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Journal of the American College of Nutrition, Vol. 22, No. 1, 18-35
(2003)
Published by the American College of Nutrition
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Review Article
Vitamin C as an Antioxidant: Evaluation of Its Role in Disease
Prevention
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Sebastian J. Padayatty, MRCP, PhD, Arie Katz, MD, Yaohui Wang, MD,
Peter Eck, PhD, Oran Kwon, PhD, Je-Hyuk Lee, PhD, Shenglin Chen, PhD,
Christopher Corpe, PhD, Anand Dutta, BS, Sudhir K Dutta, MD, FACN and
Mark Levine, MD, FACN
Molecular and Clinical Nutrition Section, Digestive Diseases Branch,
National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda (S.J.P., A.K., Y.W., P.E.,
O.K., J.-H.L., S.C., C.C., M.L.), Maryland
Division of Gastroenterology, Sinai Hospital of Baltimore, University
of Maryland School of Medicine, Baltimore (A.D., S.K.D.), Maryland

Address correspondence to: Mark Levine MD, Molecular and Clinical
Nutrition Section, Digestive Diseases Branch, Building 10, Room 4D52,
MSC 1372, National Institute of Diabetes and Digestive and Kidney
Diseases, National Institutes of Health, Bethesda, MD 20892-1372.
E-mail: MarkL{at}intra.niddk.nih.gov
Vitamin C in humans must be ingested for survival. Vitamin C is an
electron donor, and this property accounts for all its known
functions. As an electron donor, vitamin C is a potent water-soluble
antioxidant in humans. Antioxidant effects of vitamin C have been
demonstrated in many experiments in vitro. Human diseases such as
atherosclerosis and cancer might occur in part from oxidant damage to
tissues. Oxidation of lipids, proteins and DNA results in specific
oxidation products that can be measured in the laboratory. While these
biomarkers of oxidation have been measured in humans, such assays have
not yet been validated or standardized, and the relationship of
oxidant markers to human disease conditions is not clear.
Epidemiological studies show that diets high in fruits and vegetables
are associated with lower risk of cardiovascular disease, stroke and
cancer, and with increased longevity. Whether these protective effects
are directly attributable to vitamin C is not known. Intervention
studies with vitamin C have shown no change in markers of oxidation or
clinical benefit. Dose concentration studies of vitamin C in healthy
people showed a sigmoidal relationship between oral dose and plasma
and tissue vitamin C concentrations. Hence, optimal dosing is critical
to intervention studies using vitamin C. Ideally, future studies of
antioxidant actions of vitamin C should target selected patient
groups. These groups should be known to have increased oxidative
damage as assessed by a reliable biomarker or should have high
morbidity and mortality due to diseases thought to be caused or
exacerbated by oxidant damage.

Abbreviations: LDL = low density lipoprotein • 8OHdG =
8-hydroxy-2'-deoxyguanosine • SVCT = sodium dependent vitamin C
transporter • NO = nitric oxide
Key words: ascorbic acid, oxidation, diet, low-density lipoproteins

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Copyright © 2003 by the American College of Nutrition.
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