ArticleThe American journal of clinical nutrition2021
Findings in 3 clinical trials challenge the accuracy of the Institute of Medicine's estimated average requirements for vitamin A in children and women.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determination of Changes in Total Body Stores of Vitamin A in Response to Orange Maize Consumption by Zambian Children
Development of 13C-Retinol Isotope Dilution Techniques
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Selected laboratory-based biomarkers for assessing vitamin A deficiency in at-risk individuals.The Cochrane database of systematic reviews · 2025Pooled it
- Synthesis of 13C2-Retinyl Acetate and Dose Preparation for Retinol Isotope Dilution Tests.Journal of visualized experiments : JoVE · 2025Article
- Heart rate variability behavior in young men after short-term carotenoid-containing supplementation.Heliyon · 2023Article
- Prevalence of vitamin A deficiency and dietary inadequacy in Indian school-age children and adolescents.European journal of nutrition · 2022Article
- Biological evidence to define a vitamin A deficiency cutoff using total liver vitamin A reserves.Experimental biology and medicine (Maywood, N.J.) · 2021Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundVitamin A (VA) estimated average requirements (EARs) for women and children are extrapolated from rats and adult males. The retinol isotope dilution (RID) test can sensitively characterize VA status and intake requirements.
objectivesThese studies evaluated current EARs for children 4-8 y and women 19-30 y old.
methodsZambian children (n = 133, ages 5-7 y), US women (n = 51, ages 19-27 y), and Indonesian women (n = 29, ages 19-30 y) were provided diets or supplements containing 30%-155% of VA EARs for 42-90 d. RID was performed before and after the intervention to quantify changes in total body VA stores (TBSs) and total liver VA reserves (TLRs). Linear regression was performed between VA intake and change in TBSs or TLRs.
resultsBaseline mean ± SD TLRs were hypervitaminotic in Zambian children (1.13 ± 0.41 μmol VA/g liver), optimal in US women (0.46 ± 0.32 μmol/g VA/g liver), and deficient to marginal in Indonesian women (0.10 ± 0.08 μmol VA/g liver). VA intakes, resulting in no change in TBSs or TLRs, were 185 (95% CI: 18, 288) or 257 (95% CI: 124, 411) and 285 or 330 (CIs undefined) μg retinol activity equivalents (RAE)/d in the Zambian and US trials, respectively, but inconclusive in Indonesian women. The regression was not significant in either group of women.
conclusionsPoint estimates of VA intakes to maintain stores were below the current EARs of 275 (children) and 500 (women) μg RAE/d despite the TLRs being higher than the EARs were formulated to maintain (i.e., 0.07 μmol VA/g liver). Interventions based on these EARs may need to be scaled back. Lack of change in VA stores in women taking lower doses may result from physiological adaptation resulting in lower VA utilization. Longer, larger, and controlled studies are needed to accurately define EARs for VA.These trials were registered at Clinicaltrials.gov as NCT04123210 and NCT01814891.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.