Is a vitamin A deficiency rare in the United States and more common in developing countries?

December 4, 2025 •

4 min read

According to the U.S. Centers for Disease Control and Prevention (CDC), less than 1% of the U.S. population has a vitamin A deficiency. This statistic stands in stark contrast to the millions affected in developing countries, revealing a significant global health disparity that explains why a vitamin A deficiency is rare in the United States and more common in developing countries.

Quick Summary

A vitamin A deficiency is rare in the U.S. due to robust public health initiatives, food fortification, and diverse diets. In contrast, it is a significant public health problem in many developing countries, exacerbated by poverty and infections.

Key Points

Global Health Disparity: A vitamin A deficiency is rare in the U.S., but a major public health problem in many developing countries, particularly in sub-Saharan Africa and Southeast Asia.
U.S. Prevention Factors: Success in the U.S. is attributed to widespread food fortification (e.g., milk, cereals), diverse diets, readily available supplements, and effective public health infrastructure.
Developing Country Risk Factors: High prevalence in developing nations is driven by poverty, food insecurity, limited dietary diversity, and the widespread impact of infectious diseases.
Socioeconomic Connection: In LMICs, diets often lack vitamin A-rich foods due to low income, with reliance on nutrient-poor staples like rice.
Intervention Strategies: Global efforts involve both short-term solutions like mass supplementation and long-term interventions such as food fortification, biofortification, and dietary education.
Primary Health Impact: VAD is the leading cause of preventable childhood blindness and increased child mortality in developing countries, a tragic outcome largely unknown in the U.S..
Vulnerable Populations: While rare cases in the U.S. affect those with malabsorption or dietary restrictions, the most vulnerable groups globally are infants, young children, and pregnant women.

Understanding the Global Disparity in Vitamin A Deficiency

Vitamin A is a fat-soluble vitamin essential for vision, immune function, reproduction, and cell growth. A lack of this vital nutrient, known as Vitamin A Deficiency (VAD), affects millions worldwide, primarily in low- and middle-income countries (LMICs). The stark contrast in prevalence between developed and developing nations highlights the critical role that nutrition, public health infrastructure, and socioeconomic stability play in global health outcomes. While the developed world has largely eliminated VAD as a widespread public health issue, it continues to be a leading cause of preventable childhood blindness and increased mortality in many other parts of the world.

Factors Contributing to Rarity in the United States

In the U.S., several factors converge to make VAD a rare condition, primarily confined to specific at-risk groups rather than the general population. This success story is a result of a multi-pronged approach that includes widespread dietary diversity, robust public health policies, and economic stability.

Fortified Foods: The widespread practice of food fortification has significantly boosted the vitamin A intake for the general population. Many common foods, including milk and breakfast cereals, are routinely fortified with preformed vitamin A. This ensures that even individuals with less-than-perfect diets receive a baseline level of the nutrient, safeguarding them from severe deficiency.
Dietary Diversity: Economic prosperity in the U.S. allows most people access to a wide variety of foods rich in vitamin A. This includes animal-based sources containing retinol (preformed vitamin A) like meat, eggs, and dairy, as well as plant-based sources with provitamin A carotenoids like sweet potatoes, carrots, and leafy greens.
Affordable Healthcare and Supplementation: For individuals in at-risk groups, such as those with malabsorption issues, healthcare access facilitates diagnosis and treatment. Dietary supplements containing vitamin A are also widely available and affordable for those who may need them.
High Hygienic Standards: Access to clean water and sanitation, coupled with high rates of childhood immunization, reduces the prevalence of infectious diseases. Infections like measles and diarrheal diseases can deplete vitamin A stores, so their lower incidence in the U.S. protects overall vitamin A status.

Why VAD is More Common in Developing Countries

For many LMICs, VAD is a daily reality and a severe public health concern, particularly in sub-Saharan Africa and Southeast Asia. The root causes are deeply intertwined with socioeconomic challenges.

Poverty and Food Insecurity: Widespread poverty limits access to nutritious foods, particularly expensive animal products rich in bioavailable preformed vitamin A. Diets often rely heavily on staple crops like rice, which are poor sources of the nutrient, leading to chronic inadequate intake.
High Rates of Infection: A high prevalence of infectious diseases, including measles and diarrheal illnesses, is a major contributing factor to VAD in these regions. These diseases increase the body's metabolic demand for vitamin A and hinder its absorption. The risk of illness and death from these common childhood infections is significantly increased in vitamin A-deficient children.
Limited Public Health Infrastructure: Many developing nations lack the robust public health programs and infrastructure to effectively combat VAD. This includes limited access to vitamin A supplementation campaigns, food fortification programs, and maternal health services.
Barriers to Intervention: Even when interventions like supplementation are in place, they face implementation challenges. Outdated data, logistical hurdles in remote areas, and lack of consistent funding can undermine their effectiveness. In some cases, cultural practices or lack of education can also affect the uptake of vitamin A-rich foods and supplements.

