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Vitamin C intake and susceptibility to the common cold

Published online by Cambridge University Press:  07 September 2009

Harri Hemilä
Affiliation:
Department of Public Health, POB 41, University of Helsinki, FIN-00014, Finland
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Abstract

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Although the role of vitamin C in common cold incidence had been studied extensively, the level of vitamin C intake has not been unequivocally shown to affect the incidence of colds. In the present study the six largest vitamin C supplementation (≥ 1 g/d) studies, including over 5000 episodes in all, have been analysed, and it is shown that common cold incidence is not reduced in the vitamin C-supplemented groups compared with the placebo groups (pooled rate ratio (RR) 0·99; 95% CI 0·93, 1·04). Consequently these six major studies give no evidence that high-dose vitamin C supplementation decreases common cold incidence in ordinary people. Nevertheless, the analysis was continued with the hypothesis that vitamin C intake may affect common cold susceptibility in specific groups of people. It was assumed that the potential effect of supplementation might be most conspicuous in subjects with low dietary vitamin C intake. The average vitamin C intake has been rather low in the UK and plasma vitamin C concentrations are in general lower in males than in females. In four studies with British females vitamin C supplementation had no marked effect on common cold incidence (pooled RR 0·95; 95% CI 0·86, 1·04). However, in four studies with British male schoolchildren and students a statistically highly significant reduction in common cold incidence was found in groups supplemented with vitamin C (pooled RR 0·70; 95% CI 0·60, 0·81). Thus, these studies with British males indicate that vitamin C intake has physiological effects on susceptibility to common cold infections, although the effect seems quantitatively meaningful only in limited groups of people and is not very large.

Type
Human and Clinical Nutrition
Copyright
Copyright © The Nutrition Society 1997

