The total vitamin A content of the diet (from both animal and plant sources) is normally expressedas retinol equivalents (RE).Vitamin A is essential to the normal structure and function of the skin and mucous membranes suchas in the eyes, lungs and digestive system. Therefore, it is vital for vision, embryonic development,growth and cellular differentiation, and the immune system.
Vitamin A deficiency is a serious public health problem worldwide,. It can lead to night blindness(impaired adaptation to low-intensity light) and an eye condition called xerophthalmia (dryness of the conjunctiva and cornea) and eventually total blindness. Marginal deficiency contributes tochildhood susceptibility to infection, and therefore morbidity and mortality, in both developing anddeveloped countries. Vitamin A deficiency is common in many developing countries especiallyamong young children.
Liver, whole milk, cheese, butter, margarine andmany reduced fat spreads are dietary sources of retinol. Carrots, dark green leafy vegetables andorange-coloured fruits, e.g. mangoes andapricots are dietary sources of carotenoids.
Dietary vitamin D exists as either ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3).Ergocalciferol (D2) is derived from the UV irradiation of the plant sterol ergosterol, which is widelydistributed in plants and fungi. (D3 ) is formed from the action of UV irradiation on 7-dehydrocholesterol in the skin of animals including humans.Vitamin D is not classically a vitamin but a pro-hormone, acting as a precursor to one of thehormones involved in calcium homoeostasis. Cholecalciferol is metabolised to the active steroidhormone 1,25-dihydroxyvitamin D3 in the liver and kidney. In this form it works as a hormoneregulating the amount of calcium absorbed in the intestine. It is also essential for the absorption of phosphorus and for normal bone mineralisation. Vitamin D is also involved in the regulation of cell proliferation and differentiation. Vitamin D is also an activator of insulin-like growth factor (IGF-1)and, associated with this, poor vitamin D status is linked to sarcopenia (age related loss of skeletalmuscle) which affects up to 25% of those over the age of 65 years and more than half of those over
Deficiency of vitamin D results in poor calcification of the skeleton and hence skeletal deformity inchildren (rickets) and it leads to pain and bone fragility in adults (osteomalacia).