Abstract
Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn’s disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as SLC23A1 and SLC23A2 genes, encoding sodium-dependent vitamin C transporters and GSTM1, GSTP1 and GSTT1 genes which encode glutathione S-transferases. Furthermore, ascorbic acid may modify the composition of gut microbiota which plays a role in the pathogenesis of an inflammatory bowel disease.
Highlights
Vitamin C is an antioxidant, a water-soluble vitamin produced by plants and most of animals
It is vital to notice that the guidelines of the ESPEN (European society for clinical nutrition and metabolism) for patients suffering from inflammatory bowel disease (IBD) do not indicate a need for the supplementation of vitamin C [29]
A low-FODMAP (Fermentable Oligo, Di- and Mono-saccharides and Polyols) diet assumes reduced the intake of products containing fermentable, poorly digestible oligosaccharide, disaccharides, monosaccharides and polyols
Summary
Vitamin C (ascorbic acid, AA) is an antioxidant, a water-soluble vitamin produced by plants and most of animals. Recommended dietary allowances for vitamin C (for adults; age 19 years and more) is 65 mg and 75 mg for women and men, respectively. This is turn suggests that the consumption of 5–9 portions of fresh and low-processed vegetables and fruits provides about 200 mg of vitamin C [2,6,7,8]. A higher dose leads to a decreased absorption and only 33% of vitamin C is absorbed when the dose is increased to 1250 mg [7]. Manifestations of vitamin C deficiency are usually related to changes in the extracellular matrix in bone, blood vessels and tendons which leads to bone fragility and hemorrhage [10,11]
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