DIETARY VITAMIN-A INTAKE AND THE RISK OF MORTALITY AMONG CHILDREN

Increased consumption of dietary vitamin A is advocated as a long-term solution to vitamin A deficiency. We prospectively examined the relat ionship of dietary vitamin A intake and child mortality among 28 753 S udanese children aged 6 mo to 6 y, who participated in a trial of vita min A supplementation. After 18 mo of follow-up, 232 children died. To tal dietary vitamin A intake was strongly and inversely associated wit h risk of mortality. The age- and sex-adjusted relative risk (RR) of m ortality for a comparison of children in extreme quintiles was 0.35 (9 5% CIs 0.21-0.60; P for trend over quintiles < 0.0001). Even after pos sible confounding by socioeconomic variables was adjusted for, vitamin A intake was significantly protective (multivariate relative risk 0.5 3). Dietary vitamin A intake was especially protective among children who were wasted and stunted or who had diarrhea or cough. These prospe ctive data support an important role of dietary vitamin A in reducing childhood mortality in developing countries.