Are low tolerable upper intake levels for vitamin A undermining effective food fortification efforts?

Klaus Kraemer, Monika Waelti, Saskia De Pee, Regina Moench-Pfanner, John N. Hathcock, Martin W. Bloem, Richard D. Semba

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


Vitamin A deficiency (VAD) is a major health problem, particularly in low-resource countries, putting an estimated 125-130 million preschool-aged children at increased risk of morbidity and mortality from infectious diseases. Vitamin A supplementation reduces VAD and increases child survival; it is complemented by fortifying foods with vitamin A. Concern over increased risk of bone fracture associated with vitamin A intakes below the tolerable upper intake level (UL) among populations in affluent countries conflicts with the need to increase intakes in less developed countries, where populations are at greater risk of VAD and intakes are unlikely to reach the UL as diets include fewer foods containing retinol while vitamin A from carotenoids poses no risk of overdose. With the implementation of recently developed risk management tools, vitamin A can be used safely in food fortification, including point-of-use fortification in the context of supplementation among specific target groups in low-resource countries.

Original languageEnglish (US)
Pages (from-to)517-525
Number of pages9
JournalNutrition reviews
Issue number9
StatePublished - Sep 2008


  • Food fortification
  • Risk management tools
  • Safety
  • Vitamin A deficiency

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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