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Due to the pharmacokinetics and tight regulation of plasma ascorbic acid, supplementation with vitamin C will have variable effects in vitamin C-replete (plasma levels near saturation) versus sub-optimal (plasma levels The amount of vitamin C required to help prevent chronic disease is higher than the amount required for prevention of scurvy. Modulation of certain immunologic responses by vitamin C. Potentiation of in vitro and in vivo lymphocyte responses. RCTs evaluate the effect of vitamin C supplementation on the reduction of chronic disease in participants randomly assigned to receive either vitamin C or placebo for a given length of time. Effect of vitamin C supplements on cell-mediated immunity in old people. Coronary heart disease (CHD) is characterized by the build-up of plaque inside the arteries that supply blood to the heart (atherosclerosis). Information regarding vitamin C and the prevention of chronic disease is based on both observational prospective cohort studies and randomized controlled trials (RCTs) (3, 11). Prospective cohort studies assess vitamin C intake or body status in large numbers of people who are followed over time to determine whether they develop a specific chronic disease outcome. In 2004, a pooled analysis of nine prospective cohort studies found that supplemental vitamin C intake (≥400 mg/day for a mean of 10 years), but not dietary vitamin C intake, was inversely associated with CHD risk (18).
Conversely, a 2008 meta-analysis of 14 cohort studies concluded that dietary, but not supplemental, vitamin C intake was inversely related to CHD risk (19). Vitamin C also participates in redox recycling of other important antioxidants; for example, vitamin C is known to regenerate vitamin E from its oxidized form (3, 4). Vitamin C’s role as a cofactor is also related to its redox potential. Alberts B, Bray D, Lewis J, Raff M, Roberts K, Watson JD. Limitations inherent to dietary assessment methodology, such as recall bias, measurement error, and residual confounding, may account for some of the inconsistent associations between vitamin C intake and CHD risk. In order to overcome such limitations, some prospective studies measured plasma or serum levels of vitamin C as a more reliable index of vitamin C intake and biomarker of body vitamin C status. Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials. The European Investigation into Cancer and Nutrition (EPIC)-Norfolk prospective cohort study investigated the relationship between vitamin C status and incident heart failure in healthy adults (9,187 men and 11,112 women, aged 58.1±9.2 years) (21).