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Cited by 175Child Nutrition and Water AccessGlobal Maternal and Child HealthRetinoids in leukemia and cellular processes

Vitamin A deficiency disorders in children and women

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West, Keith P.·2003·Food and Nutrition Bulletin
DOI 10.1177/15648265030244s104
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Abstract

Vitamin A deficiency is an endemic nutrition problem throughout much of the developing world, especially affecting the health and survival of infants, young children, and pregnant and lactating women. These age and life-stage groups represent periods when both nutrition stress is high and diet likely to be chronically deficient in vitamin A. Approximately 127 million preschool-aged children and 7 million pregnant women are vitamin A deficient. Health consequences of vitamin A deficiency include mild to severe systemic effects on innate and acquired mechanisms of host resistance to infection and growth, increased burden of infectious morbidity, mild to severe (blinding) stages of xerophthalmia, and increased risk of mortality. These consequences are defined as vitamin A deficiency disorders (VADD). Globally, 4.4 million preschool children have xerophthalmia and 6 million mothers suffer night blindness during pregnancy. Both conditions are associated with increased risk of morbidity and mortality. While reductions of child mortality of 19–54% following vitamin A treatment have been widely reported, more recent work suggests that dosing newborns with vitamin A may, in some settings, lower infant mortality. Among women, one large trial has so far reported a ≥ 40% reduction in mortality related to pregnancy with weekly, low-dose vitamin A supplementation. Epidemiologic data on vitamin A deficiency disorders can be useful in planning, designing, and targeting interventions.

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  • Vitamin A deficiency has a direct impact on iron levels through metabolism and heme synthesis impairment, especially in children and pregnant women.

    “Its deficiency has a direct impact on iron levels through metabolism and heme synthesis impairment. This is especially important in children and pregnant women”

    From Vitamin A Update: Forms, Sources, Kinetics, Detection, Function, Deficiency, Therapeutic Use and Toxicity (2021) · cites this paper as [334]

    The Anemia section links vitamin A deficiency to anemia in children and lists impaired mobilization and transport of body iron as a plausible mechanism. The VADD in pregnant and lactating women section also reports an association with maternal anemia. Neither section identifies impaired heme synthesis as a mechanism, and the paper presents the mechanisms as plausible rather than established direct effects. Page numbers were not available in our copy. (LLM, conf=0.85)

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  • Vitamin A deficiency commonly results in ocular alterations such as xerophthalmia, night blindness, and Bitot's spots.

    “Vitamin A deficiency commonly results in ocular alterations such as xerophthalmia (dryness of the conjunctiva), night blindness, and the presence of Bitot's spots, which are keratinized plaques on the conjunctival surface [35].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [35]

  • Advanced vitamin A deficiency can lead to keratomalacia and increased susceptibility to infectious diseases.

    “Advanced deficiency can lead to keratomalacia (corneal softening) and increased susceptibility to infectious diseases.”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [35]

