IT’s a presentation on Vitamin IT’s a presentation on Vitamin AA byby

AVIJIT ROYAVIJIT ROY

INTRODUCTIONVitamin A is a group of compounds that play an important role in vision, bone growth, reproduction, cell division, and

cell differentiation (in which a cell becomes part of the brain, muscle, lungs, blood, or other specialized tissue.) [1-

5]. Vitamin A helps regulate the immune system, which helps prevent or fight off infections by making white blood

cells that destroy harmful bacteria and viruses [1,6-10]. Vitamin A also may help lymphocytes (a type of white

blood cell) fight infections more effectively

.

Vitamin A can be found in two Vitamin A can be found in two principal forms in foods:principal forms in foods:

Retinol, Retinol, the form of vitamin A absorbed when eating the form of vitamin A absorbed when eating animal food sources, is a yellow, fat-soluble animal food sources, is a yellow, fat-soluble substancesubstance

CaroteneCarotene is an orange photosynthetic pigment is an orange photosynthetic pigment important for photosynthesis. They are responsible important for photosynthesis. They are responsible for the orange colour of the carrot, for which this for the orange colour of the carrot, for which this class of chemicals is named, and for the colours of class of chemicals is named, and for the colours of many other fruits and vegetables (for example, sweet many other fruits and vegetables (for example, sweet potatoes and orange cantaloupe melon.potatoes and orange cantaloupe melon.

UNITS OF MESUREMENT UNITS OF MESUREMENT 1 RE = 1 mcg. of retinol1 RE = 1 mcg. of retinol1 RE = 6 mcg. of beta-carotene1 RE = 6 mcg. of beta-carotene1 RE = 3.333 U.I of vitamin A1 RE = 3.333 U.I of vitamin A

Intake Recommended Dietary Allowance (RDA) for the French population. RE per day

Babies 0 to 1 years - 350Children 1 to 3 years - 400Children 4 to 6 years - 450Children 7 to 9 years - 500Children 10 to 12 years - 550Teenager boy 13 to 15 - 700Teenager girl13 to 15 - 600Teenager boy 16 to 19 - 800Teenager girl 16 to 19 - 600Men - 800Women - 600Pregnant women- 700Nursing mother- 950

Vitamin A is found naturally in many Vitamin A is found naturally in many foods:foods:

Liver (beef, pork, chicken, turkey, fish) (6500 μg), including cod liver oilLiver (beef, pork, chicken, turkey, fish) (6500 μg), including cod liver oil Carrot (835 μg)Carrot (835 μg) Broccoli leaf (800 μg) - According to USDA database broccoli florets Broccoli leaf (800 μg) - According to USDA database broccoli florets

have much less.[10]have much less.[10] Sweet Potato (709 μg 79)Sweet Potato (709 μg 79) Butter (684 μg)Butter (684 μg) Spinach (469 μg)Spinach (469 μg) Pumpkin (400 μg)Pumpkin (400 μg) Cheddar cheese (265 μg)Cheddar cheese (265 μg) Cantaloupe melon (169 μg)Cantaloupe melon (169 μg) Egg (140 μg)Egg (140 μg) Papaya (55 μg)Papaya (55 μg) Mango (38 μg)Mango (38 μg) Pea (38 μg)Pea (38 μg) Milk (28 μg)Milk (28 μg)

Vitamin A plays a role in a variety of Vitamin A plays a role in a variety of functions throughout the body, such as:functions throughout the body, such as: VisionVision Gene transcriptionGene transcription Immune functionImmune function Embryonic development and reproductionEmbryonic development and reproduction Bone metabolismBone metabolism HaematopoiesisHaematopoiesis Skin healthSkin health Antioxidant activityAntioxidant activity

Vitamin A deficiencyVitamin A deficiency Deficiency symptomsDeficiency symptoms Skin (dry or rough skin) & Skin (dry or rough skin) & eyes (red and itchy eyes) problemseyes (red and itchy eyes) problems Night blindnessNight blindness Problem in bone growthProblem in bone growth Weak tooth enamelWeak tooth enamel Low infections resistanceLow infections resistance Digestive problem (kidney stones, Digestive problem (kidney stones, diarrhea, loss of appetite diarrhea, loss of appetite

