According to Goebel (2011), Vitamin C (ascorbic acid) is a water-soluble vitamin essential in the human diet because the body is unable to synthesise it. It is found in a wide variety of fruit (especially grapefruit, lemons, limes, blackcurrants, oranges and kiwi fruit) and vegetables (e.g., broccoli, green and red peppers, tomatoes, cabbage, sprouts, and sweet potatoes). It is also found in fresh milk, fish and offal such as liver and kidney. It is essential for collagen formation and helps to maintain the integrity of skin and connective tissue, bone, blood vessel walls and dentine. It is essential for wound healing and facilitates recovery from burns. It also facilitates the absorption of iron.
Vitamin C is an antioxidant. Despite claims of benefit, very high doses of vitamin C have not been shown to decrease the incidence of the common cold in the general population. It may
slightly reduce the duration of the cold. In people exposed to brief periods of severe physical exercise or cold environments, there may be some benefit to supplementation to ward off colds (Douglas, Hemila & Chalker, 2007).
Deficiency of vitamin C results in scurvy, which is characterised by haemorrhages and abnormal bone and dentine formation. The body’s pool of vitamin C can be depleted within 1-3 months. People suffering with vitamin C deficiency may also have other vitamin deficiencies and malnutrition (Goebel, 2011).
Causes of vitamin C deficiency
According to Mosdol, Erens and Brunner (2008) the following are some of the predisposing factors that can expose an individual to vitamin C deficiency:
- Infants who are fed only cows’ milk during the first year of life.
- Alcoholism and conforming to food fads.
- Low-income families, who tend not to buy foods high in vitamin C.
- Victims of famine, and refugee populations.
- Cigarette smoking, which affects the absorption of vitamin C. Vitamin C is also used up more quickly in those who smoke.
- Increased need due to increased utilisation in pregnant and lactating women, thyrotoxicosis, surgery, and burns.
- People with type 1 diabetes and those on haemodialysis or peritoneal dialysis, because of increased vitamin C requirements.
- Anorexia nervosa or anorexia from other diseases such as AIDS or cancer.
- Chronic diarrhoea, which increases faecal loss. Risk is increased in those with Crohn’s disease and ulcerative colitis, because of reduced vitamin C absorption
Signs and symptoms of vitamin C deficiency
Vitamin C deficiency is known to be associated with some signs and symptoms which according to Schleicher, Carroll and Ford (2009) which include
- Skin changes such as perifollicular hyperkeratotic papules, perifollicular haemorrhages, purpura, and ecchymoses. These are seen most commonly on the legs and buttocks. There may be poor wound healing and breakdown of old scars. Alopecia may occur.
- Occurrence if splinter haemorrhages in the nails
- Bleeding and swelling of gums, friable and infected; petechiae can occur on the mucosae.
- Conjunctival haemorrhage, flame-shaped haemorrhages, and cotton-wool spots may be seen. Bleeding into the periorbital area, eyelids, and retrobulbar space may occur.
- A scorbutic rosary (where the sternum sinks inwards at the costochondral junctions) may occur in children.
- High-output heart failure due to anaemia can be seen and hypotension may occur late in the disease.
- Fractures, dislocations, tenderness of bones and bleeding into muscles and joints are possible.
- Oedema may occur late in the disease.
- Loss of weight secondary to anorexia is common.
Dangers of vitamin C deficiency
Vitamin C is considered to be an important nutrient for the various functions it has within the human body. Schleicher, et al., (2009) stated that there are numerous dangers and health risks associated with vitamin C deficiency, including:
- Gingivitis
- Fatigue
- Effects on a person’s metabolism
- Increased risk of infections
- Anaemia
- Slower tissue, bone and cartilage repair
- Weakened tooth enamel
- Scurvy
Scurvy is the primary disease caused by vitamin C deficiency. It can lead to anaemia, skin hemorrhages, gum disease and a general feeling of weakness throughout a person’s body. Those primarily at risk for obtaining scurvy are malnourished individuals who lack enough vitamin C in their diet.
Prevention of vitamin C deficiency
Vitamin C deficiency can be prevented by a diet that includes certain citrus fruits such as oranges or lemons. Other sources rich in vitamin C are fruits such as blackcurrants, guava, kiwifruit, papaya, tomatoes, bell peppers, and strawberries. It can also be found in some vegetables, such as carrots, broccoli, potatoes, cabbage, spinach and paprika. Some fruits and vegetables not high in vitamin C may be pickled in lemon juice, which is high in vitamin C. Though redundant in the presence of a balanced diet, various nutritional supplements are available that provide ascorbic acid well in excess of that required to prevent vitamin C deficiency, and even some candies contain vitamin C as a preservative (Stephen, 2003).
Many animal products, including liver, Muktuk (whale skin), oysters, and parts of the central nervous system, including the brain, spinal cord, and adrenal medulla, contain large amounts of vitamin C, and can even be used to treat scurvy (Rivers, 2007).
Fresh meat from animals which make their own vitamin C (which most animals do) contains enough vitamin C to prevent scurvy, and even partly treat it. This caused confusion in the early history of vitamin C deficiency, since the disease was only seen in people eating long-preserved diets or canned goods, but not in people eating any sort of fresh diet, including arctic diets primarily based upon meat. In some cases (notably in French soldiers eating fresh horse meat), it was discovered that meat alone, even partly cooked meat, could alleviate scurvy. In other cases, a meat-only diet could cause scurvy. Some of these observations that scurvy was associated only with preserved foods prompted explorers to blame vitamin C deficiency upon some type of tainting or poison which pervaded tinned foods (Stephen, 2003).
Diet management of vitamin C deficiency
Dietary management of vitamin C deficiency involve the intake of foods that are rich in vitamin C. Citrus fruits such as oranges, kiwifruits, grapefruits, and gooseberries should be consumed on a regular basis. Your doctor can help you make a scurvy diet plan. Since vitamin C deficiency is induced by dietary deficiency, it can be completely prevented. Vitamin C food allergies are one of the many causes of this condition, so if you have food allergies, take vitamin C regularly. Consume a lot of vitamin C food to prevent the condition. Some of the foods to prevent vitamin C deficiency include citrus fruits and green vegetables.
Conclusion
Vitamin C is an extremely important nutrient which is required for various functions in the body and therefore requires a steady consumption. The daily recommended allowance of vitamin C is an average of 90mg for males and 75mg for females. If an individual’s diet is deficient in the daily recommended allowance for an extended period of time lead to the experience of symptoms of scurvy and some other health complications. To prevent this occurrence, it is recommended that individuals should consume diets rich in vitamin C such as oranges, kiwifruits, grapefruits, and gooseberries on a regular basis.
References
Douglas, R.M., Hemila, H. & Chalker, E. (2007). Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 18;(3):CD000980.
Goebel, L. (2011). Scurvy. New York: Medscape
Mosdol, A., Erens, B. & Brunner, E. (2008). Estimated prevalence and predictors of vitamin C deficiency. UK’s J Public Health (Oxf). 30(4):456-60.
Schleicher, R.L., Carroll, M.D. & Ford, E.S. (2009). Serum vitamin C and the prevalence of vitamin C deficiency in the United States: National Health and Nutrition Examination Survey (NHANES). Am J Clin Nutr. 90(5):1252-63.
Rivers, J.M. (2007). “Safety of high-level vitamin C ingestion”. Ann. N. Y. Acad. Sci. 498 (1): 445–54.
Stephen, R. (2003). Scurvy: How a Surgeon, a Mariner and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail. New York: Viking.
