Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES)

Schleicher, Rosemary L; Carroll, Margaret D; Ford, Earl S; Lacher, David A

doi:10.3945/ajcn.2008.27016

Cited by 520Vitamin C and Antioxidants ResearchAntioxidant Activity and Oxidative StressNutrition and Health Studies

Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES)

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Schleicher, Rosemary L, Carroll, Margaret D, Ford, Earl S, Lacher, David A·2009·The American Journal of Clinical Nutrition

DOI 10.3945/ajcn.2008.27016

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Abstract

Background Vitamin C (ascorbic acid) may be the most important water-soluble antioxidant in human plasma. In the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994), approximately 13% of the US population was vitamin C deficient (serum concentrations <11.4 micromol/L).Objective The aim was to determine the most current distribution of serum vitamin C concentrations in the United States and the prevalence of deficiency in selected subgroups.Design Serum concentrations of total vitamin C were measured in 7277 noninstitutionalized civilians aged > or =6 y during the cross-sectional, nationally representative NHANES 2003-2004. The prevalence of deficiency was compared with results from NHANES III.Results The overall age-adjusted mean from the square-root transformed (SM) concentration was 51.4 micromol/L (95% CI: 48.4, 54.6). The highest concentrations were found in children and older persons. Within each race-ethnic group, women had higher concentrations than did men (P < 0.05). Mean concentrations of adult smokers were one-third lower than those of nonsmokers (SM: 35.2 compared with 50.7 micromol/L and 38.6 compared with 58.0 micromol/L in men and women, respectively). The overall prevalence (+/-SE) of age-adjusted vitamin C deficiency was 7.1 +/- 0.9%. Mean vitamin C concentrations increased (P < 0.05) and the prevalence of vitamin C deficiency decreased (P < 0.01) with increasing socioeconomic status. Recent vitamin C supplement use or adequate dietary intake decreased the risk of vitamin C deficiency (P < 0.05).Conclusions In NHANES 2003-2004, vitamin C status improved, and the prevalence of vitamin C deficiency was significantly lower than that during NHANES III, but smokers and low-income persons were among those at increased risk of deficiency.

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A national survey in the United States in the years 2003-2004 reported that 7% of persons had a vitamin C plasma level below 11.4 μM.
“a national survey in the United States in the years 2003–2004 reported that 7% of persons had a vitamin C plasma level below 11.4 µM [61].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]
Vitamin C plasma levels fluctuate with age: they are highest in the 6 to 11 years old category, then gradually decrease, with an increase in the population over 60 years old in both men and women.
“The levels of vitamin C fluctuate with age. They are highest in the category of 6 to 11 years old and then gradually decrease. There is, however, an increase in the population over 60 years old in both men and women [61].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]
Women have, in general, higher plasma vitamin C levels than men.
“Women have, in general, higher plasma levels than men [61].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]
Smoking decreases vitamin C plasma levels on average by 25-50%.
“Smoking decreases the plasma level of vitamin C on an average by 25–50% [52,61,63].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]
There is no difference between serum and plasma vitamin C levels.
“There is no difference between serum and plasma [59,60,61,62,63].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]

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Authors: Schleicher, R. L., Carroll, M. D., Ford, E. S., & Lacher, D. A.
Affiliations: Centers for Disease Control and Prevention (US)
Corresponding author: Schleicher, Rosemary L
ORCID: Schleicher, Rosemary L
Carroll, Margaret D
Lacher, David A
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2009-11
Volume: 90
Issue: 5
Pages: 1252-1263
ISSN: 0002-9165 (ISSN-L)
DOI: 10.3945/ajcn.2008.27016
OpenAlex: W2097237102
Cited by: 504
References: 65
Citations by year: 2026: 12 · 2025: 25 · 2024: 32 · 2023: 46 · 2022: 60 · 2021: 44 · 2020: 45 · 2019: 28 · 2018: 35 · 2017: 31 · 2016: 26 · 2015: 28 · 2014: 19 · 2013: 19 · 2012: 25
FWCI: 16.46
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4862 d)
Locations: American Journal of Clinical Nutrition (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 › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
Keywords: vitamin C, scurvy, prevalence, smoking, socioeconomic status, vitamin C supplementation, dietary intake, sex differences, age differences, antioxidant status
MeSH terms: Adolescent, Adult, Ascorbic Acid, Ascorbic Acid Deficiency, Child, Cross-Sectional Studies, Diet, Ethnicity, Female, Humans, Interviews as Topic, Male, Nutrition Surveys, Poverty, Probability, Smoking, Socioeconomic Factors, United States, Body Mass Index, Dietary Supplements, Young Adult

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Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES)

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