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Substrate utilization and work efficiency during submaximal exercise in vitamin C depleted-repleted adults.

A placebo-controlled, depletion-repletion protocol was utilized to examine the effect of vitamin C status on substrate utilization during a 90 min walk at 50% maximal oxygen consumption (VO2max). Nine vitamin C depleted subjects (plasma vitamin C < 28 mumol/L) agreed to participate in the 5-week study (aged, 27.6 +/- 2.5 years, mean +/- SE; 5 females, 4 males). Subjects were apparently healthy but unaware of their vitamin C status. Prior to the experimental period, VO2max was measured using open-circuit spirometry during a graded walking protocol. Subjects ingested a placebo capsule daily during weeks 1-3 and a 500 mg vitamin C capsule daily during weeks 4-5 of the experimental study. Mean plasma vitamin C rose nearly 3-fold and mean plasma carnitine fell by nearly 20% at repletion (week 5) versus depletion (week 3). At the end of weeks 3 and 5, subjects completed a 90 minute treadmill walk at an exercise intensity of 50% VO2max. The relative contribution of fat utilized for energy during walking did not differ in the vitamin C depleted versus repleted states. However, work performed by subjects and gross efficiency during exercise increased significantly at repletion versus depletion (10% and 15%, respectively). These data indicate that vitamin C depletion is associated with reduced work efficiency during submaximal exercise.

Adult↗

Risk of inadequate intakes of vitamins A, B1, B6, C, E, folate, iron and calcium in the Spanish population aged 4 to 18.

A meta-analysis of the most representative Spanish nutrition studies was carried out to identify inadequate intakes of vitamins, A, B1, B6, C, E, folate, iron, and calcium in children aged 4 to 18. Information on vegetable, fruit and fruit juice/beverage intake was also solicited. Data drawn from the selected studies yielded a total of 6540 children and adolescents in eight geographical areas. The sample was stratified by age (children: 4 to 14 years old and adolescents: 13-18 years old) and sex. Inadequate intakes (below two-thirds of the recommended values) were notable in children for vitamin E, vitamin C, and vitamin A and in girls, iron. In adolescents, low intakes were especially marked for vitamin E and vitamin A, and in girls, calcium, folate, and iron. Adolescents consumed more vegetables, fruit juice, and fruit drinks whereas children had higher fruit intakes. Regional differences in consumption were also detected. Strategies for improving nutrient intake in these vulnerable populations are discussed.

Adolescent↗

Concentrations of ascorbic acid in the plasma of pregnant smokers and nonsmokers and their newborns.

A cross-sectional study was carried out to determine the differences in vitamin C status of Brazilian pregnant women smokers and nonsmokers and their respective newborn babies, and to assess the prevalence of hypovitaminosis C among these two groups of women. The study involved 127 pregnant women, 40 pregnant smokers and 87 pregnant nonsmokers, admitted to a maternity hospital in São Paulo, Brazil. Data concerning the pregnant women's socioeconomic, demographic, obstetric, and nutritional characteristics were collected, as well as data concerning the newborns' anthropometry and Apgar scores. A strongly significant correlation (p < 0.001) was found between the concentrations of ascorbic acid (AA) in both pregnant smokers (r = 0.77) and pregnant nonsmokers (r = 0.61) and their respective umbilical cords. The mean umbilical AA concentration was significantly higher than the meanAA concentration in pregnant women (92.05 +/- 41.13 vs. 33.39 +/- 18.25 micromol/L, p < 0.001). It was observed that the mean AA was significantly lower for the newborns (p = 0.03) and pregnant women (p = 0.02) from the smoking group. Forty percent (40%) of the smokers and 27% of the nonsmokers presented hypovitaminosis C. We suggest an increase in the consumption of fruits and vegetables by pregnant women, especially the smokers.

Ascorbic Acid↗

Effect of ascorbic acid on tumour growth.

The growth of tumours in guinea-pigs was observed for 20 weeks after placing them on various doses of vitamin C. Complete tumour regression occurred in 55% of those animals receiving 0-3 mg/kg/day ascorbic acid, whereas animals given 10 mg/kg/day showed tumour inhibition but no regression. In contrast, tumours in animals maintained on 1 g/kg/day ascorbic acid grew without sign of retardation. When increased amounts of ascorbic acid were restored to the diet of scorbutic tumour-bearing animals, tumours which had not regressed responded with enhanced growth. Likewise, animals previously maintained on 10 mg/kg ascorbic acid responded in turn to the additional vitamin with enhanced tumour growth. In contrast, all tumour-bearing animals maintained on 1 g/kh ascorbic acid died within 3 weeks when this dose was replaced with 0-3 mg/kg.

Animals↗

Severe hypovitaminosis C in lung-cancer patients: the utilization of vitamin C in surgical repair and lymphocyte-related host resistance.

