Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects.Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them can also be used to assess the nutrient intakes of individuals.Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy established when evidence is insufficient to develop an RDA.Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals often used to plan nutritionally adequate diets for individuals.These values, which vary by age and sex, include: DRIs is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. Intake recommendations for vitamin A and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine. A serum or plasma retinol concentration of 20 mcg/dL (0.70 micromoles/L) or less frequently reflects moderate vitamin A deficiency, and a level of 10 mcg/dL (0.35 micromoles/L) or less is considered an indicator of severe vitamin A deficiency. In clinical practice, plasma retinol levels alone can be used to document significant deficiency. In clinical studies, specialized research laboratories can measure liver vitamin A reserves indirectly using isotope-dilution or dose-response methods, in which plasma levels of retinol, a tracer surrogate, or both are measured over several days after the administration of vitamin A. Most vitamin A is stored in the liver, so measuring vitamin A levels in the liver is the best way to assess vitamin A adequacy. However, these levels are not always reliable indicators of vitamin A status because they do not decline until vitamin A levels in the liver and other storage sites are almost depleted and because acute and chronic infections can decrease serum and plasma retinol concentrations. Retinol and carotenoid levels are typically measured in plasma or serum because blood samples are easy to collect. Most of the body’s vitamin A is stored in the liver in the form of retinyl esters. Retinol is then oxidized to retinal and retinoic acid, the two main active vitamin A metabolites in the body. Retinyl esters and provitamin A carotenoids are converted to retinol after uptake into the lumen (for retinyl esters) or absorption (for provitamin A carotenoids). The various forms of vitamin A are solubilized into micelles in the intestinal lumen and absorbed by duodenal mucosal cells. Other carotenoids in food, such as lycopene, lutein, and zeaxanthin, are not converted into vitamin A and are referred to as non-provitamin A carotenoids they might have other important activities not involving vitamin A formation. The main provitamin A carotenoids in the human diet are beta-carotene, alpha-carotene, and beta-cryptoxanthin. Provitamin A carotenoids are plant pigments that the body converts into vitamin A in the intestine. Preformed vitamin A is found in foods from animal sources, including dairy products, eggs, fish, and organ meats. The human diet contains two sources for vitamin A: preformed vitamin A (retinol and retinyl esters) and provitamin A carotenoids. Vitamin A is also critical for vision as an essential component of rhodopsin, the light-sensitive protein in the retina that responds to light entering the eye, and because it supports the normal differentiation and functioning of the conjunctival membranes and cornea. Vitamin A supports cell growth and differentiation, playing a critical role in the normal formation and maintenance of the heart, lungs, eyes, and other organs. Vitamin A is involved in immune function, cellular communication, growth and development, and male and female reproduction. Vitamin A is the name of a group of fat-soluble retinoids, primarily retinol and retinyl esters. For a general overview of Vitamin A and Carotenoids, see our consumer fact sheet on Vitamin A and Carotenoids. This is a fact sheet intended for health professionals.
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