Vitamin A deficiency rarely occurs in the United States, but the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend vitamin A administration for all children diagnosed with measles in communities where vitamin A deficiency is a serious problem and where death from measles is greater than 1%. In 1994, the American Academy of Pediatrics recommended vitamin A supplements for two subgroups of children likely to be at high risk for subclinical vitamin A deficiency: children aged 6 months to 24 months who are hospitalized with measles, and hospitalized children older than 6 months.¹

Fat malabsorption can result in diarrhea and prevent normal absorption of vitamin A. Over time this may result in vitamin A deficiency. Those conditions include:

• Celiac disease:
  Often referred to as sprue, celiac disease is a genetic disorder. People with celiac disease become sick when they eat a protein called gluten found in wheat and some other grains. In celiac disease, gluten can trigger damage to the small intestine, where most nutrient absorption occurs. Approximately 30% to 60% of people with celiac disease have gastrointestinal-motility disorders such as diarrhea.² They must follow a gluten-free diet to avoid malabsorption and other symptoms.
• Crohn's disease:
  This inflammatory bowel disease affects the small intestine. People with Crohn's disease often experience diarrhea, fat malabsorption, and malnutrition.³
• Pancreatic disorders:
  Because the pancreas secretes enzymes that are important for fat absorption, pancreatic disorders often result in fat malabsorption.⁴ ((Bell CS, Shepherd RW. Editorial: Optimising nutrition in cystic fibrosis. J Cyst Fibros 2002;1:47-50.)) Without these enzymes, it is difficult to absorb fat. Many people with pancreatic disease take pancreatic enzymes in pill form to prevent fat malabsorption and diarrhea.

Healthy adults usually have a reserve of vitamin A stored in their livers and should not be at risk of deficiency during periods of temporary or short-term fat malabsorption. Long-term problems absorbing fat, however, may result in deficiency. In these instances physicians may recommend additional vitamin A.⁵

Vegetarians who do not consume eggs and dairy foods need provitamin A carotenoids to meet their need for vitamin A.⁶ They should include a minimum of five servings of fruits and vegetables in their daily diet and regularly choose dark green leafy vegetables and orange and yellow fruits to consume recommended amounts of vitamin A.

 Email This Page  Print This Page

1. Committee on Infectious Diseases. Vitamin A treatment of measles. Pediatrics 1993;91:1014-5. [PubMed abstract] [↩]
2. Tursi A. Gastrointestinal motility disturbances in celiac disease. J Clin Gastroenterol 2004;38:642-5. [↩]
3. Krok KL, Lichtenstein GR. Nutrition in Crohns disease. Curr Opin Gastroenterol 2003;19:148-53. [↩]
4. Kiehne K, Gunther R, Folsch U. Malnutrition, steatorrhoea and pancreatic head tumour. Eur J Gastroenterol Hepatol 2004;16:711-3. [↩]
5. Ross DA. Vitamin A and public health: Challenges for the next decade. Proc Nutr Soc 1998;57:159-65. [PubMed abstract] [↩]
6. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press, Washington, DC, 2001. [↩]