“ Vitamin A “

In Children
Benefit Versus Risk

Presentation
By
‫هديل مصطفى طلحه & مروة علي أبوالخيرات‬
Pharmaceutical College
Tripoli University
September 2022
Definition

• What is a “Vitamin” ?

• Is organic molecules or set of molecules closely related chemically i.e. Vitamers.

• They are essential micronutrient for humans for proper functioning of its metabolism.

• What is a “Vitamin A” ?
• It is a group of Organic compounds that includes:-
• 1) Retinol ,Retinal also known as Retinaldehyde, Retinoic acid (RA).
• 2) Several provitamin A Carotenoids mainly Beta-carotene.

• “Vitamin A” is a fat-soluble vitamin.

N.B:- (a category that also includes vitamins D, E and K)
“Vitamin A”- Retinol Chemical and physical data:-
Structure :-

Formula :-
C20H30O

Melting Point :- 62-64 C

Boiling Point :- 137-138 C

 “Vitamin A" occurs:-

Two principal forms in foods:-

A) Retinol, found in animal-sourced foods.

B) Provitamin A as Carotenoids Alpha carotene ,B-Carotene, Gamma

Carotene,(all of which contain B– iononer rings) that function as
provitamin A in herbivore animals which possess the enzymes that
cleave and convert provitamin carotenoids to retinal and then to
retinol.
 “Vitamin A” Sources

Food Retinol Micrograms per 100 g

Cod liver Oil 30000
Beef Liver (cooked) 21145
Chicken liver (Cooked) 4296
Butter 684
Cheddar Cheese 316
Egg (Cooked) 140
Dietary recommendations
US RDAs or AIs US Upper limits
Life stage group
(μg RAE/day) (μg/day)
0–6 months 400 (AI) 600
Infants
7–12 months 500 (AI) 600
1–3 years 300 600
Children
4–8 years 400 900
9–13 years 600 1700
Males 14–18 years 900 2800
>19 years 900 3000
9–13 years 600 1700
Females 14–18 years 700 2800
>19 years 700 3000
<19 years 750 2800
Pregnancy
>19 years 770 3000
<19 years 1200 2800
Lactation
>19 years 1300 3000
Absorption, Metabolism and Excretion

• A) Dietary Retinol is absorbed from digestive tract via passive diffusion.

• B) B-Carotene is taken up by enterocytes by membrane transporter protein scavenger

receptor B1.

• Retinol Stored in lipid droplets in the liver.

• Excreted in urine and faeces.
“ Vitamin A” function in General(Benefits):-

1)Essential for Vision and Eye health.

2)Essential for Gene regulation.

3)Essential for Embryo development and growth.

4)Essential for Immune function.

5)Essential for Skin.

1)Essential for Vision and Eye health(Benefit)

• “Vitamin A” status involves eye health via two separate functions:-

A) Retinal is an essential factor in rod cells and cone cells in the retina responding to light

exposure by sending nerve signals to the brain.

An early sign of “vitamin A” deficiency is night blindness.

B) “Vitamin A” in the form of Retinoic acid is essential to normal epithelial cell functions.
Severe vitamin A deficiency, is characterized by dryness of the conjunctival epithelium
and cornea. Untreated, xerophthalmia progresses to corneal ulceration and childhood
blindness.
 How Vision get Benefit ?
• The role of vitamin A in the visual cycle is specifically related to the retinal compound.

• Retinol is converted by the enzyme RPE65 within the retinal pigment epithelium into 11-
cis-retinal.
• Within the eye, 11-cis-retinal is bound to the protein Opsin to form rhodopsin in rod cells
and iodopsin in cone cells.
• As light enters the eye, the 11-cis-retinal is isomerized to the all-trans form.
• The all-transretinal dissociates from the opsin in a series of steps called photo-bleaching.
• This isomerization induces a nervous signal along the optic nerve to the visual center of
the brain.
• After separating from opsin, the all-trans retinal is recycled and converted back to the 11-
cis-retinal form by a series of enzymatic reactions.
• which then completes the cycle by binding to opsin to reform rhodopsin in the retina.
Vitamin A deficiency (Risk)

• Vitamin A deficiency can affect Vision cause:-

1) Night Blindness(Nyctalopia)
Reversible ,Early changes

2) Childhood Blindness (Xerophthalmia)

Irreversible, in Sever deficiency ,if not treated early.
1) Night Blindness(Nyctalopia)

• “Vitamin A “ Deficiency (VAD)-(Risk) caused Night Blindness is a reversible

difficulty for the eyes to adjust to dim light.
• It is common in young children who have a diet inadequate in retinol(animal
source) and beta-carotene(Vegetable source).
• A process called Dark adaptation typically causes an increase in photopigment
amounts in response to low levels of illumination. This increases light sensitivity
by up to 100,000 times compared to normal daylight conditions.
• Significant improvement in night vision takes place within ten minutes, but the
process can take up to two hours to reach maximal effect.
• People expecting to work in a dark environment wore red-tinted goggles or were
in a red light environment to not reverse the adaptation because red light does
not deplete rhodopsin versus what occurs with yellow or green light.
2) Childhood Blindness (Xerophthalmia)

• Xerophthalmia, caused by a severe vitamin A deficiency (Risk) is described by

pathologic dryness of the conjunctival epithelium and cornea.
• The conjunctiva becomes dry, thick, and wrinkled. Indicative is the appearance of
Bitot's spots, which are clumps of keratin debris that build up inside the
conjunctiva.

• If untreated, xerophthalmia can lead to dry eye syndrome, Corneal Ulceration and
ultimately to blindness as a result of cornea and retina damage.
“Vitamin A” Deficiency in Children Statistic Data

• “Vitamin A” deficiency is common in developing countries, especially in Sub Saharan

Africa and Southeast Asia.
• Deficiency can occur at any age, but is most common in pre-school-age children and
pregnant women, the latter due to a need to transfer retinol to the fetus.
• The causes are low intake of retinol-containing, animal-sourced foods and low intake of
carotene-containing, plant-sourced foods.
• “Vitamin A” deficiency is estimated to affect approximately one third of children under the
age of five around the world, possibly leading to the deaths of 670,000 children under five
annually.
“Vitamin A” Deficiency in Children Statistic Data

• Between 250,000 and 500,000 children in developing countries become blind each year
owing to vitamin A deficiency.
• “Vitamin A” deficiency is "the leading cause of preventable childhood blindness",
according to. UNICEF.
• It also increases the risk of death from common childhood conditions, such as diarrhoea.
UNICEF regards addressing “vitamin A” deficiency as critical to reducing child mortality,
one of the UNICEF Goals.
 References
1) “Vitamin A” at the US National Library of Medicine. Medical Subject Headings (MeSH).
2) WHO publications on “Vitamin A deficiency.”
3) “Vitamin A” The American Society of Health-System Pharmacists. Archived from the
original on 30 December 2016. Retrieved 8 December 2016.
4) ”Vitamin A Fact sheet for health Professionals“ Office of Dietary Supplements, US
National Institutes of Health. March 2021. Retrieved 8 August 2021.
5) “ Vitamin” Micronutrient Information Center, Linus Pauling Institute, Oregon State
University, Corvallis. 1 July 2016. Retrieved 21 December 2021.
6) Institute of Medicine (2001). “ Vitamin A” Dietary Reference Intakes for Vitamin A,
Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum,
Nickel, Silicon, Vanadium, and Zinc. Food and Nutrition Board of the Institute of Medicine.
pp. 82–161. ISBN 0-309-07290-5.
7) en.Wikipedia,org, Vitamin A Wikipedia.
Thank you