Vitamin A supply to mothers and children: challenges and opportunities.

PURPOSE OF REVIEW: Although we are close to the centennial of the discovery of vitamin A, our understanding of the functions of this major micronutrient is still evolving. Given its major role in fetal development, growth, vision, immunity and survival, a subtle balance is required between adequate intake to avoid deficiency and excessive intake to avoid toxicity, both in low income and industrialized countries.

RECENT FINDINGS: This review highlights the potential impact of vitamin A supplementation (VAS) in mothers and children suffering from vitamin A deficiency (VAD) on mortality and morbidities, and warns against the increasingly frequent use of bariatric surgery especially to treat severely obese childbearing women, which is known to alter vitamin A status.

SUMMARY: Despite massive vitamin A supplementation public health policies in developing countries, the burden of VAD is still common and efforts should be maintained to better target populations at risk, and to develop alternative strategies for supplementation based on sustainable and integrated approaches. In industrialized countries, VAD due to insufficient intake is scarce, but it may surprisingly occur due to the decreased absorption of lipids following antiobesity treatments. Specific approaches should be developed to better monitor and supplement obese childbearing women who have undergone bariatric surgery.