Vitamin A SupplementationVitamin A Supplementation

Global efforts to support national governments in Global efforts to support national governments in addressing vitamin a deficiency are led by the Global addressing vitamin a deficiency are led by the Global Alliance for Vitamin A (GAVA), which is an informal Alliance for Vitamin A (GAVA), which is an informal partnership between A2Z, the Canadian International partnership between A2Z, the Canadian International Development Agency, Helen Keller International, the Development Agency, Helen Keller International, the Micronutrient Initiative, UNICEF, USAID, and the World Micronutrient Initiative, UNICEF, USAID, and the World Bank. Joint GAVA activity is coordinated by the Bank. Joint GAVA activity is coordinated by the Micronutrient Initiative.Micronutrient Initiative.

While strategies include intake of vitamin A through a While strategies include intake of vitamin A through a combination of breast feeding and dietary intake, delivery combination of breast feeding and dietary intake, delivery of high-dose supplements remains the principal strategy for of high-dose supplements remains the principal strategy for controlling vitamin A deficiency. Studies have shown that controlling vitamin A deficiency. Studies have shown that vitamin A supplementation of children under five who are vitamin A supplementation of children under five who are at risk of vitamin A deficiency can reduce all‐cause at risk of vitamin A deficiency can reduce all‐cause mortality by 23 per cent.mortality by 23 per cent.

ToxicityToxicity Since vitamin A is fat-soluble, Since vitamin A is fat-soluble,

disposing of any excesses taken in disposing of any excesses taken in through diet is much harder than through diet is much harder than with water-soluble vitamins B and with water-soluble vitamins B and C, thus vitamin A toxicity may C, thus vitamin A toxicity may result. This can lead to nausea, result. This can lead to nausea, jaundice, irritability, anorexia (not jaundice, irritability, anorexia (not to be confused with anorexia to be confused with anorexia nervosa, the eating disorder), nervosa, the eating disorder), vomiting, blurry vision, headaches, vomiting, blurry vision, headaches, hair loss, muscle and abdominal hair loss, muscle and abdominal pain and weakness, drowsiness, and pain and weakness, drowsiness, and altered mental status.altered mental status.

Vitamin A and derivatives in medical Vitamin A and derivatives in medical useuse

Retinyl palmitate has been used in skin Retinyl palmitate has been used in skin cremes, where it is broken down to retinoic cremes, where it is broken down to retinoic acid, which has potent biological activity, as acid, which has potent biological activity, as described above.described above.

The retinoids, (for example, 13-cis-retinoic The retinoids, (for example, 13-cis-retinoic acid) constitute a class of chemical compounds acid) constitute a class of chemical compounds that are related chemically to retinoic acid, and that are related chemically to retinoic acid, and used in medicine to modulate gene functions used in medicine to modulate gene functions in place of this compound. in place of this compound.

AIMS&OBJECTIVES OF VITAMIN AAIMS&OBJECTIVES OF VITAMIN A

Aim: The overarching aim of WHO's work in Aim: The overarching aim of WHO's work in nutrition, spearheaded by the Department of Nutrition nutrition, spearheaded by the Department of Nutrition for Health and Development (NHD), is to prevent, for Health and Development (NHD), is to prevent, reduce and eliminate malnutrition worldwide, reduce and eliminate malnutrition worldwide, (especially protein-energy malnutrition; iodine, (especially protein-energy malnutrition; iodine, vitamin A, and iron deficiencies; obesity and diet-vitamin A, and iron deficiencies; obesity and diet-related diseases; other specific deficiency diseases), related diseases; other specific deficiency diseases), and promote sustainable health and nutritional well-and promote sustainable health and nutritional well-being of all people, thereby reinforcing and being of all people, thereby reinforcing and accelerating human and national development.accelerating human and national development.

