Vitamin A intake in Vitamin A-deficient populations should equally consider both ends of the Intake Spectrum

Food fortification is a potential strategy in the prevention and management of
population-wide micronutrient deficiencies. In industrialized countries, regulations
focus on setting maximum levels of fortification. In populations in which micronutrient deficiencies are widespread, considering the risk of inadequate intake is key. This paper explores the issue in more detail.

• Depending on the country context, existing inadequate intake have to be taken into account, as well as safe upper levels
• Using upper tolerable intake as a guide may in some cases unnecessarily limit the fortification level, intake and subsequent health impact
• Risk benefit methods have been developed to balance potential benefits and may be of great help for decision making in food fortification programs
• Vitamin A deficiency is a useful example to illustrate the need for such a risk benefit based approach