Surveys undertaken in several countries suggest that intake patterns vary considerably across Europe and the U.S. The number of people at risk of vitamin A deficiency  depends on the intake of total vitamin A, which is defined as preformed (retinol) plus provitamin A (e.g. beta-carotene).

 

The survey data show that a high intake of provitamin A is possible under special conditions (as shown for vegans and vegetarians), but that the intake of preformed vitamin A (retinol) is often critically low and does not meet the recommendations.

 

According to the latest German consumption study (25) 15% men and 10% women are below the recommended reference value for vitamin A.(retinol). In addition, the study shows that the vitamin A precursor beta-carotene, contributes significantly to the overall vitamin A intake.

 

In The Netherlands, male average intake exceeded Dutch recommendations of 1,000 micrograms Retinol Activity Equivalents/day in adults, while for women average intake was 5% below the EU recommended 800 micrograms/day (26).

 

In the U.K., 50% of men and 49% of women did not meet current U.K. national recommendations for vitamin A (27).

 

Likewise in Ireland, daily average intakes for men and women were considerably below national recommendations (28).

 

In Austria, average male intakes were between 105% and 125% of the recommended dietary allowance (RDA) for all age groups. Female intakes ranged from 125% to 160% of the RDA in women aged above 56 years (29).

 

Groups at risk of inadequate vitamin A supply are mainly pregnant and lactating women, newborns, children with frequent infections, the elderly and people who avoid animal-derived foods.

 

A lack of vitamin A can occur as either a primary or secondary deficiency. A primary vitamin A deficiency occurs among children and adults who do not consume an adequate amount of yellow and green vegetables, fruits and liver. Early weaning can also increase the risk of a deficiency. Secondary vitamin A deficiency is associated with chronic inability to absorb lipids (malabsorption), low fat diets, and chronic exposure to oxidants such as cigarette smoke.