title: Vitamin A in pediatrics: An update from the Nutrition Committee of the French Society of Pediatrics.
abstract: Vitamin A (retinol) fulfills multiple functions in vision, cell growth and differentiation, embryogenesis, the maintenance of epithelial barriers and immunity. A large number of enzymes, binding proteins and receptors facilitate its intestinal absorption, hepatic storage, secretion, and distribution to target cells. In addition to the preformed retinol of animal origin, some fruits and vegetables are rich in carotenoids with provitamin A precursors such as β-carotene: 6μg of β-carotene corresponds to 1μg retinol equivalent (RE). Carotenoids never cause hypervitaminosis A. Determination of liver retinol concentration, the most reliable marker of vitamin A status, cannot be used in practice. Despite its lack of sensitivity and specificity, the concentration of retinol in blood is used to assess vitamin A status. A blood vitamin A concentration below 0.70μmol/L (200μg/L) indicates insufficient intake. Levels above 1.05μmol/L (300μg/L) indicate an adequate vitamin A status. The recommended dietary intake increases from 250μg RE/day between 7 and 36 months of age to 750μg RE/day between 15 and 17 years of age, which is usually adequate in industrialized countries. However, intakes often exceed the recommended intake, or even the upper limit (600μg/day), in some non-breastfed infants. The new European regulation on infant and follow-on formulas (2015) will likely limit this excessive intake. In some developing countries, vitamin A deficiency is one of the main causes of blindness and remains a major public health problem. The impact of vitamin A deficiency on mortality was not confirmed by the most recent studies. Periodic supplementation with high doses of vitamin A is currently questioned and food diversification, fortification or low-dose regular supplementation seem preferable.
authors.affiliation: Université de Lorraine, 54000 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Vidailhet
authors.affiliation: Université Montpellier-1, 34000 Montpellier, France.
authors.forename: D
authors.initials: D
authors.lastname: Rieu
authors.affiliation: Université de Lorraine, 54000 Nancy, France.
authors.forename: F
authors.initials: F
authors.lastname: Feillet
authors.affiliation: Université de Franche-Comté, 25000 Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bocquet
authors.affiliation: Service de pédiatrie, université de Lausanne, CHUV, CH-1011 Lausanne, Switzerland.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chouraqui
authors.affiliation: Université Nantes-Atlantique, 44000 Nantes, France.
authors.forename: D
authors.initials: D
authors.lastname: Darmaun
authors.affiliation: Université Paris Descartes, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.affiliation: Cabinet de pédiatrie, 81000 Albi, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Frelut
authors.affiliation: Université Pierre et Marie Curie-Paris 6, 75006 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Girardet
authors.affiliation: Université de Tours, Inserm U1069, Tours, France.
authors.forename: R
authors.initials: R
authors.lastname: Hankard
authors.affiliation: Université Nantes-Atlantique, 44000 Nantes, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Rozé
authors.affiliation: Service de pédiatrie, université de Lausanne, CHUV, CH-1011 Lausanne, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Siméoni
authors.affiliation: Université Lille 2, LIRIC-Inserm U995, 59000 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Turck
authors.affiliation: Institut de recherche pour le développement, 44, boulevard de Dunkerque, 13572 Marseille, France. Electronic address: andre.briend@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Briend
mesh_terms: D000293:Adolescent; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005060:Europe; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008099:Liver / Q000378:metabolism; D008297:Male; D009751:Nutritional Requirements; D012016:Reference Values; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000175:diagnosis* / Q000628:therapy
chemical_list: D014801:Vitamin A