Vitamin A: Reference and Dietary Sources

We identified Vitamin A dietary sources (highest in liver and fish oils), provided reference values, and described testing methods, benefits, and toxicity. Nutri-IQ recommends to Wellness Practitioners to check nutritional status with our Nutritional Balance Assessment Tool in order to holistically recognize and close nutritional gaps.

Abstract

In this article, we describe:

• the major purposes of this specific nutrient in the human body, 
• its experimentally confirmed health uses, 
• conventional ways to estimate nutrient status,
• nutrient’s toxicities and deficiencies,
• experimentally confirmed and approved levels of the nutrient intake for different demographics,
• dietary sources of the nutrient.

Introduction

Two forms of vitamin A are available in the human diet: preformed vitamin A (retinol) and provitamin A carotenoids. Preformed vitamin A is found in foods from animal sources, including dairy products, fish, and meat (especially liver). By far the most important provitamin A carotenoid is beta-carotene; other provitamin A carotenoids are alpha-carotene and beta-cryptoxanthin. The body converts these plant pigments into vitamin A. Both provitamin A and preformed vitamin A must be metabolized intracellularly to retinal and retinoic acid, the active forms of vitamin A, to support the vitamin’s important biological functions. Other carotenoids found in food, such as lycopene, lutein, and zeaxanthin, are not converted into vitamin A.

Retinol and carotenoid levels inadequacy are typically measured in plasma. However, they do not decline until vitamin A levels in the liver are almost depleted. Liver vitamin A reserves can be measured indirectly through the relative dose-response test, in which plasma retinol levels are measured before and after the administration of a small amount of vitamin A. A plasma retinol level increase of at least 20% indicates an inadequate vitamin A level. For clinical practice purposes, plasma retinol levels alone are sufficient for documenting significant deficiency.

Premature infants, pregnant and lactation women, patients with cystic fibrosis, cancer, age-related macular degeneration (AMD) are at risk for vitamin A inadequacy (deficiency or adverse effects). Excess preformed vitamin A can have significant toxicity (known as hypervitaminosis A) leading to increased intracranial pressure (pseudotumor cerebri), dizziness, nausea, headaches, skin irritation, pain in joints and bones, coma, and even death.

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Recommended Dietary Allowances (RDAs) for Vitamin A

RDAs (Recommended Dietary Allowance) for vitamin A are given as mcg of retinol activity equivalents (RAE) to account for the different bioactivities of retinol and provitamin A carotenoids. Because the body converts all dietary sources of vitamin A into retinol, 1 mcg of physiologically available retinol is equivalent to the following amounts from dietary sources: 1 mcg of retinol, 12 mcg of beta-carotene, and 24 mcg of alpha-carotene or beta-cryptoxanthin. From dietary supplements, the body converts 2 mcg of beta-carotene to 1 mcg of retinol.

Currently, vitamin A is listed on food and supplement labels in international units (IUs) even though nutrition scientists rarely use this measure. Conversion rates between mcg RAE and IU are as follows:

• 1 IU retinol = 0.3 mcg RAE
• 1 IU beta-carotene from dietary supplements = 0.15 mcg RAE
• 1 IU beta-carotene from food = 0.05 mcg RAE
• 1 IU alpha-carotene or beta-cryptoxanthin = 0.025 mcg RAE

However, under FDA’s new labeling regulations for foods and dietary supplements that take effect by January 1, 2020, vitamin A will be listed only in mcg RAE and not IUs. An RAE cannot be directly converted into an IU without knowing the source(s) of vitamin A. For example, the RDA of 900 mcg RAE for adolescent and adult men is equivalent to 3,000 IU if the food or supplement source is preformed vitamin A (retinol). However, this RDA is also equivalent to 6,000 IU of beta-carotene from supplements, 18,000 IU of beta-carotene from food, or 36,000 IU of alpha-carotene or beta-cryptoxanthin from food. So, a mixed diet containing 900 mcg RAE provides between 3,000 and 36,000 IU of vitamin A, depending on the foods consumed.

Age	Male	Female	Pregnancy	Lactation
0–6 months*	400 mcg RAE	400 mcg RAE
7–12 months*	500 mcg RAE	500 mcg RAE
1–3 years	300 mcg RAE	300 mcg RAE
4–8 years	400 mcg RAE	400 mcg RAE
9–13 years	600 mcg RAE	600 mcg RAE
14–18 years	900 mcg RAE	700 mcg RAE	750 mcg RAE	1,200 mcg RAE
19–50 years	900 mcg RAE	700 mcg RAE	770 mcg RAE	1,300 mcg RAE
51+ years	900 mcg RAE	700 mcg RAE

* Adequate Intake (AI), equivalent to the mean intake of vitamin A in healthy, breastfed infants.

Dietary Sources of Vitamin A

Concentrations of preformed vitamin A are highest in liver and fish oils. Other sources of preformed vitamin A are milk and eggs, which also include some provitamin A. Most dietary provitamin A comes from leafy green vegetables, orange and yellow vegetables, tomato products, fruits, and vegetable oils. The top food sources of vitamin A in Western diet include dairy products, liver, fish, and fortified cereals; the top sources of provitamin A include carrots, broccoli, cantaloupe, and squash.

The table below suggests many dietary sources of vitamin A. The foods from animal sources contain primarily preformed vitamin A, the plant-based foods have provitamin A, and the foods with a mixture of ingredients from animals and plants contain both preformed vitamin A and provitamin A.

Selected Food Sources of Vitamin A

Food	mcg RAE per serving	Percent DV*
Beef liver, pan fried, 3 ounces	6,582	731
Sweet potato, baked in skin, 1 whole	1,403	156
Spinach, frozen, boiled, ½ cup	573	64
Pumpkin pie, commercially prepared, 1 piece	488	54
Carrots, raw, ½ cup	459	51
Ice cream, French vanilla, soft serve, 1 cup	278	31
Cheese, ricotta, part skim, 1 cup	263	29
Herring, Atlantic, pickled, 3 ounces	219	24
Milk, fat-free or skim, with added vitamin A , 1 cup	149	17
Cantaloupe, raw, ½ cup	135	15
Peppers, sweet, red, raw, ½ cup	117	13
Mangos, raw, 1 whole	112	12
Breakfast cereals, fortified with 10% of the DV , 1 serving	90	10
Egg, hard boiled, 1 large	75	8
Black-eyed peas (cowpeas), boiled, 1 cup	66	7
Apricots, dried, sulfured, 10 halves	63	7
Broccoli, boiled, ½ cup	60	7
Salmon, sockeye, cooked, 3 ounces	59	7
Tomato juice, canned, ¾ cup	42	5
Yogurt, plain, low fat, 1 cup	32	4
Tuna, light, canned in oil, drained solids, 3 ounces	20	2
Baked beans, canned, plain or vegetarian, 1 cup	13	1
Summer squash, all varieties, boiled, ½ cup	10	1
Chicken, breast meat and skin, roasted, ½ breast	5	4
Pistachio nuts, dry roasted, 1 ounce	4	0

*DV = Daily Value. The DV for vitamin A is 900 mcg RAE for adults and children age 4 years and older, where 1 mcg RAE = 1 mcg retinol, 2 mcg beta-carotene from supplements, 12 mcg beta-carotene from foods, 24 mcg alpha-carotene, or 24 mcg beta-cryptoxanthin.  Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

References

1. Elson Haas. “Staying Healthy with Nutrition”
2. U.S. Department of Health & Human Services: https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/#h3