Comparison of VAD Landscape: United States vs. Developing Countries


Feature	United States	Developing Countries
Prevalence	Very low (less than 1% of population)	Significant public health problem; millions affected
Primary Cause	Primarily affects specific risk groups (e.g., malabsorption issues)	Primarily caused by widespread poverty and inadequate diet
Food Fortification	Widespread and mandatory for staple foods like milk and cereals	Often limited or inconsistent due to logistical and economic challenges
Dietary Sources	Diverse diet including animal and plant sources	Monotonous diets focused on low-nutrient staple crops
At-Risk Groups	People with fat malabsorption disorders, alcoholism, vegans, recent immigrants	Infants, young children, and pregnant/breastfeeding women
Health Consequences	Rare, localized cases	Leading cause of preventable childhood blindness and increased mortality
Primary Intervention	Prevention through dietary diversity and fortification	Mass supplementation, fortification, biofortification, and dietary programs

The Role of Intervention Programs

International health organizations have long prioritized interventions to address the global burden of VAD. The World Health Organization (WHO) and UNICEF advocate for a multifaceted approach that includes both short-term and long-term strategies. Short-term measures, such as the periodic distribution of high-dose vitamin A supplements to young children in endemic areas, have been shown to significantly reduce mortality rates from common childhood infections. Long-term solutions focus on sustainable dietary improvements through strategies like food fortification, biofortification (breeding vitamin A-rich crops), and promoting home gardening and nutrition education. The success of these programs is, however, highly dependent on governmental commitment, adequate funding, and robust delivery systems, which are often lacking in the countries that need them most.

Conclusion

The difference in the prevalence of vitamin A deficiency between the United States and developing countries is a stark reminder of the global health inequities driven by socioeconomic factors. While America’s stable food supply, diverse diet, and public health initiatives make VAD a rarity, millions in low-income nations still face the severe consequences of this preventable condition. Continued progress in combating VAD globally requires sustained efforts to improve nutrition, strengthen healthcare systems, and address the root causes of poverty. A combination of short-term supplementation and long-term, food-based strategies is essential for creating a healthier, more equitable future where VAD no longer threatens the lives and vision of vulnerable populations.

Frequently Asked Questions

The main symptoms include vision problems like night blindness (difficulty seeing in low light), dry eyes (xerophthalmia), and in severe cases, irreversible blindness. It can also cause dry skin, delayed growth, impaired immunity, and increased susceptibility to infections, particularly respiratory and diarrheal illnesses.

The most vulnerable populations in developing countries are infants, young children, and pregnant or breastfeeding women. This is due to increased nutritional demands for growth and reproduction, limited access to nutritious foods, and a higher prevalence of infectious diseases.

Food fortification is effective because it adds vitamin A to commonly consumed staples like milk, cereal, and margarine, ensuring a baseline intake for the majority of the population regardless of individual dietary choices. This strategy successfully integrates the nutrient into the existing food supply chain.

Infections, especially measles and diarrheal diseases, increase the body's demand for vitamin A and hinder its absorption. High fever and loss of appetite during illness also reduce dietary intake, further depleting stores. This creates a vicious cycle where VAD increases infection risk, and infections worsen VAD.

Biofortification is the process of breeding or genetically engineering staple crops to be more nutritious, such as developing orange-fleshed sweet potatoes and orange maize with higher levels of provitamin A. This provides a sustainable, food-based solution to VAD, especially in rural areas where these crops are a primary food source.

Yes, while rare overall, certain groups in the U.S. face a higher risk. These include individuals with chronic malabsorption disorders like cystic fibrosis, inflammatory bowel disease, and chronic liver disease, as well as vegans, people with alcoholism, and recent immigrants or refugees from endemic areas.

The long-term solution involves a combination of sustainable, food-based approaches that address the root causes of malnutrition. This includes promoting dietary diversity, supporting home gardening, implementing effective food fortification programs, and focusing on nutrition education alongside broader public health improvements.