Objective 1. To strengthen and support the capabilities Objective 1. To strengthen and support the capabilities and effectiveness of Member States for assessing and and effectiveness of Member States for assessing and addressing nutrition, malnutrition, and diet-related addressing nutrition, malnutrition, and diet-related problems, primarily through the development and problems, primarily through the development and implementation of national nutrition policies, programmes implementation of national nutrition policies, programmes and plans of action.and plans of action.

Objective 2. To develop through consultation, research Objective 2. To develop through consultation, research and collaboration, the scientific knowledge base, and collaboration, the scientific knowledge base, methodologies, authoritative standards, norms and methodologies, authoritative standards, norms and criteria, and guidelines and strategies for detecting, criteria, and guidelines and strategies for detecting, preventing and managing all major forms of malnutrition, preventing and managing all major forms of malnutrition, whether of deficiency or excess, for application by Member whether of deficiency or excess, for application by Member StatesStates

The 2 main objectives in support of this aim are:The 2 main objectives in support of this aim are:

REVIEW WORK ON LITERATUREREVIEW WORK ON LITERATURE

Gregg Duester suggested that Gregg Duester suggested that Retinoic acid, a derivative of Retinoic acid, a derivative of vitamin A, is an essential component of cell-cell signaling vitamin A, is an essential component of cell-cell signaling during vertebrate organogenesis.during vertebrate organogenesis. Recent studies suggest Recent studies suggest that retinoic acid may act primarily in a paracrine manner that retinoic acid may act primarily in a paracrine manner and provide insight into the cell-cell signaling networks and provide insight into the cell-cell signaling networks that control differentiation of pluripotent cells.that control differentiation of pluripotent cells.

van Beek ME, Meistrich ML.said that van Beek ME, Meistrich ML.said that in retinol-deficient in retinol-deficient rats maintained on retinoic acid, the permatogonial rats maintained on retinoic acid, the permatogonial population is qualitatively normal, but quantitatively population is qualitatively normal, but quantitatively subnormal, while spermatocyte development is subnormal, while spermatocyte development is qualitatively and quantitatively abnormal.qualitatively and quantitatively abnormal.

Manuela Strobel, Jana Tinz and Hans-Konrad Biesalski Manuela Strobel, Jana Tinz and Hans-Konrad Biesalski informed that informed that Vitamin A is essential for growth and Vitamin A is essential for growth and differentiation of a number of cells and tissues. Notably differentiation of a number of cells and tissues. Notably during pregnancy and throughout the breastfeeding during pregnancy and throughout the breastfeeding period, vitamin A has an important role in the healthy period, vitamin A has an important role in the healthy development of the fetus and the newborn, with lung development of the fetus and the newborn, with lung development and maturation being particularly important. development and maturation being particularly important. The German Nutrition Society (DGE) recommends a 40% The German Nutrition Society (DGE) recommends a 40% increase in vitamin A intake for pregnant women and a increase in vitamin A intake for pregnant women and a 90% increase for breastfeeding women.90% increase for breastfeeding women.

Schulz C, Engel U, Kreienberg R, Biesalski HK. given a Schulz C, Engel U, Kreienberg R, Biesalski HK. given a conception that an adequate supply of vitamin A during conception that an adequate supply of vitamin A during pregnancy and breastfeeding plays an important role for pregnancy and breastfeeding plays an important role for development of foetus and neonate, especially in lung development of foetus and neonate, especially in lung development and function.development and function.

Am J Clin Nutr. 2006 Aug;84(2):462; author reply Am J Clin Nutr. 2006 Aug;84(2):462; author reply 462-3. 462-3. noticed that the acute and chronic effects of noticed that the acute and chronic effects of vitamin A toxicity are well documented in the vitamin A toxicity are well documented in the literature. Emerging evidence suggests that literature. Emerging evidence suggests that subtoxicity without clinical signs of toxicity may be a subtoxicity without clinical signs of toxicity may be a growing concern, because intake from preformed growing concern, because intake from preformed sources of vitamin A often exceeds the recommended sources of vitamin A often exceeds the recommended dietary allowances (RDA) for adults, especially in dietary allowances (RDA) for adults, especially in developed countries. developed countries.

