Food fortification with preformed vitamin A: persistent challenges and agro-industrial relevance for embryo-fetal safety
DOI:
https://doi.org/10.59410/PREPRINT-UEA-v2026ep06-1206Keywords:
Preformed vitamin A, food fortification, cumulative exposure, agro-industrial chain, pregnancy, teratogenicityAbstract
Food fortification with preformed vitamin A is a strategy used to prevent nutritional deficiencies. However, its implementation poses technological and control-related challenges that may modify dietary exposure and become particularly relevant during pregnancy. The aim of the present study was to analyze food fortification with preformed vitamin A, its persistent challenges along the agro-industrial chain, and its implications for embryofetal safety. To this end, an integrative literature review was conducted based on scientific and technical publications related to formulation, dosing, mixing, stability, labeling, and dietary exposure. The analysis was organized according to the main stages of the agro-industrial chain: formulation, processing, storage, labeling, and consumption. It was found that factors such as premix dosing, mixing homogeneity, degradation during shelf life, the use of safety margins, and labeling clarity may alter the final concentration of the micronutrient and promote conditions such as excessive exposure, intra-batch variability, compensatory overdosing, and cumulative exposure. During pregnancy, these situations acquire preventive relevance due to the teratogenic potential of preformed vitamin A. It is concluded that risk management requires an integrated approach among key sectors.
Downloads
References
ALBERTA HEALTH SERVICES, 2024. Pregnancy. . Online. January 2024. Available from: https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-pregnancy.pdf [Accessed 6 April 2026].
ALLEN, Lindsay, DE BENOIST, Bruno, DARY, Omar and HURRELL, Richard, 2006. Guidelines on food fortification with micronutrients. Online. Hong Kong: World Health Organization. ISBN 9241594012. Available from: https://iris.who.int/server/api/core/bitstreams/8ea6327f-bd8c-4997-b8f5-705ed9d0c445/content [Accessed 6 April 2026].
AZAÏS-BRAESCO, Véronique and PASCAL, Gérard, 2000. Vitamin A in pregnancy: requirements and safety limits. The American Journal of Clinical Nutrition. Online. May 2000. Vol. 71, no. 5, p. 1325S-1333S. DOI: 10.1093/ajcn/71.5.1325s. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002916523071642
BASTOS MAIA, Sabina, ROLLAND SOUZA, Alex Sandro, COSTA CAMINHA, Maria de Fátima, LINS DA SILVA, Suzana, CALLOU CRUZ, Rachel de Sá Barreto Luna,
CARVALHO DOS SANTOS, Camila and BATISTA FILHO, Malaquias, 2019. Vitamin A and Pregnancy: A Narrative Review. Nutrients. Online. 22 March 2019. Vol. 11, no. 3, p. 681. DOI: 10.3390/nu11030681. Available from: https://www.mdpi.com/2072-6643/11/3/681
CLEVELAND CLINIC, 2022. Teratogens. Cleveland Clinic. Online. 2022. Available from: https://my.clevelandclinic.org/health/articles/24325-teratogens [Accessed 16 April 2026].
FAO, 2015. Codex Alimentarius. Online. Available from: https://www.fao.org/fao-who-codexalimentarius/sh-proxy/it/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXG%2B9-1987%252FCXG_009s_2015.pdf [Accessed 6 April 2026].
FRIESEN, Valerie M, MBUYA, Mduduzi NN, AARON, Grant J, PACHÓN, Helena, ADEGOKE, Olufemi, NOOR, Ramadhani A, SWART, Rina, KAAYA, Archileo, WIERINGA, Frank T and NEUFELD, Lynnette M, 2020. Fortified Foods Are Major Contributors to Apparent Intakes of Vitamin A and Iodine, but Not Iron, in Diets of Women of Reproductive Age in 4 African Countries. The Journal of Nutrition. Online. August 2020. Vol. 150, no. 8, p. 2183–2190. DOI: 10.1093/jn/nxaa167. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0022316622022829
GARCÍA-CASAL, María Nieves, 2013. Valores de referencia de vitamina A para la población venezolana. Archivos Latinoamericanos de Nutrición. Online. 2013. Vol. 63, no. 4, p. 321–328. Available from: https://ve.scielo.org/scielo.php?pid=S0004-06222013000400008&script=sci_arttext [Accessed 16 April 2026].
GONÇALVES, Antónia, ESTEVINHO, Berta N. and ROCHA, Fernando, 2016. Microencapsulation of vitamin A: A review. Trends in Food Science & Technology. Online. May 2016. Vol. 51, p. 76–87. DOI: 10.1016/j.tifs.2016.03.001. Available from: https://linkinghub.elsevier.com/retrieve/pii/S092422441530131X
HAN, Joohun, DURAND-MORAT, Alvaro and MOTTALEB, Khondoker, 2025. Vitamin A fortification: key factors and considerations for effective implementation. Frontiers in Public Health. Online. 1 April 2025. Vol. 13. DOI: 10.3389/fpubh.2025.1534375. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2025.1534375/full
KIN TING KAM, Richard, DENG, Yi, CHEN, Yonglong and ZHAO, Hui, 2012. Retinoic acid synthesis and functions in early embryonic development. Cell & Bioscience. Online. 22 March 2012. Vol. 2, no. 1, p. 11. DOI: 10.1186/2045-3701-2-11. Available from: https://cellandbioscience.biomedcentral.com/articles/10.1186/2045-3701-2-11
LINUS PAULING INSTITUTE’S MICRONUTRIENT INFORMATION CENTER, 2026. Vitamin A . . 2026.
