Micronutrients : Vitamin A,Vitamin E,Vitamin K

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Nutrition in Children

Micronutrients Articles

Micronutrients : Vitamin A,E and K

NUTRITION IN CHILDREN

Micronutrients in Children

Role of Micronutrients in Diet of Preschooler

Micronutrient Status of Children in India

Micronutrient Supplementation and it's Effect on Children

Micronutrients Vitamin B complex

Micronutrients Vitamin C and Vitamin D

Calcium and phosphorus in diet

Vitamin D insufficiency and deficiency in children

Community Level Micronutrient Deficiency in Preschoolers

Micronutrients: Vitamin A, E and K

Immunity and Growth of Children

Nutrition For Healthy Growth and Immunity

Nutrition and Brain Development

Nutrition and Infections

Dietary Inadequacy in First Three Years of Life

Feeding guidelines for infants and young children in India

Prebiotics for Children

Prebiotics & Probiotics And Gut Health in Children

Prebiotics and Probiotics for Healthy Children

Role of probiotics in children

Role of prebiotics in children

Prebiotics and probiotic combinations in children

DHA in children

DHA Need and Importance During Growing Period

Malnutrition in children

Problems of Malnutrition in India among Children

Adult Onset Diseases and Malnutrition

Nutrition In Indian Urban Children

Malnutrition Among Preschoolers

Nutrition Growth Charts

Length/Height for age

Subscapular skin fold thickness

Triceps skin fold thickness

MICRONUTRIENTS : VITAMIN A,E AND K

Share |

Vitamin A

Vitamin A is a fat-soluble vitamin that is necessary for the function of photoreceptors in the retina. It also helps keep the epithelium of the skin, lungs, intestine, and urinary tract healthy and protects against infections. (1) Vitamin A is also known as retinol. Vitamin A is necessary for both low-light (scotopic vision) and color vision. (2) Vitamin A is an antioxidant. (3)

Functions: In food, vitamin A typically occurs as a fat compound called retinyl palmitate. The body converts retinyl palmitate to retinol in the small intestine. The retinol functions as a storage form of the vitamin, and can be converted to its visually active form, retinal. The associated acid (retinoic acid), a metabolite that can be irreversibly synthesized from vitamin A, has only partial vitamin A activity, and does not function in the retina for the visual cycle. (2,4)

Food Sources: While retinol, or preformed vitamin A, occurs only in foods of animal origin, fruits and vegetables that contain certain carotenoids also provide vitamin A activity. Carotenoids are plant pigments, responsible for the red, orange, and yellow color of fruits and vegetables. (4) Carotenoids are available as alpha-carotene, beta-carotene, gamma-carotene; and the xanthophyll beta-cryptoxanthin. (2) Once consumed, carotenoids are slowly converted to vitamin A in the body. Carotenoids are best absorbed from cooked or homogenized vegetables served with some fat or oil. (1). However it has been found that vegetarian foods contain much less of vitamin A and night blindness can be common unless Vitamin A fortified food it given. (2)

Recommended daily allowance: 0-8 years = 4-8mcg/d, 9-18 years = 600-700mcg/d (Boys 14-18 years: 900mcg/d)

Deficiency: Vitamin A deficiency is estimated to affect approximately one third of children under the age of five around the world. (2) Vitamin A deficiency can occur due to poor intake of vitamin A rich foods, due to malabsorption or due to liver disease. Vitamin A deficiency impairs immunity, the vision and affects the epidermal growth. It leads to night blindness and xerosis of cornea and conjunctiva and even keratomalacia which may ultimately lead to permanent blindness. Keratinization of the skin and of the mucous membranes in the respiratory, GI, and urinary tracts can occur. Drying, scaling, and follicular thickening of the skin and respiratory infections can result. Serum vitamin A levels will be low. Normal range of serum retinol levels are 28 to 86 ?g/dL. (1) Treatment consists of vitamin A. Oral vitamin A is administered in a dose of 50,000, 1 lakh and 2 lakh international units (IU) in children aged <6 months, 6-12 months and 2 years respectively. The same dose is repeated next day and 4 weeks later. Parenteral doses are recommended in persistent vomiting and severe malabsorption.

Overdosage: Accidental ingestion of high dose of vitamin A can lead to headache and increased intracranial pressure. Long term ingestion of high dose of vitamin A (> 10 times the RDA) can lead to alopecia, visual impairment, dry itchy skin, weight loss, hypoplastic anemia and benign increased intracranial pressure. Pregnant women who require vitamin A supplementation should not given high-dose supplements due to potential teratogenic effects. Treatment consists of stopping vitamin A.

Vitamin E

Vitamin E is a family of alpha, beta, gamma, and delta tocopherols and corresponding four tocotrienols. (5). Alpha tocopherol is the most important of them. It is a fat soluble vitamin that acts as an antioxidant.

