Vitamin A deficiency among children not public health problem anymore: Study

Hyderabad: Vitamin A deficiency among children is not a public health problem anymore, a new study has revealed.

A group of researchers from the ICMR-National Institute of Nutrition, along with those from the St John’s Research Institute, Bengaluru and Sitaram Bhartia Institute of Science and Research, New Delhi, evaluated whether Vitamin A deficiencies (VAD) still presented a serious public health problem among children below five years of age in India.

The results published recently in the prestigious American Journal of Clinical Nutrition suggest that the national prevalence of VAD risk is below 20% in Indian children, and there is a possible risk of hypervitaminosis caused by excess intake with food fortification and supplementation.

The researchers suggest it is time to revise the mega-dose of vitamin A and consider a targeted state-based Vitamin A supplementation (VAS) program, unlike the nation-wide program that is currently the norm in India.

“The study draws on the sample of the Comprehensive National Nutrition Survey (CNNS) which was conducted in 30 states during 2016-2018. The survey showed that VAD based on serum retinol levels was 15.7% among 1-5 y children across the country, certainly lesser than the 20% mark that defines a serious public health problem”, said Dr Hemalatha, Director of NIN.

VAD along with nutritional blindness was a major public health problem in 1950s and 60s. In 1970, the ‘National Prophylaxis Program Against Nutritional Blindness’ was initiated with the specific aim of preventing nutritional blindness by providing mega doses of Vitamin A. Under this program, in tune with the WHO/UNICEF recommendations, all children below 5 years of age are administered mega doses of vitamin A once in six months.

Later, with studies reporting its beneficial impact even in reducing child mortality, the focus of this program shifted to decreasing mortality rates also. This, however, was widely debated.

In view of India’s progress with the reduction of infant and child mortality rates, immunization coverage, underpinned by almost complete decline in clinical signs of Vitamin A deficiencies in children, there perhaps is the need to revisit the programme.

The researchers, therefore, are suggesting there definitely is a need for broader public education to resort to food-based initiatives rather than mere supplementation, as the amount of carotene available through economical sources like green leafy vegetables, fruits can meet the daily vitamin A requirement, while not putting the children at risk of excess intake.