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Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation.
- Source :
-
Food and nutrition bulletin [Food Nutr Bull] 2017 Jun; Vol. 38 (2), pp. 260-266. Date of Electronic Publication: 2017 Mar 10. - Publication Year :
- 2017
-
Abstract
- Background: Although vitamin A supplementation reduces child mortality, it remains unclear whether dosing frequency, total dose, or duration modifies effectiveness.<br />Objective: Determine whether mortality effects of vitamin A vary by dosing frequency, total dose, or duration.<br />Methods: Meta-analysis of randomized controlled trials, identified by systematic review and expert opinion, utilizing relatively standard World Health Organization doses in children <5 years. Meta-regression evaluated whether mortality effects varied by dosing frequency, total dose, or supplementation duration.<br />Results: Identified 17 trials, including 1,180,718 children, mean (standard deviation [SD]) age 31.5 (15.4) months at baseline. Supplementation frequency ranged every 3 months-every 2 years, supplementation duration 4-60 months (mean = 15.4; SD = 12.8), and total dose 134,361-2,200,000 IU (mean = 667,132 IU; SD = 540,795). Compared with control, vitamin A reduced mortality 22% (95% confidence interval [CI] = 10-32; P = 0.002). This protective effect was not modified by increasing supplementation frequency (dose/year: relative risk [RR] = 1.02; 95% CI = 0.98-1.06; P = .22), total dose (per 200,000 IU: RR = 1.02; 95% CI = 0.97-1.06; P = .31), nor supplementation duration (per year: RR = 1.06; 95% CI = 0.97-1.15; P = 0.14). Multivariate meta-regression showed similar results. Sensitivity analyses excluding 1 controversial trial (Aswathi 2013) did not alter findings.<br />Conclusion: Results confirm benefits of vitamin A supplementation in children <5 years in nations with vitamin A deficiency, without influence of frequency, total dose, or dosing duration within ranges evaluated. These findings inform design and efficiency of vitamin A supplementation policies.
- Subjects :
- Child Mortality
Child, Preschool
Humans
Randomized Controlled Trials as Topic
Time Factors
Vitamin A administration & dosage
Vitamin A Deficiency mortality
Vitamin A Deficiency prevention & control
Child Nutritional Physiological Phenomena
Dietary Supplements
Evidence-Based Medicine
Global Health
Vitamin A therapeutic use
Vitamin A Deficiency diet therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1564-8265
- Volume :
- 38
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Food and nutrition bulletin
- Publication Type :
- Academic Journal
- Accession number :
- 28513263
- Full Text :
- https://doi.org/10.1177/0379572117696663