Plasma and buffy-coat vitamin C were estimated in 158 samples from 139 lung-cancer patients, at all stages of the disease. Most samples showed hypovitaminosis C in both estimations: 64% had plasma, and 25% buffy-coat values below the thresholds for incipient clinical scurvy (0.3 mg% and 10 micrograms/10(8) cells respectively). Levels were diet-dependent and could be increased by oral supplements. Levels were low both in tumour-bearing patients and in those clinically free of disease after resection. The latter had particularly low values during the first 6 months, indicating the utilization of vitamin C in surgical repair. The vitamin C content of 13 primary lung tumours was assayed: tumours had a higher vitamin C content (mean 111.6 +/- 55.1 micrograms/g tissue) than normal lung (58.5 +/- 20.4 micrograms/g). Mononuclear cells from normal individuals show a higher vitamin C content than polymorphs, but in lung-cancer patients the expected correlation of buffy-coat vitamin C with the proportion of lymphocytes in peripheral blood was obscured by an inverse correlation in patients with relative lymphocytosis (greater than or equal to 25% lymphocytes), confirmed by an inverse correlation of the proportion of lymphocytes in peripheral blood with mononuclear-cell vitamin C in 14 patients in whom this was measured. These correlations were unaffected by controlling for plasma values, and indicate the utilization of vitamin C in lymphocyte-related anti-tumour mechanisms. Vitamin C is necessary for phagocytosis and for the expression of cell-mediated immunity. In view of the increasing circumstantial evidence that immune mechanisms exert some measure of control on tumour extension and metastasis in man, the effect of supplementation with vitamin C in lung-cancer patients on survival should be tested in a clinical trial.

Adult↗

Micronutrients in gastrointestinal cancer.

The monitoring of micronutrients and the relationship between dietary intake and micronutrient status prior to and after surgery in patients with histologically proven gastrointestinal adenocarcinoma, both weight-stable and weight-losing (> 7.5% of their pre-illness weight) has been studied and the results compared to controls. Plasma vitamin C and red blood cell thiamine levels were significantly lower in weight-losing cancer patients when compared to their weight-stable counterparts (P < 0.05 and P < 0.02 respectively). Weight-losing patients had a lower vitamin C (P < 0.05) and thiamine (P < 0.002) intake, and a higher elevation in plasma C-reactive protein and a lower prealbumin level (P < 0.02), when compared to both weight-stable cancer patients and controls. Plasma vitamin C, prealbumin and C-reactive protein levels remained unchanged after curative resections of the tumours compared to a preoperative value, and there was a highly significant correlation between plasma vitamin C and dietary intake of vitamin C. This study suggests that the lower vitamin C and thiamine status in weight-losing gastrointestinal cancer patients prior to surgery is due to a lower micronutrient intake and an acute phase response to their illness. Dietary intake of vitamin C appears to be the major factor in determining plasma vitamin C concentration following curative surgical resection.

Adenocarcinoma↗

Low intakes of vegetables and fruits, especially citrus fruits, lead to inadequate vitamin C intakes among adults.

OBJECTIVE: To determine vitamin C intakes among adults and to identify differences in dietary intake associated with vitamin C consumption. DESIGN: This cross-sectional study compared vitamin C intake, nutrient intake, and food group choices of adults with low (<30 mg/d), marginal (30-60 mg/d), and desirable (>60 mg/d) vitamin C intakes. SUBJECTS: Data from 2472 men and 2334 women aged 25-75 y were obtained from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). RESULTS: Overall, 18% of the sample had low vitamin C intakes, 24% had marginal intakes, and 58% had desirable intakes. In addition to consuming less vitamin C, adults with low vitamin C intakes consumed significantly less (P</=0.001) energy-adjusted (ie nutrient/1000 kcal) folate, fiber, beta-carotene, and vitamin B6, and significantly more (P<0.001) fat. Compared to adults with low intakes, adults with desirable vitamin C intakes consumed significantly more (P</=0.001) high-vitamin C fruit juice and low-vitamin C vegetables, while consuming significantly less (P</=0.009) soft drinks, coffee/tea and alcoholic beverages. On average, adults with desirable vitamin C intakes consumed more than five daily servings of vegetables and fruits, of which more than one was citrus. Adults with low and marginal vitamin C intakes consumed less than one-fifth of a serving of citrus. CONCLUSIONS: A considerable number of adults under-consume vitamin C and total vegetables and fruits. Nutritionists should continue to promote five to nine daily servings of vegetables and fruits, at least one of which should be rich in vitamin C.

Adult↗

The relative validity of a computerized food frequency questionnaire for estimating intake of dietary iron and its absorption modifiers.

OBJECTIVE: To determine the relative validity of an iron food frequency questionnaire (iron FFQ) designed to assess intakes of dietary iron and its absorption modifiers. DESIGN: A computer-administered food frequency questionnaire was designed to estimate intake of total, non-haem, haem and meat iron as well as dietary components which influence iron absorption (vitamin C, phytate, calcium, grammes of meat/fish/poultry, tea and coffee) in women consuming a Western diet. The relative validity of the iron FFQ was assessed by comparing its results with those from weighed diet records collected over 11 days. SETTING: Dunedin, New Zealand. PARTICIPANTS: Forty-nine women aged 19-31 y attending the University of Otago. RESULTS: There was good agreement between the iron FFQ and the weighed diet records for median intakes of total iron, non-haem iron, calcium, tea and coffee. For dietary component intakes, correlations between the two methods ranged from 0.39 (for vitamin C) to 0.87 (for coffee) with 0.52 for total iron, and 0.61 for haem iron. In cross-classification with the weighed diet record, the iron FFQ correctly classified between 22% (for vitamin C) and 51% (for phytate) of participants into the same quartile. Actual values for surrogate categories indicated that the questionnaire can clearly differentiate between low and high intakes of all the dietary components assessed. The questionnaire also showed an acceptable level of agreement between repeat administrations (eg a correlation for total iron of 0.65). CONCLUSIONS: The iron FFQ is appropriate for assessing group intakes of total iron, and iron absorption modifiers, in population studies to assess the aetiology and treatment of iron deficiency states in adult women consuming a Western diet. SPONSORSHIP: This research was supported (in part) by a grant from the Health Research Council of New Zealand.

Adult↗