Collaborative research: Some A a day keeps the doctor away: study

Experts say supplements could save 600,000 infants a year in countries like Pakistan.

KARACHI: Researchers at the University of Oxford and Karachi’s Aga Khan University (AKU) have found that vitamin A supplements reduce child mortality from low- and middle-income countries such as Pakistan, by nearly 24 per cent.

The study, published in the online version of the British Medical Journal, reads that the supplements also played a major role in reducing rates of diarrhoea and measles.

The findings are based on 43 trials in which some children were given vitamin A while others received no intervention or a placebo. About 215,633 healthy children between the ages of six months to five years in 19, mostly Asian, countries took part. The average age for children was 2.5 years when they were recruited for the trials which lasted for about a year.

“After just one year, children who had taken supplements were less likely to have died than children who received a placebo,” said lead author Dr Evan Mayo-Wilson of the department of social policy and intervention at the University of Oxford. “We estimate that by providing supplements to all children in countries where they are at risk, we could save up to 600,000 lives a year and prevent millions of serious infections.” The supplements are highly effective and cheap to produce and administer, Wilson added.

Vitamin A is required for the visual and immune systems to function normally. It is an essential nutrient that cannot be made by the human body, therefore, it must be obtained through the diet. Deficiency increases vulnerability to a range of infections, including diarrhoea, measles, malaria and respiratory infections, which are the leading causes of childhood mortality.

According to the World Health Organisation, 190 million under-fives do not get enough Vitamin A.

“This study underlines the need to shift the focus of attention towards an effective scale up of vitamin A supplementation programmes,” said Professor Dr Zulfiqar Bhutta, the chair of Women and Child Health at AKU and the senior corresponding author of the study. “We must ensure that the benefits are sustained with effective oversight by national programmes.”

On the ethical issue of Vitamin A supplements Wilson added, “Recent editorials criticising Vitamin A programmes have received international attention, but the evidence taken as a whole leaves little doubt that [it] prevents early childhood mortality.” The largest clinical trial ever conducted ran from 1999 to 2004 and assigned about 1,000,000 children to receive Vitamin A or a placebo. Since that trial began, only one relatively small trial has examined Vitamin A for childhood mortality.

Vitamin A is found in plants, such as the orange-fleshed sweet potato, eggs and dairy products. A high intake of synthetic Vitamin A over a long period may lead to short-term side effects including vomiting. According to the researchers of the study the side effects are rare and taking supplements of vitamin A over relatively short periods, for example, once every six months, should not cause serious adverse effects.

Published in The Express Tribune, August 26^th,  2011.