With the availability of high quality nutrition and access to vitamin and mineral supplements, evidence of vitamin deficiencies should be absent from Western nations. However, reports of vitamin and mineral deficiencies continue to accumulate. In addition, a new classification of vitamin and mineral status, the insufficiency, has been used in research to describe those with inadequate intakes of essential nutrients above the level required to cause classic deficiency symptoms. Evidence suggests that large numbers of people in Western countries have nutrient insufficiencies, particularly vitamin D, selenium, zinc and magnesium. Deficiencies of vitamin C have been shown to prolong recovery from disease and decrease the efficiency of the immune system. Despite this evidence of deficiencies of vitamin C amongst hospitalised patients in Western health care have been reported, suggesting that the population as a whole may have poor vitamin C status.
To investigate the vitamin C status of the population, researchers1 have measured the plasma vitamin C of 149 patients admitted to the acute-care ward of a Canadian teaching hospital. A reference sample of 141 non-hospitalised subjects was also assessed to provide additional control data. Of the reference group, 13% had vitamin C plasma concentrations below 28.4µmol/L and 3% were deficient in vitamin C (<11.4µmol/L). However, 50% of the hospital patients group has vitamin C plasma levels that were suboptimal and 19% were deficient. More importantly, in a follow up sample take 17 days after hospital admission, none of the patients had improved vitamin C plasma concentrations, suggesting that hospital care was not addressing the patient’s basic nutritional and healthcare needs. The use of vitamin supplements was associated with adequate vitamin C status on admission to hospital, while poor nutrition predicted inadequate status.
These results suggest that large numbers of individuals in Western nations could benefit from addition of a vitamin C supplement. This study was careful to include a reference group of normally nourished and healthy individuals in order to validate the methodology, which is important because vitamin C in plasma is prone to degrade if not carefully treated. Because vitamin C levels can drop precipitously in acute illness due to increased clearance, addressing the needs of ill patients is vital, something that does not appear to have happened in this case. Those at risk of vitamin C deficiency in hospital should receive adequate nutrition in order to reverse their poor vitamin C status. No patient that had used a vitamin C supplement in this study was deficient, even if they had reported weight loss or poor diet. Studies in other countries have found similar results suggesting that vitamin C deficiencies are widespread.
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