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Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective

by Anitra C. Carr 1,* and Sam Rowe 2
1
Nutrition in Medicine Research Group, Department of Pathology & Biomedical Science, University of Otago, Christchurch 8011, New Zealand
2
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L35QA, UK
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(7), 1963; https://doi.org/10.3390/nu12071963
Received: 3 June 2020 / Revised: 23 June 2020 / Accepted: 26 June 2020 / Published: 1 July 2020
(This article belongs to the Special Issue Vitamin C and D: A Global Health Perspective)
A recent review of global vitamin C status has indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here, we provide a narrative review of potential factors influencing vitamin C status globally. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use, with those who supplement having a higher mean status and a lower prevalence of deficiency. Dietary intake can be influenced by cultural aspects such as traditional cooking practices and staple foods, with many staple foods, such as grains, contributing negligible vitamin C to the diet. Environmental factors can also affect vitamin C intake and status; these include geographic region, season, and climate, as well as pollution, the latter partly due to enhanced oxidative stress. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects can affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various noncommunicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time; therefore, we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global dietary intake recommendations for vitamin C. View Full-Text
Keywords: vitamin C; vitamin C status; vitamin C deficiency; global health; dietary intake; obesity; smoking; communicable disease; infection; noncommunicable disease vitamin C; vitamin C status; vitamin C deficiency; global health; dietary intake; obesity; smoking; communicable disease; infection; noncommunicable disease
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Carr, A.C.; Rowe, S. Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective. Nutrients 2020, 12, 1963.

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