MARTÍNEZ GARCÍA, Rosa María, 2016. Suplementos en gestación: últimas recomendaciones. Nutrición Hospitalaria. Online. 12 July 2016. DOI: 10.20960/nh.336. Available from: http://revista.nutricionhospitalaria.net/index.php/nh/article/view/336
MATUSZEK, Dominika Barbara, BIERCZYŃSKI, Karol, JĘDRYSIAK, Andżelika and KRASZEWSKA, Angelika, 2021. Homogeneity of the selected food mixes. Czech Journal of Food Sciences. Online. 29 June 2021. Vol. 39, no. 3, p. 197–207. DOI: 10.17221/225/2020-CJFS. Available from: http://cjfs.agriculturejournals.cz/doi/10.17221/225/2020-CJFS.html
MAURYA, Vaibhav Kumar, SHAKYA, Amita, BASHIR, Khalid, KUSHWAHA, Satish Chand and MCCLEMENTS, David Julian, 2022. Vitamin A fortification: Recent advances in encapsulation technologies. Comprehensive Reviews in Food Science and Food Safety. Online. 5 May 2022. Vol. 21, no. 3, p. 2772–2819. DOI: 10.1111/1541-4337.12941. Available from: https://ift.onlinelibrary.wiley.com/doi/10.1111/1541-4337.12941
MONTOYA SOLANO, Daniela, VALERIO VEGA, Mariam and MORA CHACON, Sebastián, 2024. La importancia del consumo de micronutrientes durante el embarazo: una revisión. Revista Científica Arbitrada Multidisciplinaria PENTACIENCIAS. Online. 8 August 2024. Vol. 6, no. 5, p. 300–309. DOI: 10.59169/pentaciencias.v6i5.1225. Available from: https://editorialalema.org/index.php/pentaciencias/article/view/1225
NHS, 2023. https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/. . Online. 1 September 2023. Available from: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/ [Accessed 6 April 2026].
NIH, 2025. Vitamin A and Carotenoids. . Online. 10 March 2025. Available from: https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/ [Accessed 6 April 2026].
ROTHMAN, Kenneth J., MOORE, Lynn L., SINGER, Martha R., NGUYEN, Uyen-Sa D.T., MANNINO, Salvatore and MILUNSKY, Aubrey, 1995. Teratogenicity of High Vitamin A Intake. New England Journal of Medicine. Online. 23 November 1995. Vol. 333, no. 21, p. 1369–1373. DOI: 10.1056/NEJM199511233332101. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM199511233332101
TANUMIHARDJO, Sherry A., KALIWILE, Chisela, BOY, Erick, DHANSAY, Muhammad A. and VAN STUIJVENBERG, Martha E., 2019. Overlapping vitamin A interventions in the United States, Guatemala, Zambia, and South Africa: case studies. Annals of the New York Academy of Sciences. Online. 28 June 2019. Vol. 1446, no. 1, p. 102–116. DOI: 10.1111/nyas.13965. Available from: https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/nyas.13965
TAZHIBAYEV, Shamil, DOLMATOVA, Oxana, NEVZOROV, Konstantin, PANAGIDES, Dora, DARY, Omar and MANSOU, Mohamed, 2022. Peroxide formation and vitamin a stability in fortified refined sunflower oil along the commercial chain of large and small/medium factories in Kazakhstan. International Journal of Food Science and Nutrition. Online. 2022. Vol. 7, no. 2, p. 11–22. Available from: https://www.foodsciencejournal.com/assets/archives/2022/vol7issue2/7-1-27-243.pdf [Accessed 6 April 2026].
TECNOSERVE, 2019. Landscape Study of Vitamins and Premix for Food Fortification in Nigeria . . Online. 2019. Available from: https://www.technoserve.org/wp-content/uploads/2022/08/Premix-Study-Full-Report.pdf [Accessed 6 April 2026].
THE ASEAN SECRETARIAT JAKARTA, 2024. Guidelines and Minimum Standards for Implementation of Mandatory Large-scale Food Fortification. . Online. 2024. Available from: https://asean.org/wp-content/uploads/2024/08/ASEAN_Mandatory-Large-Scale-Food-Fortification_with-forewords.pdf [Accessed 6 April 2026].
TURCK, Dominique, BOHN, Torsten, CASTENMILLER, Jacqueline, DE HENAUW, Stefaan, HIRSCH‐ERNST, Karen‐Ildico, KNUTSEN, Helle Katrine, MACIUK, Alexandre, MANGELSDORF, Inge, MCARDLE, Harry J., PENTIEVA, Kristina, SIANI, Alfonso, THIES, Frank, TSABOURI, Sophia, VINCETI, Marco, LIETZ, Georg, PASSERI, Giovanni, CRACIUN, Ionut, FABIANI, Lucia, HORVATH, Zsuzsanna, VALTUEÑA MARTÍNEZ, Silvia and NASKA, Androniki, 2024. Scientific opinion on the tolerable upper intake level for preformed vitamin A and β‐carotene. EFSA Journal. Online. June 2024. Vol. 22, no. 6. DOI: 10.2903/j.efsa.2024.8814. Available from: http://doi.wiley.com/10.2903/j.efsa.2024.8814
WORLD HEALTH ORGANIZATION, 2023. Vitamin A supplementation during pregnancy. e-Library of Evidence for Nutrition Actions (eLENA). Online. 9 August 2023. Available from: https://www.who.int/tools/elena/interventions/vitamina-pregnancy [Accessed 6 April 2026].
Downloads
Posted
How to Cite
License
Copyright (c) 2026 PREPRINT UEA

This work is licensed under a Creative Commons Attribution 4.0 International License.