showed no growth benefit in pooled analysis; eggs are one option, not essential.
12. Transferability to Germany and Europe
Global guideline; applicable to Egypt and Europe.
13. Overall methodological judgement
Key guideline: eggs are an appropriate food for young children; removing several animal-source food groups at once is the nutritional risk.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | low |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Whether children following the full system eat enough meat/fish to compensate is unknown.
15. Linked fact checks
- Eggs should be completely avoided (all kinds, all cooking methods). – Studies contradicting or limiting the claim
- Liver and organ meats (lamb liver, beef liver, trotters, head meat, tripe/mumbar, veal) are allowed without a stated frequency limit. – Studies with mixed or unclear results