Functions: The roles and importance of all of the various forms of vitamin E are presently unclear. (5) Vitamin E stops the production of reactive oxygen species formed when fat undergoes oxidation.

Food Sources: Mustard greens, chard, sunflower seeds, and turnip greens are good sources of vitamin E. Very good sources include almonds and spinach (6).

Recommended daily allowance: 0-8 years = 4-8mg/d, 9-18 years = 11-15mg/d

Deficiency: The main symptoms of vitamin E deficiency are hemolytic anemia and neurologic deficits including spinocerebellar ataxia with loss of deep tendon reflexes, truncal and limb ataxia, loss of vibration and position senses, ophthalmoplegia, muscle weakness, ptosis, and dysarthria. (7). Treatment consists of vitamin E supplements.

Overdosage: Usually high doses of Vitamin E do not cause any problems. However, sometimes it may interfere with Vitamin K and lead to bleeding. Thus it should not be given in patients on warfarin therapy.

Vitamin K

Vitamin K is a fat soluble vitamin important for production of various factors in the coagulation cascade and thus helps in preventing prolonged bleeding. It is also called as anti-hemorrhagic factor.

Functions: Vitamin K is absorbed from the small intestine with help of bile secreted by the liver. It is incorporated into the chylomicrons and reaches the liver through the portal circulation where it helps in formation of vitamin K dependent factors such as Factor II, VII, IX and X. Protein C and S also require vitamin K for their activity.

Food Sources: Two forms of vitamin K exists: vitamin K1 or phylloquinone and vitamin K2 or menaquinone. Phylloquinones are derived from vegetables and animal sources. Menaquinone is synthesized from the gut flora.

Recommended daily allowance: Upto 1 year = 2-2.5mcg/d, 1-18 years=50-75mcg/d

Deficiency: Vitamin K deficiency presents as easy bruisability, mucosal bleeding, malena or even CNS bleeds. In newborns, due to immature liver and low vitamin K in breast milk, it can lead to hemorrhagic disease of newborn (HDN). This can lead to bleeding manifestations. typically presenting in the first week of life. Late HDN can occur due to excessive use of antibiotics, cystic fibrosis, biliary atresia, cholestatic hepatitis, celiac disease and chronic warfarin exposure which decreases gut production or absorption of vitamin K. Diagnosis is established by markedly prolonged partial thromboplastin time (PTT) and Prothrombin time (PT) and presence of PIVKA (proteins induced in vitamin K absence- These are non carboxylated forms of Vitamin K dependent factors).

Overdosage: Vitamin K toxicity is very rare. Menadione can cause hemolytic anemia, hyperbilirubinemia, jaundice and kernicterus in infants.

References :

	1.	Vitamin A: Vitamins: Merck Manual Home edition. Available at URL: http://www.merck.com/mmhe/sec12/ch154/ch154f.html. Accessed on 25th October 2010

	2.	Vitamin A - Wikipedia, the free encyclopedia. Available at URL: http://en.wikipedia.org/wiki/Vitamin_a. Accessed on 25th October 2010.

	3.	Vitamin A - Medline Plus. Available at URL: www.nlm.nih.gov/medlineplus/vitamina.html. Accessed on 25th October 2010

	4.	WHFoods: Vitamin A. Available at URL: http://www.whfoods.com/genpage.php?tname=nutrient&dbid=106. Accessed on 25th October 2010

	5.	Vitamin E - Wikipedia, the free encyclopedia. Available at URL: http://en.wikipedia.org/wiki/Vitamin_e. Accessed on 25th October 2010

	6.	WHFoods: Vitamin E. Available at URL: http://www.whfoods.com/genpage.php?tname=nutrient&dbid=111. Accessed on 25th October 2010

	7.	Vitamin E: Vitamins: Merck Manual Professional Edition. Available at URL: http://www.merckmanuals.com/professional/sec01/ch004/ch004l.html. Accessed on 25th October 2010

Nutrition in children

Nutrition in children less than 5 years in India

Nutrition in preschoolers and effect on adult health

Diet of children in Indian cities

Growth and Immunity Of Children

Nutrition for growth and immunity

Preschoolers Nutrition and Infections

Role of healthy eating and brain development

Prebiotics for Children

Prebiotics and probiotics for a healthy digestive system

Pre and probiotics in healthy children

Probiotics in children - Frequently asked questions

Prebiotics - Frequently asked questions

Synbiotics - Frequently asked questions

DHA in Children

Role of DHA for mental development

Vitamins and minerals in Children

Role of micronutrients in physical growth

Vitamins and minerals in children

Vitamin and mineral problems in children in India

Vitamin C:Commonly asked Questions

Vitamin B Complex

Role of Vitamin D in Children

Vitamin A

Role of Calcium and Phosphorus in Diet

Iron Deficiency in Children and Their Health Consequences

Zinc Deficiency in Children

Vitamin B12 deficiency in children

Nutrition In Children:Research

Food Consumption Pattern

Nutrition Related Problems

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids