Netherlands investigates safe vitamin A intake from supplements

The report​ conducted by the Dutch National Institute for Public Health and the Environment (RIVM) was requested by the country’s Ministry of Health.

It calculated tolerable upper intake limits for vitamin A from food supplements by estimating how much the Dutch population got from the rest of their diets.

The institute advised maximum daily doses from supplements depending on age, gender and ‘life stage’ ranging from 0 to 1500 micrograms (µg) per day.

The overall upper tolerable limit from all dietary sources was taken from a Scientific Committee on Food (SCF), now the European Food Safety Authority (EFSA), report in 2002. Average food intakes by age from various studies conducted between 1997 and 2012 were then deducted from this amount to calculate how much ‘room’ was left over for supplement intake.

For children up to three years the report said there was "no room"​ for vitamin A supplements. The institute found about 5-33% of children aged up to three old had retinol intakes above the SCF tolerable upper intake level, in part due to high retinol foods like liver sausage.

Dr Janneke Verkaik-Kloosterman, a RIVM nutrition scientist and epidemiologist who worked on the report, told us it was now up to the ministry to decide what it would do with the findings, which could mean labelling changes or keeping the legislation the same.

Under current Dutch law supplements may contain a maximum daily dose of 1200 µg with an age limit of one year for doses over 650 µg.

The question now was whether the Dutch government would require further age group conditions on pack.

The generation gap ​

For other age groups there was more scope for supplementation.

Children aged four to six years could take up to 100 µg per day. For teenagers aged 15-17 this jumped to 1500 µg per day, while for adult men this was set at 1450 µg.

For children aged 4-14, about 95% had overall intakes below the SCF upper limit.

For women of childbearing age the RIVM set 1200 µg per day, while for postmenopausal women this was capped at 400 µg due to their risk of osteoporosis.

Verkaik-Kloosterman said there had been a “lack of certainty”​ for pregnant and lactating women since available data was old and of a small sample size.

Over-consumption of vitamin A could cause liver toxicity and during pregnancy problems in the development of the foetus, the institute said.