Vitamin A deficiency -Health tips fit - health tips fit

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Thursday, 18 June 2020

Vitamin A deficiency -Health tips fit

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Vitamin A
Vitamin A (Vit A) deficiency refers to all forms of the body and any degree of Vit A deficiency, including clinical Vit A deficiency, subclinical Vit A deficiency and suspected subclinical Vit A deficiency (or marginal Vit A lack of). At present, the prevalence of Vit A deficiency in preschool children is about 190 million, and that of pregnant women is about 19 million. Most of them come from developing countries such as Africa and Southeast Asia. Vit A deficiency in preschool children in my country is 9% to 11%, and suspected subclinical Vit A deficiency is 30% to 40%. In 2000, 2005 and 2008, the research group investigated the incidence of suspected subclinical Vit A deficiency in the suburbs of Chongqing, which were 42.50%, 26.00% and 22.64% [1,2,3]. Infants, children, and pregnant women are all Vit A susceptible people [4]. Vit A deficiency not only affects children's visual function and growth, but also impairs immune function and leads to various diseases. It is one of the most important nutritional influencing factors for serious infection and death of children in developing countries, and has been included in the UN Millennium Development Goals One of the key to eliminate diseases. Nutrient supplementation is currently recognized as an effective way to improve nutritional deficiency diseases. Therefore, the safe and effective prevention and treatment of Vit A deficiency is of great significance. Based on the Vit A supplementary intervention plan developed by WHO and the International Vit A Advisory Group (IVACG), combined with the research results of the research group in the past 20 years and the relevant research progress at home and abroad, Vit A lacks a diagnosis, prevention and treatment plan.

Vit A source and recommended dietary intake
There are two main sources of Vit A, one is retinyl esters of animal foods, such as milk, eggs and animal offal, and the other is carotenoids that can become the original Vit A in plant foods ( carotenoid), of which β-carotene has the highest Vit A activity and is rich in dark vegetables and fruits, and its ratio in the intestine to Vit A is 6:1.The recommended dietary intake .


Medical history
High-risk factors for Vit A deficiency:
(1)   Insufficient storage:
 premature infants, twin fetuses, low birth weight infants, etc., insufficient Vit A storage in the body, rapid growth and development are prone to Vit A deficiency.
(2)  intake and increased demand:
A 24-hour dietary intake review method was used to investigate children’s dietary intake of Vit A, focusing on the four types of foods including vegetables, fruits, animal foods and fortified foods. Such as infants with insufficient breast milk or no breast milk for long-term feeding with simple starch-based foods, or after weaning, give skimmed milk, condensed milk, supplementary foods are scarce, animal foods and β-carotene-rich vegetables and fruits intake is low.
(2)   Malabsorption:
 Various digestive diseases, such as chronic dysentery, chronic hepatitis, enteritis, congenital biliary obstruction, etc. or dietary fat is too low to affect the absorption of Vit A and β-carotene.

Clinical manifestations
The clinical manifestations of Vit A deficiency are closely related to the stage and degree of deficiency. According to the presence or absence of ocular symptoms and signs, it is divided into clinical Vit A deficiency and subclinical Vit A deficiency. The clinical Vit A deficiency manifests itself as eye and skin manifestations. Night blindness is the earliest clinical manifestation of human Vit A deficiency. Patients with night blindness have reduced vision at night and reduced dark adaptation ability, mainly in older children. Vit A's continued lack, especially infants and young children who are malnourished, can produce dry eye disease. Skin lesions are another important manifestation of Vit A deficiency. The main changes in the skin are keratinization of the hair follicles and dry skin, both of which can occur independently or coexist. The early manifestations of Vit A deficiency include atrophy, dryness, and loss of cilia in the mouth, throat, respiratory tract, and urogenital tract, which reduces its ability to resist infection. If Vit A is insufficiently ingested for a long time, the skin will become dry and rough, the hair follicles will be hyperkeratotic, and the skin will look like chicken skin. It will first occur on the upper arm, thigh, shoulder and back skin.

In recent years, it has been recognized that subclinical and marginal Vit A deficiency is significantly associated with increased morbidity and mortality in children In endemic areas, dietary Vit A intake  repeated respiratory tract, Diagnosis of gastrointestinal and urinary tract infections and anemia, etc., eye examination can find damage to the function of retinal rod cells, corneal and conjunctival changes. It has also recently been found to have a significant relationship with children's brain development. Clinically, it is mainly diagnosed by supplementing Vit A improve its corresponding symptoms .



  Vit A deficiency prevention
(1) Primary prevention:
 For health education, the daily intake of Vit A in the diet should reach  Breastfeeding is promoted, and Vit A and vitamin D should be added in time 15 days after the child is born, and children who are under- or without breast milk should be instructed to consume formula milk powder. Carry out prevention in high-risk areas where Vit A lacks epidemic or suspected subclinical Vit A lacks a large number of high-risk areas and other serious infectious diseases such as measles, diarrhea, respiratory diseases, chickenpox, or protein-energy malnutrition Sexual Vit A supplementation, the specific supplementation 
(2) Secondary prevention:
 For early suspicious cases, further RDR test, dark adaptation detection, etc. For subclinical and marginal Vit A deficiency, in addition to increasing the intake of Vit A and β-carotene in the diet, and actively treating the original nutritional deficiency diseases and other chronic disease.
Vit A deficiency treatment
Regardless of whether the clinical symptoms are serious or subclinical Vit A deficiency without obvious symptoms, supplemental treatment of Vit A should be performed as soon as possible, because most pathological changes may be reversed and recovered after treatment. The lack of Vit A in pregnant women has a serious impact on the fetus and should be supplemented. However, due to the teratogenic effect of high-dose Vit A in early pregnancy, special attention should be paid to pregnant women with dry eye disease. Women of childbearing age with severe dry eye disease are given full treatment regardless of whether they are pregnant or not. In case of vomiting or malabsorption, intramuscular injection of Vit A is given.

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