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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)
Open accessAbstract
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 [61].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [61]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“In contrast, only 7.1% of the general US population are vitamin C deficient.57”
From Vitamin C-induced epigenomic remodelling in IDH1 mutant acute myeloid leukaemia (2018) · cites this paper as [57]
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Metadata
- 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
- 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)
- 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
- 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 (medical) › 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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