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Anti-blindness drive backfires
They say too much of a good thing can be bad. That's exactly what's happening with the government's National Programme for Prevention of Nutritional Blindness.
They say too much of a good thing can be bad. That's exactly what's happening with the government's National Programme for Prevention of Nutritional Blindness.
Under this programme, around 70 million children under the age of three are being given extremely high doses of vitamin A, which can cause toxicity and lead to weak bones and fractures.
According to the Indian Council of Medical Research, the recommended daily allowance (RDA) for vitamin A for children aged 1 to 3 is 400 mcg per day.
The government is administering 66,000 mcg (two lakh international units) in a single dose — 165 times higher than the RDA.
The government programme recommends five doses of vitamin A, given every six months, to children between the age of nine months and three years.
"The dosage needs to be reviewed immediately as vitamin A toxicity has been confirmed yet again in a scientific paper in the February issue of American Journal of Clinical Nutrition.
It reports that 'osteoporosis and hip fracture are associated with preformed vitamin A intakes that are only twice the current RDA'," says Dr Umesh Kapil, a professor at AIIMS.
"No studies of children have been done, so we don't know whether the government's supplementation is hurting them," he adds.
Though the government has no plan to halt the programme, nutrition experts say it is expected to undergo a major overhaul for the 11th Five Year Plan.
"We are going to review the programme for the 11th Plan to ensure there is no adverse health fallout," says a senior health ministry official.
"The current programme is based on studies by the National Institute of Nutrition in Hyderabad in 1970, which found that 3-4 per cent blindness in India was associated with vitamin A deficiency, and vitamin A supplementation was a safe way to prevent it," says Dr Prema Ramachandran, director, Nutrition Foundation of India.
The situation has changed in the past four decades and new data shows no evidence of vitamin A deficiency blindness anywhere in the country.
Though deficiency exists in some parts, there's no need for supplementation to all children, says Kapil.
"Scientific evidence in the past two decades has shown that overdosing in healthy children can cause toxicity. So the programme should be limited to districts in Bihar ((Patna, Gaya) and Rajasthan (Bikaner), which have shown vitamin A deficiency," he adds.