Am J Clin Nutr. 2006 Aug;84(2):462; author reply Am J Clin Nutr. 2006 Aug;84(2):462; author reply 462-3.462-3.said that Pseudotumor cerebri (PTC) is a said that Pseudotumor cerebri (PTC) is a syndrome of increased intracranial pressure without syndrome of increased intracranial pressure without hydrocephalus or mass lesion and with normal hydrocephalus or mass lesion and with normal cerebrospinal fluid (CSF) composition. cerebrospinal fluid (CSF) composition.

Forsmo S, Fjeldbo SK, Langhammer AForsmo S, Fjeldbo SK, Langhammer A. gave a concept that . gave a concept that

Use of cod liver oil, which is rich in vitamins A and D, is Use of cod liver oil, which is rich in vitamins A and D, is traditionally recommended during the fall and winter months traditionally recommended during the fall and winter months as a protective measure against vitamin D deficiency in as a protective measure against vitamin D deficiency in several countries.several countries.

Sale TA, Stratman E. Sale TA, Stratman E. discovered Carotenemia is a condition discovered Carotenemia is a condition characterized by yellow discoloration of the skin and elevated characterized by yellow discoloration of the skin and elevated blood carotene levels.blood carotene levels.

Nishimura Y, Ishii N, Sugita Y, Nakajima H.Nishimura Y, Ishii N, Sugita Y, Nakajima H. informed informed Carotenodermia may arise from excessive dietary intake of Carotenodermia may arise from excessive dietary intake of carotene containing foods. We reported a 22-year-old woman carotene containing foods. We reported a 22-year-old woman who had eaten excessive amount of carotene-rich seaweed to who had eaten excessive amount of carotene-rich seaweed to lose weight. Her skin color changed to orange-yellow, and her lose weight. Her skin color changed to orange-yellow, and her serum beta-carotene was 573 micrograms/dl. After stopping serum beta-carotene was 573 micrograms/dl. After stopping

the ingestion of seaweed, her skin color returned to normalthe ingestion of seaweed, her skin color returned to normal. .

REFERENCEREFERENCE

Carolyn Berdanier. 1997. Advanced Nutrition Micronutrients. CRC Carolyn Berdanier. 1997. Advanced Nutrition Micronutrients. CRC Press, ISBN 0849326648, pp. 22-39Press, ISBN 0849326648, pp. 22-39

a b Wolf, George (2001-04-19). "Discovery of Vitamin A". a b Wolf, George (2001-04-19). "Discovery of Vitamin A". Encyclopedia of Life Sciences. doi:10.1038/npg.els.0003419.Encyclopedia of Life Sciences. doi:10.1038/npg.els.0003419.

Composition of Foods Raw, Processed, Prepared USDA National Composition of Foods Raw, Processed, Prepared USDA National Nutrient Database for Standard Reference, Release 20 USDA, Feb. Nutrient Database for Standard Reference, Release 20 USDA, Feb. 20082008

a b Chapter 4, Vitamin A of Dietary Reference Intakes for Vitamin A, a b Chapter 4, Vitamin A of Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, Food Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, Food and Nutrition Board of the Institute of Medicine, 2001and Nutrition Board of the Institute of Medicine, 2001

Solomons, NW; Orozco, M (2003). "Alleviation of vitamin A Solomons, NW; Orozco, M (2003). "Alleviation of vitamin A deficiency with palm fruit and its products.". Asia Pacific journal of deficiency with palm fruit and its products.". Asia Pacific journal of clinical nutrition 12 (3): 373-84. PMID 14506004. clinical nutrition 12 (3): 373-84. PMID 14506004. http://www.healthyeatingclub.org/APJCN/volume12/vol12.3/fullArticlhttp://www.healthyeatingclub.org/APJCN/volume12/vol12.3/fullArticles/SolomonsVit.pdf. es/SolomonsVit.pdf.