References

REFERENCES

Allen, R. J. L., Brook, M. & Broadbent, S. R. (1968). The variability of vitamin C in our diet. British Journal of Nutrition 22, 555563.CrossRefGoogle ScholarPubMed
Anderson, R., Hay, I., van Wyk, H., Oosthuizen, R. & Theron, A. (1980). The effect of ascorbate on cellular humoral immunity in asthmatic children. South African Medical Journal 58, 974977.Google ScholarPubMed
Anderson, T. W., Reid, D. B. & Beaton, G. H. (1972). Vitamin C and the common cold: a double-blind trial. Canadian Medical Association Journal 107, 503508.Google ScholarPubMed
Anderson, T. W., Reid, D. B. & Beaton, G. H. (1973) Vitamin C and the common cold (correction). Canadian Medical Association Journal 108, 133.Google Scholar
Anderson, T. W., Suranyi, G. & Beaton, G. H. (1974). The effect on winter illness of large doses of vitamin C. Canadian Medical Association Journal 111, 3136.Google ScholarPubMed
Baird, I. M., Hughes, R. E., Wilson, H. K., Davies, J. E. W. & Howard, A. N. (1979) The effects of ascorbic acid and flavonoids on the occurrence of symptoms normally associated with the common cold. American Journal of Clinical Nutrition 32, 16861690.CrossRefGoogle ScholarPubMed
Bates, C. J., Rutishauser, I., Black, A. E., Paul, A. A., Mandal, A. R. & Patnaik, B. K. (1979). Long-term vitamin status and dietary intake of healthy elderly subjects. British Journal of Nutrition 42, 4356.CrossRefGoogle ScholarPubMed
Bergsten, P., Amitai, G., Kehrl, J., Dhariwal, K. R., Klein, H. G. & Levine, M. (1990). Millimolar concentrations of ascorbic acid in purified human mononuclear leukocytes. Journal of Biological Chemistry 265, 25842587.CrossRefGoogle ScholarPubMed
Black, A. E., Billewicz, W. Z. & Thomson, A. M. (1976). The diets of preschool children in Newcastle upon Tyne, 1968–71. British Journal of Nutrition 35, 105113.CrossRefGoogle ScholarPubMed
Block, G. & Sorenson, A. (1987). Vitamin C intake and dietary sources by demographic characteristics. Nutrition and Cancer 10, 5365.CrossRefGoogle ScholarPubMed
Bolton-Smith, C., Woodward, M., Brown, C. A. & Tunstall-Pedoe, H. (1993). Nutrient intake by duration of exsmoking in the Scottish Heart Health Study. British Journal of Nutrition 69, 315332.CrossRefGoogle ScholarPubMed
Bourne, G. H. (1949). Vitamin C and immunity. British Journal of Nutrition 2, 341347.CrossRefGoogle Scholar
Briggs, M. (1984). Vitamin C and infectious disease: a review of the literature and the results of a randomized, double-blind, prospective study over 8 years. In Recent Vitamin Research pp. 3982 [Briggs, M. H., editor]. Boca Raton: CRC Press.Google Scholar
Burr, M. L., Elwood, P. C., Hole, D. J., Hurley, R. J. & Hughes, R. E. (1974). Plasma and leucocyte ascorbic acid levels in the elderly. American Journal of Clinical Nutrition 27, 144151.CrossRefGoogle ScholarPubMed
Carson, M., Cox, H., Corbett, M. & Pollitt, N. (1975). Vitamin C and the common cold. Journal of the Society of Occupational Medicine 25, 99102.CrossRefGoogle ScholarPubMed
Charleston, S. S. & Clegg, K. M. (1972). Ascorbic acid and the common cold. Lancet i, 14011402.CrossRefGoogle Scholar
Clegg, K. M. (1974). Studies associated with ascorbic acid. Acta Vitaminologica Enzymologica 28, 101102.Google ScholarPubMed
Clegg, K. M. & Macdonald, J. M. (1975). L-Ascorbic acid and D-isoascorbic acid in a common cold survey. American Journal of Clinical Nutrition 28, 973976.CrossRefGoogle Scholar
Crombie, I. K., Todman, J., McNeill, G., Florey, C. V., Menzies, I. & Kennedy, R. A. (1990). Effect of vitamin and mineral supplementation on verbal and non-verbal reasoning of schoolchildren. Lancet 335, 744747.CrossRefGoogle ScholarPubMed
Dahl, H. & Degre, M. (1976). The effect of ascorbic acid on production of human interferon and antiviral activity in vitro. Acta Pathologica Microbiologica Scandinavica 84B, 280284.Google ScholarPubMed
Darke, S. J., Disselduff, M. M. & Try, G. P. (1980). Frequency distributions of mean daily intakes of food energy and selected nutrients obtained during nutrition surveys of different groups of people in Great Britain between 1968 and 1971. British Journal of Nutrition 44, 243252.Google Scholar
Department of Health (1991). Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H. M. Stationery Office.Google Scholar
Elwood, P. C., Lee, H. P., Leger, A. S., Baird, I. M. & Howard, A. N. (1976). A randomized controlled trial of vitamin C in the prevention and amelioration of the common cold. British Journal of Preventive and Social Medicine 30, 193196.Google ScholarPubMed
