Abstract
BackgroundStudies from the UK and North America have reported vitamin C deficiency in around 1 in 5 men and 1 in 9 women in low income groups. There are few data on vitamin C deficiency in resource poor countries.ObjectivesTo investigate the prevalence of vitamin C deficiency in India.DesignWe carried out a population-based cross-sectional survey in two areas of north and south India. Randomly sampled clusters were enumerated to identify people aged 60 and over. Participants (75% response rate) were interviewed for tobacco, alcohol, cooking fuel use, 24 hour diet recall and underwent anthropometry and blood collection. Vitamin C was measured using an enzyme-based assay in plasma stabilized with metaphosphoric acid. We categorised vitamin C status as deficient (<11 µmol/L), sub-optimal (11–28 µmol/L) and adequate (>28 µmol/L). We investigated factors associated with vitamin C deficiency using multivariable Poisson regression.ResultsThe age, sex and season standardized prevalence of vitamin C deficiency was 73.9% (95% confidence Interval, CI 70.4,77.5) in 2668 people in north India and 45.7% (95% CI 42.5,48.9) in 2970 from south India. Only 10.8% in the north and 25.9% in the south met the criteria for adequate levels. Vitamin C deficiency varied by season, and was more prevalent in men, with increasing age, users of tobacco and biomass fuels, in those with anthropometric indicators of poor nutrition and with lower intakes of dietary vitamin C.ConclusionsIn poor communities, such as in our study, consideration needs to be given to measures to improve the consumption of vitamin C rich foods and to discourage the use of tobacco.
Highlights
Vitamin C plays a major role in human metabolism ranging from the synthesis of collagen, carnitine and norepinephrine to a large number of antioxidant activities [1]
Vitamin C deficiency varied by season, and was more prevalent in men, with increasing age, users of tobacco and biomass fuels, in those with anthropometric indicators of poor nutrition and with lower intakes of dietary vitamin C
In poor communities, such as in our study, consideration needs to be given to measures to improve the consumption of vitamin C rich foods and to discourage the use of tobacco
Summary
Vitamin C (ascorbic acid) plays a major role in human metabolism ranging from the synthesis of collagen, carnitine and norepinephrine to a large number of antioxidant activities [1]. Even in high income countries population-based studies have reported blood levels of vitamin C in the range indicating deficiency in around 1 in 5 men and 1 in 9 women in low income groups [2,3,4,5,6]. Tobacco use is common in India with a third of adults smoking or chewing tobacco [10] These factors: poor diets, especially in the older age group, and high use of tobacco suggest that vitamin C deficiency might be high in the older Indian population but currently no studies have investigated this or whether risk factors for vitamin C deficiency differ from those reported in high income populations. There are few data on vitamin C deficiency in resource poor countries
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