Vitamin A and vitamin D deficiencies in children in the Palestinian Territories

A few months ago I published a healthy vegan guide for the Palestinian Territories which the Palestinian Territories based vegan/animal rights organization PAL (Palestinian Animal League) has translated into Arabic.

A new study has just been published in the prestigious medical journal The Lancet confirming that vitamin D and vitamin A are two important nutrients to pay some attention to – not just for vegan children but for most children (and adults) in the Palestinian Territories (and practically everywhere else). The study was conducted by researchers from The London School of Hygiene & Tropical Medicine, UNICEF Iraq and the Nutrition Department at the Palestinian Ministry of Health.

Good source of provitamin A: pumkins (grown in the Gaza Strip)

Where does the new data come from?
The Palestinian Micronutrient Survey in 2013 tested vitamin A status in blood samples of 1054 children (569 children in the West Bank and 485 children in the Gaza Strip) and vitamin D status in blood samples of 150 children (75 children in the West Bank and 75 children in the Gaza Strip). The children were ages 6 months to 5 years old.

Study results:
  • 771 (73%) children in the survey had vitamin A deficiency, and 91 (61%) children had vitamin D deficiency.
  • Compared with children living in the West Bank, children living in the Gaza Strip were about 30% more likely to be deficient in vitamin A, and about twice as likely (100% more likely) to be deficient in vitamin D.
  • Vitamin A deficiency was especially common in children with anaemia. For more information great sources of iron and vitamin B12 (a deficiency of these nutrients can cause anaemia) see the Healthy vegan guide for the Palestinian Territories.
  • Vitamin D deficiency was almost three times more common in girls compared to boys – this emphasizes that clothing and/or staying inside or in the shade all day long might be a health risk especially for Palestinian girls.
  • Vitamin A deficiency was defined as < 1.05 μmol/L vitamin A in the serum. Vitamin D deficiency was defined as < 50 nmol/L (20 ng/mL) 25-OH-D in the serum. (The exact parameters are not stated in the article which was only published as an abstract.)

Do Palestinian children need vitamin D and vitamin A supplements?
The study authors describe a “low adherence to the full supplementation regimen” – probably supplements given out by UNICEF. If exposure to sunshine is possible and if weekly consumption of sufficient amounts of vegetables is possible then supplementation of both of these nutrients is not necessary – in healthy children.   

Good source of provitamin A: orange-fleshed sweet potatoes (grown in the Gaza Strip)

Avoiding vitamin D and vitamin A deficiencies:
Vitamin A and vitamin D are very important for good health, and both vitamins are easy to obtain – also from animal friendly (vegan) sources.

Great sources of vitamin D: Sunshine – it is important that all children (and adults) receive direct sunshine on their skin. It is important not to cover all of your body all of the time. The Palestinian Territories receive plenty of sunshine year-round – so exposing some naked skin to sunshine for 10 or 20 minutes daily is likely a feasible option for most people.

Great sources of vitamin A: All cooked orange vegetablescooked dark green leafy vegetables an orange-fleshed fruits are good sources of beta-carotene (provitamin A).

Good sources of provitamin A: cantaloupe melon, and tomatoes also contain some provitamin A (grown in the Gaza Strip)

Chaudhry A, Hajat S, Rizkallah N, Abu-Rub A: Risk factors for vitamin A and vitamin D deficiencies in children younger than 5 years in the occupied Palestinian territory: a cross-sectional study. Lancet (2018) Feb 21;391 Suppl 2:S3. doi: 10.1016/S0140-6736(18)30369-6 . Epub 2018 Feb 21.