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      Regular vitamin C supplementation during pregnancy reduces hospitalization: outcomes of a Ugandan rural cohort study

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          Abstract

          Background

          Vitamin C or ascorbic acid is a hydro-soluble lactone (synthesized from glucose) essential to human body and available from diet. Despite its broad availability in fruits and vegetables, in many developing countries the incidence of clinical symptoms due to the vitamin deficiency is still very high. Also, pregnant women in the developing countries are frequently hospitalized for several preventable reasons such as anemia in pregnancy, mostly iron-deficient anemia (IDA) and the upper/lower respiratory tract infections (RTI). The aim of the study was to investigate, in a Ugandan rural pregnant women cohort, the preventive effects of vitamin C supplementation on hospital admission.

          Methods

          384 pregnant women met the inclusion criteria and were randomly assigned to receive either 400 mg of vitamin C daily (187) or not (197) in addition to their standard antenatal vitamins until delivery. The primary outcome measure of this study was to assess the prevention of hospitalization during pregnancy in the group of women supplemented with vitamin C compared to the controls. Fisher‘s exact test was employed in this assessment.

          Results

          42.2% women in the vitamin C group and 27.9% in the control group were not hospitalized during pregnancy; this difference was found statistically significant.

          Conclusion

          The results of this study suggest including vitamin C in the guidelines of multivitamin prevention for pregnant women, especially in developing countries where seasonal availability of fruits and vegetables could result in adverse clinical outcomes.

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          Most cited references26

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          Cloning and chromosomal mapping of the human nonfunctional gene for L-gulono-gamma-lactone oxidase, the enzyme for L-ascorbic acid biosynthesis missing in man.

          Man is among the exceptional higher animals that are unable to synthesize L-ascorbic acid because of their deficiency in L-gulono-gamma-lactone oxidase, the enzyme catalyzing the terminal step in L-ascorbic acid biosynthesis. In the present study, we isolated a segment of the nonfunctional L-gulono-gamma-lactone oxidase gene from a human genomic library, and mapped it on chromosome 8p21.1 by spot blot hybridization using flow-sorted human chromosomes and fluorescence in situ hybridization. Sequencing analysis indicated that the isolated segment represented a 3'-part of the gene, where the regions corresponding to exons VII, IX, X, and XII of the rat L-gulono-gamma-lactone oxidase gene remain with probable deletion of the regions corresponding to exons VIII and XI. In the identified exon regions were found various anomalous nucleotide changes, such as deletion and insertion of nucleotide(s) and nonconformance to the GT/AG rule at intron/exon boundaries. When the conceptual amino acid sequences deduced from the four exon sequences were compared with the corresponding rat sequences, there were a large number of nonconservative substitutions and also two stop codons. These findings indicate that the human nonfunctional L-gulono-gamma-lactone oxidase gene has accumulated a large number of mutations without selective pressure since it ceased to function during evolution.
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            Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans.

            The current recommended dietary allowance (RDA) for vitamin C for adult nonsmoking men and women is 60 mg/d, which is based on a mean requirement of 46 mg/d to prevent the deficiency disease scurvy. However, recent scientific evidence indicates that an increased intake of vitamin C is associated with a reduced risk of chronic diseases such as cancer, cardiovascular disease, and cataract, probably through antioxidant mechanisms. It is likely that the amount of vitamin C required to prevent scurvy is not sufficient to optimally protect against these diseases. Because the RDA is defined as "the average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all healthy individuals in a group," it is appropriate to reevaluate the RDA for vitamin C. Therefore, we reviewed the biochemical, clinical, and epidemiologic evidence to date for a role of vitamin C in chronic disease prevention. The totality of the reviewed data suggests that an intake of 90-100 mg vitamin C/d is required for optimum reduction of chronic disease risk in nonsmoking men and women. This amount is about twice the amount on which the current RDA for vitamin C is based, suggesting a new RDA of 120 mg vitamin C/d.
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              Vitamin and mineral requirements in human nutrition

              (2004)
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                Author and article information

                Journal
                Pan Afr Med J
                pamj
                The Pan African Medical Journal
                African Field Epidemiology Network
                1937-8688
                1937-8688
                2010
                30 May 2010
                : 5
                : 15
                Affiliations
                [1 ]Gastroenterology Unit, Department of Clinical Sciences, University “La Sapienza”, Rome, Italy
                [2 ]St. Mary‘s Health Center, P.O.BOX 9 Kyeibuza, Kiruhura District , Uganda
                Author notes
                [& ]Corresponding author: Dr. Unim Hans, Gastroenterology Unit, Department of Clinical Sciences, Viale del Policlinico, 157, 00161 Rome, Phone: (+s 39) 3406707613, Italy.
                Article
                3032617
                21293742
                bc673452-5181-443e-a3ef-afc1b131aafb
                Copyright © Unim Hans et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 May 2010
                : 27 May 2010
                Categories
                Life Sciences
                Medicine

                Medicine
                vitamin c supplementation,pregnancy,hospitalization rate,ugandan women
                Medicine
                vitamin c supplementation, pregnancy, hospitalization rate, ugandan women

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