Why do you need it?
You need vitamin A for healthy skin and mucus membranes – the protective layers that line parts of your ear, nose, throat, digestive tract etc. It’s also very important for your immune system, eye health and vision.
For people who want to have a baby, vitamin A is essential for keeping your reproductive system healthy, in both men and women, and for the normal development of the baby during pregnancy. In infants and children, vitamin A is needed for growth and development and helps them fight off infection. Vitamin A and beta-carotene (which is turned into vitamin A in the body), are antioxidants, protecting your cells and DNA from damage linked to heart disease, cancer and other diseases.
Deficiency
Symptoms of deficiency include night blindness, frequent and persistent skin infections, mouth ulcers, thrush or cystitis, dandruff and dry hair, dry eyes and sore eyelids. In children, deficiency is the leading cause of preventable blindness, it inhibits growth and weakens the immune system increasing the risk of illness and death from childhood infections such as measles and those causing diarrhoea.
In 2005, almost one in three (28 per cent) of Ugandan preschool children suffered from vitamin A deficiency. This number may have fallen in recent years for two reasons; people are eating more foods that contain vitamin A (or beta-carotene) and the reach of vitamin A supplement programmes has increased. However, there is more improvement to be made. Find out below what the difference is between vitamin A (retinol) and beta-carotene and why beta-carotene is safer.
What’s the difference between retinol and beta-carotene? Click to read more…
Vitamin A can be found in food, either as preformed vitamin A (also called retinol) in animal products such as eggs and dairy products, or as ‘provitamin A’ (mainly beta-carotene) in plant foods such as green leafy and yellow-coloured vegetables and orange-coloured fruit. Your body converts beta-carotene (and other carotenes) from food into vitamin A. Carotene (or retinol made from it), is also added to some oils, margarine and fat spreads. It was first discovered in carrots, hence the name.
High intakes of vitamin A from animal foods, such as oily fish, liver or supplements can be toxic and have been linked to birth defects – hence can be dangerous if eaten in pregnancy. Excess vitamin A from animal sources may also cause weaker bones, which is of particular concern to middle-aged and older people. Adverse side effects have been seen with regular vitamin A daily intakes of over 1.5 milligrams – easy to reach if you eat liver more than once a week or take a fish liver oil supplement. Your body only converts as much beta-carotene (and other carotenes) from plant foods into vitamin A as it needs and simply stops converting it when there’s enough. So, beta-carotene from plant foods is a safer source of vitamin A.
How much do you need?
The World Health Organisation’s (WHO) ‘safe intake’ is simply how much you need to avoid symptoms of deficiency and to allow for normal growth. If you have suffered from frequent or long periods of infections or other health problems, you may need more. The safe intake for vitamin A in adults, WHO says, is 500 micrograms (μg) for women and 600 micrograms for men. The safe intake levels for infants, children and adolescents, as well as pregnant and lactating women are given below.
The vitamin A content of a food is usually expressed as micrograms (µg) of retinol equivalents (RE). Click to read more…
| Age group | Recommended safe intake (μg RE/day) |
|---|---|
| Infants and children | |
| 0-6 months | 375 |
| 7-12 months | 400 |
| 1-3 years | 400 |
| 4-6 years | 450 |
| 7-9 years | 500 |
| Adolescents | |
| 10-18 years | 600 |
| Adults | |
| Females, 19-65 years | 500 |
| Males, 19-65 years | 600 |
| 65+ | 600 |
| Pregnant women | 800 |
| Lactating women | 850 |
Do you need a supplement?
Dark green leafy vegetables, yellow/orange sweet potatoes, carrots and orange and yellow fruits are the main sources of vitamin A in sub-Saharan Africa. In places where these foods are widely available, most adults should be able to get enough from a varied plant-based diet with no need for supplements. However, dark green veg alone cannot be relied on as the absorption of carotenes from these can fall short of how much you need each day – you must eat the yellow and orange fruit and veg too!
Vitamin A deficiency affects about 190 million children under five, mostly from Africa and South-East Asia. This vitamin, according to the WHO, can be safely given to children in a large dose, rather than more frequent smaller doses, as it can be stored by the body and released over time as needed. The WHO says that in areas where vitamin A deficiency is a public health problem, periodic high-dose vitamin A supplementation is recommended in children under five years of age. These supplements are often given as part of national or local health programmes.
Vitamin A toxicity can develop if large amounts are used over a long period of time. Supplementing high doses of vitamin A during pregnancy is not recommended because it may lead to birth defects and liver toxicity – instead, dietary intake of foods containing vitamin A is recommended. After giving birth, a vitamin A supplement may be given to mothers to increase vitamin A in their breast milk to a level adequate to meet the infant’s needs, as well as to improve the mother’s immunity to help her stay healthy.
Where to find vitamin A
The best plant sources of beta-carotene include carrots, sweet potatoes, green leafy vegetables, papaya, mango and some fortified foods.
- Carrots: A great source of beta-carotene, carrots are commonly consumed in Uganda and are available year-round, they can be eaten in salads, roasted, grilled or used to make carrot chapatis or to sweeten cakes and desserts. Half a cup (78 grams) of cooked, sliced carrots contains 665 micrograms of vitamin A. ⠀⠀
- Sweet potatoes: The yellow and orange type are particularly high in beta-carotene and are a popular food that can be baked, boiled, steamed or used to make sweet potato chapatis. Half a cup (100 grams) of baked sweet potato contains 960 micrograms of vitamin A.
- Cassava leaves: Unlike the roots, cassava leaves are a rich source of beta-carotene. Note: raw cassava contains chemicals called cyanogenic glycosides that can release cyanide into your body. Cooking cassava reduces the content of these harmful chemicals.
- Green leafy vegetables: Vegetables like spinach, kale and amaranth leaves are rich in beta-carotene, providing a good source of vitamin A. Try to include some greens in your diet every day.
- Moringa (drumstick) leaves: Rich in beta-carotene, moringa leaves can be eaten raw in salads or cooked in soups, stews and sauces.
- Pumpkins: Also rich in beta-carotene, commonly used in soups, stews and other dishes.
- Mangoes: A good source of beta-carotene, mangoes can be eaten fresh, juiced or added to smoothies. Dried mango is also a popular snack in Uganda. One cup (165 grams) of fresh mango pieces contains 89 micrograms of vitamin A while a 40-gram handful of dried mango contains 27 micrograms.
- Papayas: Another good source of beta-carotene, papayas can be eaten in much the same way as mangoes or made into a fresh zingy salad with tomatoes, onions, cilantro (coriander) and lime juice.
- Red palm oil: This traditional cooking oil in Uganda is a good source of carotenoids and vitamin E, however, it contains considerably more saturated fat than olive oil, for example, so should only be used sparingly.
- Pumpkin seeds: These provide a good source of beta-carotene and are often roasted and eaten as a snack in Uganda.
- Fortified foods: Vegetable oils, maize flour and wheat flour may be fortified with vitamin A, check the label.
Fortified foods
In Uganda, some foods including some vegetable oils, maize flour and wheat flour are fortified with a form of vitamin A called retinyl palmitate. However, not all producers comply with the fortification rules and when they do, not everyone has access to these foods – only 11 per cent of the population eat wheat flour, for example.