Effect of Edible Cricket Enriched Complementary Porridge and Nutrition Education on Linear Growth of Children 6–14 Months in Siaya County, Kenya: A Randomized 2 × 2 Factorial Trial

Edible crickets are commonly farmed insects containing high-quality protein and micronutrients. They can potentially replace common animal source protein in complementary food (CF). We evaluated the effect of edible cricket-enriched CF on linear growth in a 2 × 2 factorial randomized control trial based on Cricket treatment (+/-CR) and Nutrition Education treatment (+/-ED). We enrolled 284 eligible mother-infant dyads with infants from 6 months having a middle upper arm circumference (MUAC) > 11.5 cm at Rwambwa Sub-County Hospital, Siaya County, Kenya. Participants were randomized to treatment arms with intervention foods issued monthly as a take-home food ration adjusted for age, were offered +ED sessions monthly as personalized audio-visual sessions where education messages and reminders were sent to the mother's mobile phones. Monthly infant anthropometry, feeding practices and child health data were collected. A significant contrast (Z = -0.28 (95% CI: 0.03, 0.53) [p = 0.03]) in length-for-age Z-score (LAZ) between -CR and +CR was observed. By MUAC, girls were significantly 1.98 (1.15, 3.41) (p = 0.01) times likely to be undernourished. Increased illness episodes significantly increased the child's risk to undernutrition, with those experiencing three episodes being 4.30 (95% CI: 1.21, 15.37) times likely to suffer undernutrition, while those with above five episodes were almost six times as likely to be malnourished. Consuming either of the intervention foods resulted in a similar growth rate irrespective of nutrition education treatment offered. Nutrition education improved weight-for-length, irrespective of CF consumed. The similarity in growth rate across study arms signifies the potential of edible cricket protein in growth of infants' comparative to the super cereal. Trial registration: https://clinicaltrials.gov NCT06002620.