In a paper entitled « Proposed recommended nutrient densities for moderately malnourished children » published in Food and Nutrition Bulletin in 2009, Michael Golden proposed that “the [Vitamin A] RNI should take into account the presence of [Vitamin A] capsule distribution”, considering the question of “the possible danger to children who receive large doses of vitamin A from multiple sources” (p326). Indeed, it seems that there is a Vitamin A capsule program on-going in most of the countries where nutritional programs (targeting moderate or severe acute malnutrition) are implemented. So I am wondering whether the proposition to adapt the Vitamin A RNI to contexts of high-coverage Vitamin A capsule distribution has lead to any official recommendation (for instance by the International Vitamin A Consultative Group) in order to avoid hypervitaminosis A? In such contexts, does the high Vitamin A density of the foods specially formulated to treat moderate acute malnutrition need to be adapted? Should the Vitamin A density of the RUTF/F100 also be adapted if the children treated for SAM are shown to follow a Vitamin A capsule program?
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