Dietary vitamin C in human health

Granger, Matthew; Eck, Peter

doi:10.1016/bs.afnr.2017.11.006

Cited by 218Vitamin C and Antioxidants ResearchAntioxidant Activity and Oxidative StressPhytochemicals and Antioxidant Activities

Dietary vitamin C in human health

Granger, Matthew, Eck, Peter·2018·Advances in food and nutrition research

DOI 10.1016/bs.afnr.2017.11.006

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Abstract

Vitamin C is essential to prevent scurvy in humans and is implicated in the primary prevention of common and complex diseases such as coronary heart disease, stroke, and cancer. This chapter reviews the latest knowledge about dietary vitamin C in human health with an emphasis on studies of the molecular mechanisms of vitamin C maintenance as well as gene-nutrient interactions modifying these relationships. Epidemiological evidence indicates 5% prevalence for vitamin C deficiency and 13% prevalence for suboptimal status even in industrialized countries. The daily intake (dose) and the corresponding systemic concentrations (response) are related in a saturable relationship, and low systemic vitamin C concentrations in observational studies are associated with negative health outcomes. However, there is no evidence that vitamin C supplementation impacts the risks for all-cause mortality, impaired cognitive performance, reduced quality of life, the development of eye diseases, infections, cardiovascular disease, and cancers. This might be related to the fact that prevention would not be realized by supplementation in populations already adequately supplied through dietary sources. Recent genetic association studies indicate that the dietary intake might not be the sole determinant of systemic concentrations, since variations in genes participating in redox homeostasis and vitamin C transport had been associated with lowered plasma concentrations. However, impact sizes are generally low and these phenomena might only affect individual of suboptimal dietary supply.

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Typical symptoms of scurvy include muscle weakness, swollen and bleeding gums, loss of teeth, petechial hemorrhaging, spontaneous ecchymoses, anemia, impaired wound healing, hyperkeratosis, weakness, myalgia, arthralgia, and weight loss.
“Typical symptoms of scurvy are muscle weakness, swollen and bleeding gums, loss of teeth, petechial hemorrhaging, spontaneous ecchymoses, anemia, impaired would healing, hyperkeratosis, weakness, myalgia, arthralgia, and weight loss”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Smokers are at much higher risk of vitamin C deficiency.
“As already discussed, smokers are at much higher risk [2].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Vitamin C deficiency is associated with higher C-reactive protein levels and with higher mortality.
“Moreover, vitamin C deficiency is associated with higher C-reactive protein levels and with higher mortality [2,175,177].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
The relationship between higher plasma vitamin C and lower cardiovascular risk seems to be valid only for inadequate plasma levels.
“However, this relationship seems to be valid only for inadequate plasma levels.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Higher levels of plasma vitamin C are correlated with a lower risk of coronary artery disease and mortality in terms of cardiovascular diseases.
“Higher levels of plasma vitamin C are correlated with a lower risk of coronary artery disease and mortality in terms of cardiovascular diseases.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]

Humans are fully dependent on vitamin C intake from the diet.
“They are, therefore, fully dependent on vitamin C intake from the diet [1,2,3].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Humans and several other species (guinea pigs, bats, passeriform birds, and primates) lack L-gulono-1,4-lactone oxidase and cannot synthesize vitamin C.
“In contrast to most of the vertebrates, guinea pigs, bats, passeriform birds, and primates, including humans, lack L-gulono-1,4-lactone oxidase, and, hence, cannot synthesize vitamin C.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
The pKa of ascorbic acid is 4.1-4.2, so it is present completely as a monoanion-ascorbate-at physiological pH.
“The pKa of ascorbic acid is 4.1–4.2. Hence, it is present completely as a monoanion—ascorbate at the physiological pH [1,2,4,68].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
The influence of genetic variations on vitamin C pharmacokinetics is based on single nucleotide polymorphisms (SNPs) found in SLC23A1 and SLC23A2 genes with a possible association to human diseases.
“The influence of genetic variations on vitamin C pharmacokinetics is based on single nucleotide polymorphisms (SNPs) found in SLC23A1 and SLC23A2 genes with a possible association to human diseases (reviewed in References [2,6]).”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
The effect of individual SNPs on the vitamin C system level has an additive character, depending on genotype and allele dosage.
“An effect of individual SNPs on the vitamin C system level has an additive character, which depends on genotype and an allele dosage (additive) effect that was also described.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Biochemically, vitamin C plasma levels below 11 μM are considered to coincide with clinical symptoms of scurvy.
“Biochemically, vitamin C plasma levels below 11 µM are considered to coincide with clinical symptoms of scurvy.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Symptoms of scurvy are not seen unless the total vitamin C content in the body falls below 300-400 mg.
“Similarly, symptoms are not seen unless the total vitamin C content in the body falls below 300–400 mg [2,3,6,157,170].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Patients with cancer often have lower plasma levels of vitamin C than healthy adults.
“As mentioned, patients with cancer often have lower plasma levels of vitamin C than healthy adults.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
In adequate vitamin C plasma levels, supplementation with vitamin C has a little effect.
“In adequate vitamin C plasma levels, supplementation with vitamin C has a little effect [2,5,189].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [2]
Due to a genetic mutation of the L-gulonolactone oxidase gene in the last step of the synthesis pathway, humans have lost the ability to make vitamin C and thus must obtain it from the diet.
“However, due to a genetic mutation of the L-gulonolactone oxidase gene in the last step of the synthesis pathway, humans have lost the ability to make vitamin C and thus must obtain it from the diet134.”
From Key points for the development of antioxidant cocktails to prevent cellular stress and damage caused by reactive oxygen species (ROS) during manned space missions (2021) · cites this paper as [134]
Advanced vitamin C deficiency may cause scurvy, presenting with severe fatigue, musculoskeletal pain, gingival hypertrophy, and widespread hemorrhagic manifestations.
“In advanced cases, scurvy may occur, presenting with severe fatigue, musculoskeletal pain, gingival hypertrophy, and widespread hemorrhagic manifestations [38].”
From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [38]

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Cellular Red-Ox system in health and disease: The latest update
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Authors: Granger, M., & Eck, P.
Affiliations: University of Manitoba (CA)
Corresponding author: Eck, Peter
ORCID: Granger, Matthew
Eck, Peter
Venue: Advances in food and nutrition research
Publisher: Elsevier
Published: 2018
Volume: 83
Pages: 281-310
ISSN: 1043-4526 (ISSN-L)
DOI: 10.1016/bs.afnr.2017.11.006
OpenAlex: W2790046020
Cited by: 217
References: 152
Citations by year: 2026: 12 · 2025: 28 · 2024: 39 · 2023: 33 · 2022: 28 · 2021: 40 · 2020: 25 · 2019: 10 · 2018: 2
FWCI: 48.38
Type: book chapter
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Advances in food and nutrition research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
Keywords: vitamin C intake, vitamin C, scurvy, vitamin C supplementation, gene-nutrient interactions, redox homeostasis, plasma vitamin C concentration, coronary artery disease, stroke, cancer prevention, all-cause mortality, cognitive performance, eye diseases, infection
MeSH terms: Ascorbic Acid, Diet, Haptoglobins, Homeostasis, Humans, Scurvy, Vitamins, Dietary Supplements

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Dietary vitamin C in human health

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