Diarrhea, respiratory infections, and growth are not affected by a weekly low-dose vitamin A supplement: a masked, controlled field trial in children in southern India

Abstract

Incidence, duration, and severity of diarrhea and respiratory symptoms were monitored weekly for 1 y in 15,419 children 6-60 mo of age in a randomized, placebo-controlled, masked clinical trial conducted in southern India. Half the children received weekly doses of 8.7 mumol (2500 microgram) vitamin A and 46 mumol (20 mg) vitamin E (treated) and the other half, 46 mumol vitamin E (control). Medical and ocular examinations and anthropometric measurements were obtained before and after 52 wk of intervention. Ocular examinations also were obtained after 26 wk. Supplements were delivered weekly from calibrated dispenser bottles by community health volunteers who also recorded each mother's recall of daily morbidity of her child during the previous week. Baseline characteristics of treated and control subjects were similar and documented a prevalence of 11% xerophthalmia and 72% undernutrition. Weekly treatment with the low-dose vitamin A supplement did not influence the incidence, severity, or duration of diarrhea or respiratory infections and did not influence linear or ponderal growth.

Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life

“…Vitamin A supplementation of pregnant women MK Schmidt et al diarrhoea or respiratory diseases (Coutsoudis et al, 2000;Rahmathullah et al, 1991), or only an effect on duration of acute respiratory infections (Rahman et al, 1996). The type of feeding during the first year of life and immunisation coverage were comparable between the groups, thus these could not have accounted for the lack of difference in growth and morbidity of infants.…”

The impact of vitamin A supplementation on physical growth of children is dependent on season

“…In West Java, increasing the intakes of vitamin A by fortification of monosodium glutamate significantly improved linear growth in preschool children (Muhilal, 1988). However, two studies from south India reported that weekly low-dose or large dose vitamin A supplementation had no impact on physical growth of children (Rahmathullah, 1991;Ramakrishnan, Latham and Abel, 1995). The variability in the growth impact following vitamin A supplementation across studies may be attributable to differences in baseline vitamin A status, dietary factors, infection burden, season and duration of follow up.…”

“…The few intervention studies which have examined the impact of vitamin A supplementation on growth of children have reported variable results; one study found a benefit in ponderal growth in males (West, 1988), another observed improvement in linear growth (Muhilal, 1988), while the remaining reported no benefit at all (Rahmathullah, 1991;Ramakrishnan, Latham and Abel, 1995). Improved physical growth following vitamin A supplementation could be a direct effect possibly involving stimulation of growth factors, or may result from a reduction in the incidence or severity of common infections (Semba, 1994).…”

Níveis plasmáticos de vitamina A, carotenóides e proteína ligadora de retinol em crianças com infecções respiratórias agudas e doenças diarréicas

“…Níveis inadequados de vitamina A plasmática têm sido, também, associados às infecções 3 , mesmo em regiões onde a deficiência de vitamina A não é endêmica 13 . No entanto, outros estudos epidemiológicos, em nível de comunidade, não verificaram diminuição significativa da incidência dessas infecções após suplementação com a vitamina A 21 .…”