Does Early Vitamin A Supplement Reduce Infant Mortality?

By Jessica Bombace, ASU Nutrition Student

 

First and foremost, Vitamin A deficiency is well known in the world to poor and underprivileged populations. A vitamin A deficiency can cause serious complications if left untreated. According to the World Health Organization (WHO), vitamin A deficiency can lead to blindness, decreased immune systems and may lead to death, sadly (1). According to The Journal for Specialists in Pediatric Nursing, an estimated 190 million preschool-aged children have a vitamin A deficiency. Even though it’s well established that vitamin A is the best, safest as well as most cost-effective way to conduct an intervention to observe if vitamin A in global health helps reduce the mortality rate in children, Vitamin A supplementation has yet to be effective in developing countries (3).

The reason why people in poor or underdeveloped countries may most likely have this deficiency is because they have limited access to foods that contain vitamin A, or simply cannot afford the foods with high percentages of Vitamin A. Since this is a major throughout the world, The Department of Nutrition for Health and Development (NHD) is continuing to research how vitamin A supplementation may be able to help reduce neonatal mortality rates (1).

The ultimate goal is to be able to obtain more information to really understand how vitamin A supplementation in the very beginning of life can actually have an impact on prolonging the longevity of babies and reduce mortality rates (1). There are three studies, according to WHO, currently being conducted. One study is an animal study while the other two is a human blind, placebo-controlled trial (1).

Study Details in Tanzania 2015

  • Individually randomized double-blind, placebo-controlled trial of infants
  • Infants must be born in Tanzania
  • Newborns accepted must be able to feed orally (2)
  • Newborns also accepted if the family plans on staying in the area of study for at least 6 months (2)
  • 31,999 newborn babies were randomly assigned to receive vitamin A or the placebo (2)
  • Infants were given one single dose of 50,000 IU of vitamin A or the placebo in the first 3 days after being born (2)
  • Results: In this study, there was no evidence to support that vitamin A supplementation in the first few days of life had an affect on the mortality rates (2)

Even though there were no results of vitamin A being beneficial, it doesn’t rule out that vitamin A has no impact. More studies need to be conducted along with increasing the one single dose of 50,000 IU of vitamin A to really see if there is an effect.

 

Study Details in United States in 2011

  • Infants 1-6 months
  • Children aged 6 months- 59 months
  • 21 studies in total to evaluate preventive effect of vitamin A supplementation in a community setting (reported all-cause mortality)
  • 12 reported specific mortality for diarrhea & pneumonia
  • 6 reported specific mortality for measles
  • Results: combined results from 6 studies actually showed that vitamin A supplementation reduced all-cause mortality by 12%
  • Results: infants 1-6 months vitamin A had no effect
  • Results: children 6-59 months reduced diarrhea specific mortality by 30%
  • Pooled results for preventive Vitamin A supplementation showed that it reduced all-cause mortality by 25% ( 6-59 months old)
  • Had no effect on measles, meningitis and pneumonia-specific results

 

 

Vitamin A studies still have a long way to go to see how much of it will be effective to developing countries. Other health conditions could be the cause of vitamin A supplementation not being as effective as it is in the United States.

 

According to the National Institutes of Health, the top 10 foods highest in Vitamin A Follow:

  1. Sweet potato, baked in skin, 1 whole
  2. Beef liver, pan-fried, 3 ounces
  3. Spinach, frozen, boiled, ½ cup
  4. Carrots, raw, ½ cup
  5. Pumpkin pie, one slice
  6. Cantaloupe, raw, ½ cup
  7. Peppers, sweet, red, raw, ½ cup
  8. Mangos, raw, 1 whole
  9. Black-eyed peas (cowpeas, boiled, 1 cup
  10. Apricots, dried, 10 halves

 

In America, besides a varied diet including the foods above, vitamin A is available in multivitamins and as a stand-alone supplement, often in the form of retinyl acetate or retinyl palmitate. A portion of the vitamin A in some supplements is in the form of beta-carotene and the remainder is preformed vitamin A. Supplement labels usually indicate the percentage of each form of the vitamin.

 

The vast array of recipes on Fill Your Plate feature some of these foods high in vitamin A. Remember to source for a favorite recipe on Fill Your Plate when trying out new foods.

 

 

(1) WHO | Mechanistic studies on vitamin A in newborn health. (n.d.). Retrieved from http://www.who.int/nutrition/research_effects_vitA_newborn/en/

 

(2) Masanja, H., Smith, E. R., Muhihi, A., Briegleb, C., Mshamu, S., Ruben, J., … Fawzi, W. W. (2015). Effect of neonatal vitamin A supplementation on mortality in infants in Tanzania (Neovita): a randomised, double-blind, placebo-controlled trial. The Lancet385(9975), 1324-1332. doi:10.1016/s0140-6736(14)61731-1

 

(3) Murray, J. S. and White, J. (2016), Vitamin A supplementation in infants and children. J Spec Pediatr Nurs, 21: 212–217. doi:10.1111/jspn.12156

 

(4) Retrieved from https://www.google.com/search?q=Vitamin+A&rlz=1C5CHFA_enUS703US704&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj61tCgjdLWAhWGOiYKHQfDAQMQ_AUICygC&biw=1123&bih=618#imgrc=YZ-JxXw5Ibm02M:

 

(5) Retrieved from https://www.google.com/search?q=Vitamin+A&rlz=1C5CHFA_enUS703US704&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj61tCgjdLWAhWGOiYKHQfDAQMQ_AUICygC&biw=1123&bih=618#imgrc=JGtc_qUHn3pD6M:

 

 

About Jessica: Jessica Bombace, is a  27-year-old originally from Brooklyn, New York now residing in Northern New Jersey. She’s happily married with a one-year-old son and another baby on the way (girl) due early January. She’s a United States Navy Veteran, having served four years active duty and currently finishing her reserves time.

 

Jessica was stationed in sunny San Diego and traveled the Pacific on deployment. After being discharged from the Navy she moved to New Jersey where her husband was living. Hobbies and interests of hers include sports, fitness, cooking, gardening and making candles. She obtained her personal training certification and right after started attending Montclair State University majoring in Nutrition. She studied there till she had her first child and began attending ASU full-time online.

 

Jessica is currently a senior and will graduate early next year with a BA in Nutrition and Food Management.

Editor’s Note: Thank you Jessica for your Service!

 

 

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