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Vitamin A is essential in a wide spectrum of physiological activities such as clear retinal vision [13], skin health [14], immune system [15], reproduction [16], and embryonic development as previously reviewed in [16,17,18,19]

Secondary outcomes included cardiovascular mortality, all-cause mortality, non-fatal myocardial infarction, non-fatal stroke, hospitalisation for heart failure, and adverse events

Inflammatory cytokines (266), epigenetics and hormonal appetite control and satiety are also integral in the development and progression of obesity and metabolic syndrome