Probe • Vol LXII • No. 3 • May–Aug 2023 • 49 Insufficiency of Vitamins and Health Outcomes in Children regulating the functions of the central nervous system, and neutralizing reactive oxygen species.2 The recommended dietary allowance of vitamin C in children ranges from 35 to 75 mg/day. Vitamin C supplementation is found to be useful in ameliorating recurrent respiratory infections, iron-deficiency anemia, and depressive symptoms.2 Deficiency of Lipid-Soluble Vitamins Vitamin A deficiency Vitamin A, a group of lipid-soluble retinoids, are typically found in foods of animal origin (eg, fish, egg, and dairy products) and in several types of fruits and vegetables containing carotenoids (eg, carrot). Vitamin A is essential for good vision, to support cellular growth and differentiation, for cell-to-cell signaling, to maintain muscular integrity, and for immunologic functions.2 The recommended dietary allowance of vitamin A in children ranges from 200 to 500 μg/day. Vitamin A deficiency is an important cause of morbidity and mortality in infectious diseases, in diarrhea and measles, and in visual problems, primarily affecting the nocturnal vision (ie, xerophthalmia). Vitamin A deficiency remains one of the leading causes of pediatric blindness. Thus, the WHO recommends vitamin A supplementation in all children between 6 months and 5 years who are at a risk of vitamin A deficiency.2 Vitamin D deficiency Vitamin D is endogenously synthesized, but is also commonly found in fishes rich in ω-3 fatty acids, egg yolk, cheese, and butter. Vitamin D is fundamental for bone metabolism. The maximum tolerable and safe dose of vitamin D is 1000 IU/day in infants younger than 6 months, and 1500 IU/day in children older than 6 months.2,3 Vitamin D deficiency is commonly seen in children with poor sun exposure and malabsorption. Thus, vitamin D supplementation is indicated as early as the first year of life to prevent the risk of rickets, osteopenia, and idiopathic juvenile arthritis.2 Vitamin E deficiency Vitamin E is found in vegetable oils, cereals, and some types of nuts. It is an important antioxidant agent with antimicrobial action. The recommended vitamin E consumption is 6 mg/day (between 1 and 3 y of age) to 15 mg/day (between 14 and 18 y of age).2,3 Vitamin E deficiency is seen in children with reduced gastrointestinal absorption, lipid malabsorption, and congenital disorders that impair the absorption and storage of vitamin E. Clinical signs of vitamin E deficiency include hemolytic anemia, ataxia, myopathy, and impaired response to infectious stimuli.2 While the best source of vitamins is indeed a balanced diet, to further compensate for the inadequacy of essential nutrients, adequate consumption of vitamins through nutritional supplements should be considered.1 References 1. Roop JK. Int J Health Sci Res. 2018;8(10):280–288. 2. Martini L, et al. J Nutr Sci. 2020;9:e20. 3. Shasho R, Shasho M. Sch J App Med Sci. 2022;10(1):1–8.
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