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Flawed analyses and historical data inflate vitamin A deficiency in India to misdirect policy

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  1. Arlappa N. Vitamin A supplementation policy: a shift from universal to geographical targeted approach in India considered detrimental to health and nutritional status of under 5 years children. Eur J Clin Nutr. 2022;28:1–6.

    Google Scholar 

  2. Comprehensive National Nutrition Survey (CNNS). CNNS National Report 2016-18. New Delhi, India: Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council, 2019.

  3. Arlappa N. Sample size covered for serum vitamin A is not nationally representative: data are not suggestive for Targeted Vitamin A Supplementation Programme in India. Am J Clin Nutr. 2021;113:1708–09.

    Article  Google Scholar 

  4. Reddy GB, Pullakhandam R, Ghosh S, Boiroju NK, Tattari S, Laxmaiah A, et al. Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation. Am J Clin Nutr. 2021;113:939–47.

    Article  Google Scholar 

  5. Reddy GB, Pullakhandam R, Ghosh S, Boiroju N, Tattari S, Laxmaiah A, et al. Reply to J Sheftel et al. and N Arlappa. Am J Clin Nutr. 2021;113:1709–11.

    Article  Google Scholar 

  6. National Nutrition Monitoring Bureau (NNMB). Diet and Nutritional Status of Rural Population, Prevalence of Hypertension and Diabetes Among Adults and Infant and Young Child Feeding Practices, 3rd Repeat Survey. Hyderabad, India: National Institute of Nutrition, Indian Council of Medical Research; 2012.

  7. Allen LH, Carriquiry AL, Murphy SP. Perspective: Proposed Harmonized Nutrient Reference Values for Populations. Adv Nutr. 2020;11:469–83.

    Article  Google Scholar 

  8. Food Standard and Safety Authority of India. Ban on sale of loose edible oils can check adulteration.

  9. Ford JL, Green JB, Haskell MJ, Ahmad SM, Mazariegos Cordero DI, Oxley A, et al. Use of model-based compartmental analysis and a superchild design to study whole-body retinol kinetics and vitamin A total body stores in children from 3 lower-income countries. J Nutr. 2020;150:411–18.

    Article  Google Scholar 

  10. Lopez-Teros V, Ford JL, Green MH, Monreal-Barraza B, García-Miranda L, Tanumihardjo SA, et al. The “Super-Child” approach is applied to estimate retinol kinetics and Vitamin A total body stores in Mexican preschoolers. J Nutr. 2020;150:1644–51.

    Article  Google Scholar 

  11. Thomas T, Sachdev HS, Ghosh S, Kapil U, Kurpad AV. Association of Vitamin A Status With Under-Five Mortality in India. Indian Pediatr. 2022;59:206–9.

    Article  Google Scholar 

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HSS and AVK are recipients of the Wellcome Trust/Department of Biotechnology India Alliance Clinical/Public Health Research Centre Grant # IA/CRC/19/1/610006.

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HSS, GB and AVK wrote the paper. All authors reviewed and approved the submitted paper. HSS and AVK had final responsibility for the decision to submit for publication.

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Correspondence to Harshpal S. Sachdev or Anura V. Kurpad.

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Competing interests

HSS designed the draft protocol of the CNNS with consultancy support from the UNICEF, India. HSS and AVK were members of the Technical Advisory Committee of the CNNS, constituted by the Ministry of Health and Family Welfare of the Government of India, to oversee its conduct and analysis. HSS is a member of the World Health Organization Nutrition Guidance Expert Advisory Subgroup on Diet and Health. HSS and AVK are members of Expert Groups of the Ministry of Health and Family Welfare on Nutrition and Child Health, and the National Technical Board on Nutrition of the Niti Ayog, Government of India.

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Sachdev, H.S., Reddy, G.B., Pullakhandam, R. et al. Flawed analyses and historical data inflate vitamin A deficiency in India to misdirect policy. Eur J Clin Nutr (2022).

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