American Journal of Clinical Nutrition, Vol 27, 234-253, Copyright © 1974 by The American Society for Clinical Nutrition, Inc.

Vitamins A and E nutrition via intramuscular or oral route

¹ From the Departments of Biochemical Nutrition and Product Development, Hoffmann-La Roche, Inc., Nutley, New Jersey 07110

Intermittent massive dose administration of vitamin A as an emergency measure to prevent hypovitaminosis A has a sound nutritional basis and has been substantiated by successful field testing over the last decade as prophylaxis against blindness due to vitamin A deficiency in the developing countries. Because surveys reveal that low vitamin E status may also exist in children suffering from hypovitaminosis A and protein-calorie malnutrition, and because vitamin E is needed for efficient vitamin A utilization, liver storage, and may also alleviate hypervitaminosis A, it is recommended that vitamin E be included in the intermittent massive dose formulation.

In the intermittent massive oral dose approach for children, 200,000 IU of vitamin A (and 50 to 200 IU of vitamin E) in an oil solution administered under supervision every 6 months, appears to be indicated. Children 5 years and older, because of an increasing vitamin A requirement with age, should receive more. When malabsorption syndromes are suspected, an emulsified or water-dispersible oral form of vitamin A is a preferred delivery system. Vitamins A and E administered intramuscularly are useful forms to supplement oral programs under conditions of specialized use.

The nutrification of indigenous foods with added vitamin A should be the long-term objective for the eradication of xerophthalmia, particularly if natural vitamin A-containing foods are either not easily available or are too expensive to procure.