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  1. [8]8. Olson JA. Serum levels of vitamin A and carotenoids as reflectors of nutritional status. J Natl Cancer Inst 1984; 73:1439-44.
  2. [10]10. Stoltzfus RJ, Underwood BA. Breast-milk vitamin A as an indicator of the vitamin A status of women and infants. Bull World Health Organ 1995;73:703-11.
  3. [16]16. Humphrey JH, West KP Jr, Sommer A. Vitamin A deficiency and attributable mortality among under-5- year-olds. Bull World Health Organ 1992;70:225-32.
  4. [18]18. Goodman T, Dalmiya N, de Benoist B, Schultink W. Polio as a platform: using national immunization days to deliver vitamin A supplements. Bull World Health Organ 2000;78:305-14.
  5. [20]20. Fawzi WW, Herrera MG, Willett WC, Nestel P, el Amin A, Mohamed KA. Dietary vitamin A intake and the incidence of diarrhea and respiratory infection among Sudanese children. J Nutr 1995;125:1211-21.
  6. [30]30. Stephensen CB. Vitamin A, infection, and immune func- tion. Annu Rev Nutr 2001;21:167-92.
  7. [41]41. Galan P, Samba C, Luzeau R, Amedee-Manesme O. Vita- min A deficiency in pre-school age Congolese children during malarial attacks. Part 2: impact of parasitic dis- ease on vitamin A status. Int J Vitam Nutr Res 1990;60: 224-8.
  8. [49]49. The Vitamin A and Pneumonia Working Group. Potential interventions for the prevention of childhood pneumonia in developing countries: a meta-analysis of data from field trials to assess the impact of vitamin A supplementation on pneumonia morbidity and mortal- ity. Bull World Health Organ 1995;73:609-19.
  9. [63]63. Ramakrishnan U, Latham MC, Abel R. Vitamin A sup- plementation does not improve growth of preschool children: a randomized, double-blind field trial in south India. J Nutr 1995;125:202-11.
  10. [76]76. Fawzi WW, Chamers TC, Herrera MG, Mosteller F. Vitamin A supplementation and child mortality: a meta-analysis. JAMA 1993;269:898-903.
  11. [88]88. Shaul PW. Maternal vitamin A administration and the fetal ductus arteriosus. Pediatr Res 2001;49:744-6.
  12. [91]91. West KP Jr. Vitamin A deficiency in the first six months of life. In: Delange F, West KP Jr, eds. Nestle Nutrition Workshop Series Pediatric Program, vol 52. Philadelphia: Lippincott, Williams & Wilkins 2003;103-27.
  13. [105]105. West KP Jr. Preventing vitamin A deficiency: translat- ing science to action. In: Black RE, Michaelsen KF, eds. Public Health Issues in Infant and Child Nutrition. Nestle Nutrition Workshop Series, Pediatric Program, Nestec Ltd. Philadelphia: Lippincott Williams & Wilkins, 2002;48:71-96.
  14. [107]107. West KP Jr, Sommer A. Delivery of oral doses of vitamin A to prevent vitamin A deficiency and nutritional blindness: a state-of-the-art review. Nutrition Policy Discussion Paper No 2. Rome, Italy: United Nations Administrative Committee on Coordination, Subcommittee on Nutrition, revised 1992.
  15. [114]114. Solon FS, Solon MS, Mehansho H, West KP Jr, Sarol J, Perfecto C, Nano T, Sanchez L, Isleta M, Wasantwisut E, Sommer A. Evaluation of the effect of vitamin A forti- fied margarine on the vitamin A status of preschool Filipino children. Eur J Clin Nutr 1996;50:720-3.

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Authors
West, K. P.
Affiliations
Johns Hopkins University (US)
Corresponding author
West, Keith P.
ORCID
West, Keith P.
Venue
Food and Nutrition Bulletin
Publisher
SAGE Publications
Published
2003-01
Volume
24
Issue
4_suppl_1
Pages
S78-S90
ISSN
  • 0379-5721 (ISSN-L)
  • 1564-8265
DOI
10.1177/15648265030244s104
OpenAlex
W2212452382
Cited by
175
References
95
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 15 · 2022: 11 · 2021: 11 · 2020: 17 · 2019: 9 · 2018: 8 · 2017: 8 · 2016: 3 · 2015: 5 · 2014: 9 · 2013: 11 · 2012: 7
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Food and Nutrition Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • United States Agency for International Development (HRN-A-00-97-00015-00)
  • Bill and Melinda Gates Foundation (HRN-A-00-97-00015-00)
  • Johns Hopkins University (HRN-A-00-97-00015-00)
  • Johns Hopkins Bloomberg School of Public Health
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
Keywords
vitamin A deficiency, xerophthalmia, night blindness, preschool children, pregnant women, lactating women, infant mortality, child mortality, vitamin A supplementation, infectious morbidity, host resistance to infection, maternal mortality, developing countries
MeSH terms
Adolescent, Adult, Child, Child, Preschool, Developing Countries, Female, Growth, Humans, Infant, Infant, Newborn, Male, Night Blindness, Pregnancy, Pregnancy Complications, Reproduction, Vitamin A, Vitamin A Deficiency, Global Health, Xerophthalmia, Prevalence, Cost of Illness

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