Abstract
Vitamin C, well-established in immune function and a key factor in epigenetic inflammatory modifications, is only obtained through consistent dietary intake. Identifying individuals at risk for Vitamin C insufficiency may guide prevention and treatment, however, national surveillance has not been evaluated in the United States since 2006. A descriptive, cross-sectional secondary analysis was performed utilizing data from the 2003–2006 National Health and Nutrition Examination Surveys (NHANES) assessing non-institutionalized adults. Five categories of plasma Vitamin C were delineated: deficiency (<11 μmol/L), hypovitaminosis (11–23 μmol/L), inadequate (23–49 μmol/L), adequate (50–69 μmol/L), and saturating (≥70 μmol/L). Results indicated 41.8% of the population possessed insufficient levels (deficiency, hypovitaminosis, and inadequate) of Vitamin C. Males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty to income ratio and food insecurity were significantly associated with insufficient Vitamin C plasma levels. Plasma Vitamin C levels reveal a large proportion of the population still at risk for inflammatory driven disease with little to no symptoms of Vitamin C hypovitaminosis. Recognition and regulation of the health impact of Vitamin C support the goal of Nutrition and Healthy Eating as part of the Healthy People 2030.
Highlights
Prior to the Coronavirus-19 (COVID-19) pandemic, the United States (USA) led the world in the incidence of food insecurity among high-income nations [1,2], with as many as 40% of households affected [3]
The identification of increased supplementation necessary to reverse hypovitaminosis [11] as well as the uncertainty of the pervasiveness of food insecurity caused by the coronavirus pandemic, highlight the importance of nutritional surveillance and better tailored interventions
This study provides evidence from plasma blood levels that suggest that percentage of Vitamin C insufficiency is much higher
Summary
Prior to the Coronavirus-19 (COVID-19) pandemic, the United States (USA) led the world in the incidence of food insecurity among high-income nations [1,2], with as many as 40% of households affected [3]. A comprehensive list of its full benefits has still not been clearly identified, many of its valuable properties are believed to be the result of its ability to act as an electron donor [18,19,20] These include neutralizing free radical oxygen species, inhibition of low-density lipoprotein (LDL) oxidation [21], alleviating chronic inflammation [12], supporting growth and development of healthy gut microbiota [9], enhancing neutrophil motility [10,11], aiding the proliferation of natural killer cells [12], recycling Vitamin E [22,23], and enhancing the bioavailability of iron [24]. Current recommendations for daily intake of Vitamin C are inconsistent worldwide with ranges from 40 to 220 mg/day [29] and there remains little to no consistent evaluation of population intake or standard guidelines for increased consumption/supplementation when necessary
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