Evans, R. M., Currie, L. & Campbell, A. (1982). The distribution of ascorbic acid between various cellular components of blood, in normal individuals, and its relation to the plasma concentration. British Journal of Nutrition 47, 473482.CrossRefGoogle ScholarPubMed
Garry, P. J., Goodwin, J. S., Hunt, W. C. & Gilbert, B. A. (1982). Nutritional status in a healthy elderly population: vitamin C. American Journal of Clinical Nutrition 36, 332339.CrossRefGoogle Scholar
Geber, W. F., Lefkowitz, S. S. & Hung, C. Y. (1975). Effect of ascorbic acid, sodium salicylate, and caffeine on the serum interferon level in response to viral infection. Pharmacology 13, 228233.CrossRefGoogle ScholarPubMed
Ginter, E. (1989). Ascorbic acid in cholesterol metabolism and in detoxification of xenobiotic substances: problem of optimum vitamin C intake. Nutrition 5, 369374.Google ScholarPubMed
Glazebrook, A. J. & Thomson, S. (1942). The administration of vitamin C in a large institution and its effect on general health and resistance to infection. Journal of Hygiene 42, 119.Google Scholar
Hemilä, H. (1984). Nutritional need versus optimal intake. Medical Hypotheses 14, 135139.CrossRefGoogle ScholarPubMed
Hemilä, H. (1986). A re-evaluation of nutritional goals — not just deficiency counts. Medical Hypotheses 20, 1727.CrossRefGoogle Scholar
Hemilä, H. (1991). Is there a biochemical basis for ‘nutrient need’? Trends in Food Science and Technology 2, 73.Google Scholar
Hemilä, H. (1992). Vitamin C and the common cold. British Journal of Nutrition 67, 316.CrossRefGoogle ScholarPubMed
Hemilä, H. (1994). Does vitamin C alleviate the symptoms of the common cold? – A review of current evidence. Scandinavian Journal of Infectious Diseases 26, 16.Google Scholar
Hemilä, H. (1996 a). Vitamin C, the placebo effect, and the common cold. A case study of how preconceptions influence the analysis of results. Journal of Clinical Epidemiology 49, 10791084.CrossRefGoogle ScholarPubMed
Hemilä, H. (1996 b). Vitamin C and common cold incidence: a review of studies with subjects under heavy physical stress. International Journal of Sports Medicine 17, 379383.CrossRefGoogle ScholarPubMed
Hemilä, H. & Herman, Z. S. (1995). Vitamin C and the common cold: a retrospective analysis of Chalmers' review. Journal of the Americal College of Nutrition 14, 116123.CrossRefGoogle ScholarPubMed
Hess, A. F. (1932). Diet, nutrition and infection. New England Journal of Medicine 207, 637648.CrossRefGoogle Scholar
Hodges, R. E., Hood, J., Canhan, J. E., Sauberlich, H. E. & Baker, E. M. (1971). Clinical manifestations of ascorbic acid deficiency in man. American Journal of Clinical Nutrition 24, 432443.CrossRefGoogle ScholarPubMed
Höjer, J. A. (1924). Studies in scurvy. Scurvy and infection. Acta Paediatrica 3 Suppl., 115122.Google Scholar
Hughes, R. E. (1981). Recommended daily amounts and biochemical roles. In Vitamin C, pp. 7586 [Counsell, J. N. and Hornig, D. H., editors]. London: Applied Science Publishers.Google Scholar
Itoh, R., Yamada, K., Oka, J., Echizen, H. & Murakami, K. (1989). Sex as a factor in levels of serum ascorbic acid in a healthy elderly population. International Journal for Vitamin and Nutrition Research 59, 365372.Google Scholar
Karlowski, T. R., Chalmers, T. C., Frenkel, L. D., Kapikian, A. Z., Lewis, T. L. & Lynch, J. M. (1975). Ascorbic acid for the common cold. A prophylactic and therapeutic trial. Journal of the American Medical Association 231, 10381042.CrossRefGoogle ScholarPubMed
Kennes, B., Dumont, I., Brohee, D., Hubert, C. & Neve, P. (1983). Effect of vitamin C supplements on cellmediated immunity in old people. Gerontology 29, 305310.CrossRefGoogle ScholarPubMed
Kleijnen, J., Riet, G. & Knipschild, P. G. (1989). Vitamin C and the common cold; a review of the megadose literature (in Dutch). Nederlands Tijdschrift voor Geneeskunde 133, 15321535.Google Scholar
Levine, M. & Morita, K. (1985). Ascorbic acid in endocrine systems. Vitamins and Hormones 42, 164.CrossRefGoogle ScholarPubMed
Lonergan, M. E., Milne, J. S., Maule, M. M. & Williamson, J. (1975). A dietary survey of older people in Edinburgh. British Journal of Nutrition 34, 517527.CrossRefGoogle ScholarPubMed
Ludvigsson, J., Hansson, L. O. & Tibbling, G. (1977). Vitamin C as a preventive medicine against common colds in children. Scandinavian Journal of Infectious Diseases 9, 9198.CrossRefGoogle ScholarPubMed
