Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation

source extracted confidence: high 2026-04-09
#child-mortality #child-nutritional-physiological-phenomena #child-preschool #dietary-supplements #evidence-based-medicine

Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation

Kranz et al., 2017 | Food Nutr Bull | Meta Analysis

Citation

Kranz Sarah, Pimpin Laura, ... Mozaffarian Dariush. Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation. Food Nutr Bull. 2017-Jun;38(2):260-266. doi:10.1177/0379572117696663

Abstract

BACKGROUND: Although vitamin A supplementation reduces child mortality, it remains unclear whether dosing frequency, total dose, or duration modifies effectiveness. OBJECTIVE: Determine whether mortality effects of vitamin A vary by dosing frequency, total dose, or duration. 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. 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. 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.

Key Findings

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 frequenc

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 15
Age Range See abstract
Condition deficiency

MeSH Terms

  • Child Mortality
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Dietary Supplements
  • Evidence-Based Medicine
  • Global Health
  • Humans
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Vitamin A
  • Vitamin A Deficiency

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Comparative Study, Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-a

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09