Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review

Abstract

Vitamin A deficiency is a major health risk for infants and children in low- and middle-income countries. This scoping review identified, quantified, and mapped research for use in updating nutrient requirements and upper limits for vitamin A in children aged 0 to 48 months, using health-based or modelling-based approaches. Structured searches were run on Medline, EMBASE, and Cochrane Central, from inception to 19 March 2021. Titles and abstracts were assessed independently in duplicate, as were 20% of full texts. Included studies were tabulated by question, methodology and date, with the most relevant data extracted and assessed for risk of bias. We found that the most recent health-based systematic reviews and trials assessed the effects of supplementation, though some addressed the effects of staple food fortification, complementary foods, biofortified maize or cassava, and fortified drinks, on health outcomes. Recent isotopic tracer studies and modelling approaches may help quantify the effects of bio-fortification, fortification, and food-based approaches for increasing vitamin A depots. A systematic review and several trials identified adverse events associated with higher vitamin A intakes, which should be useful for setting upper limits. We have generated and provide a database of relevant research. Full systematic reviews, based on this scoping review, are needed to answer specific questions to set vitamin A requirements and upper limits.

Assessment of vitamin status; A, E and D in Egyptian neonates with IUGR: a cross sectional study

“…Deficiency of vitamin A represents a serious pediatric health hazard in countries of low- and middle income [ 29 ]. Deficient Vitamin A can be injurious to development of the brain in fetus and in newborns can cause high susceptibility to bronchopulmonary dysplasia and increase the possibility of inflammation [ 30 , 31 ].…”

Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research

“…Likewise, nutrition advice given to individual patients by health care providers for both health promotion and disease prevention is also driven by scientific evidence generated by nutrition scientists, including nutritional epidemiologists. Clinical recommendations often follow systematic evidence reviews by the World Health Organization ( 35 , 36 ), the American Heart Association and the American College of Cardiology ( 47 , 90 , 103 ), the American Cancer Society ( 88 , 89 ), the American Diabetes Association ( 25 ), the Academy of Nutrition and Dietetics ( 21 , 39 ), the World Cancer Research Fund and the American Institute for Cancer Research ( 104 ), and other professional groups and societies. In addition, these and other evidence reviews have been used by the US Preventive Services Task Force in their published nutrition-related recommendations on healthy weight and weight gain during pregnancy ( 22 ), vitamin D deficiency screening in adults ( 42 ), healthy diet and physical activity for CVD prevention in adults ( 41 ), and weight loss to prevent obesity-related morbidity and mortality in adults ( 19 ).…”