Manzella, J. P. & Roberts, N. J. (1979). Human macrophage and lymphocyte responses to mitogen stimulation after exposure to influenza virus, ascorbic acid, and hyperthermia. Journal of Immunology 123, 19401944.CrossRefGoogle ScholarPubMed
Milne, J. S., Lonergan, M. E., Williamson, J., Moore, F. M. L., McMaster, R. & Percy, N. (1971). Leucocyte ascorbic acid levels and vitamin C intake in older people. British Medical Journal 4, 383386.CrossRefGoogle ScholarPubMed
National Research Council (1989). Recommended Dietary Allowances, 10th ed.Washington, DC: National Academy Press.Google Scholar
Oh, C. & Nakano, K. (1988). Reversal by ascorbic acid of suppression by endogenous histamine of rat lymphocyte blastogenesis. Journal of Nutrition 118, 639644.Google Scholar
Oreopoulos, D. G., Lindeman, R. D., VanderJagt, D. J., Tzamaloukas, A. H., Bhagavan, H. N. & Garry, P. J. (1993). Renal excretion of ascorbic acid: effect of age and sex. Journal of the American College of Nutrition 12, 537542.Google Scholar
Pauling, L. (1970). Vitamin C and the Common Cold (reprinted in 1976 as Vitamin C, the Common Cold, and the Flu). San Francisco: Freeman.Google Scholar
Pauling, L. (1971). The significance of the evidence about ascorbic acid and the common cold. Proceedings of the National Academy of Sciences USA 68, 26782681.Google Scholar
Pauling, L. (1974). Are recommended daily allowances for vitamin C adequate? Proceedings of the National Academy of Sciences USA 71, 44424446.Google Scholar
Perla, D. & Marmorston, J. (1937 a). Role of vitamin C in resistance. I. Archives of Pathology 23, 543575.Google Scholar
Perla, D. & Marmorston, J. (1937 b). Role of vitamin C in resistance. II. Archives of Pathology 23, 683712.Google Scholar
Pitt, H. A. & Costrini, A. M. (1979). Vitamin C prophylaxis in marine recruits. Journal of the American Medical Association 241, 908911.CrossRefGoogle ScholarPubMed
Reynolds, R. D. (1994). Vitamin supplements: current controversies. Journal of the American College of Nutrition 13, 118126.CrossRefGoogle ScholarPubMed
Riemersma, R. A., Oliver, M., Elton, R. A., Alfthan, G., Vartiainen, E., Salo, M., Rubba, P., Mancini, M., Georgi, H., Vuilleumier, J. P. & Gey, K. F. (1990). Plasma antioxidants and coronary heart disease: vitamins C and E, and selenium. European Journal of Clinical Nutrition 44, 143150.Google Scholar
Robertson, E. C. (1934). The vitamins and resistance to infection: vitamin C. Medicine 13, 190206.CrossRefGoogle Scholar
Rothman, K. J. (1986). Modern Epidemiology. Boston: Little, Brown and Company.Google Scholar
Schwerdt, P. R. & Schwerdt, C. E. (1975). Effect of ascorbic acid on rhinovirus replication in WI-38 cells. Proceedings of the Society for Experimental Biology and Medicine 148, 12371243.CrossRefGoogle ScholarPubMed
Siegel, B. V. (1974). Enhanced interferon response to murine leukemia virus by ascorbic acid. Infection and Immunity 10, 409410.CrossRefGoogle ScholarPubMed
Siegel, B. V. (1975). Enhancement of interferon production by poly(rl)·poly(rC) in mouse cell cultures by ascorbic acid. Nature 254, 531532.Google Scholar
Smit, M. J. & Anderson, R. (1990). Inhibition of mitogen-activated proliferation of human lymphocytes by hypochlorous acid in vitro: protection and reversal by ascorbate and cysteine. Agents and Actions 30, 338343.CrossRefGoogle ScholarPubMed
Smithells, R. W., Ankers, C., Carver, M. E., Lennon, D., Schorah, C. J. & Sheppard, S. (1977). Maternal nutrition in early pregnancy. British Journal of Nutrition 38, 497506.CrossRefGoogle ScholarPubMed
Trichopoulou, A. & Vassilakou, T. (1990). Recommended dietary intakes in the European community member states. European Journal of Clinical Nutrition 44 Suppl. 2, 51126.Google ScholarPubMed
Tyrrell, D. A. J., Craig, J. W., Meade, T. W. & White, T. (1977). A trial of ascorbic acid in the treatment of the common cold. British Journal of Preventive and Social Medicine 31, 189191.Google Scholar
Walker, G. H., Bynoe, M. L. & Tyrrell, D. A. J. (1967). Trial of ascorbic acid in prevention of colds. British Medical Journal 1, 603606.CrossRefGoogle ScholarPubMed
Washko, P. W., Wang, Y. & Levine, M. (1993). Ascorbic acid recycling in human neutrophils. Journal of Biological Chemistry 268, 1553115535.CrossRefGoogle ScholarPubMed
Yonemoto, R. H. (1979). Vitamin C and immune responses in normal controls and cancer patients. International Journal for Vitamin and Nutrition Research Suppl. 19, 143154.Google Scholar