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To the Editor: The conclusion of Dr Sesso and colleagues¹ that vitamin C does not affect cardiovascular outcome in male physicians is not surprising because of an experimental design that did not consider human vitamin C physiology and did not include vitamin C measurements. In humans, plasma and tissue vitamin C concentrations are tightly controlled. Plasma concentrations have a steep sigmoidal response in relation to dose, and a similar steep response occurs in tissue.^2-5 At doses above approximately 100 mg daily, circulating immune cells are saturated, and at doses of 200 mg daily or greater, there are only marginal increases in plasma concentrations.^2-5 Physicians in the control group, who likely consumed at least 3 servings of fruits or vegetables daily, would have ingested more than 100 mg of vitamin C per day. Even a single glass of orange juice would have provided 90 mg of vitamin C. Those who took . . . [Full Text of this Article]

Sebastian J. Padayatty, MD, PhD; Mark Levine, MD
markl@intra.niddk.nih.gov
Molecular and Clinical Nutrition Section
Digestive Diseases Branch
National Institute of Diabetes and Digestive and Kidney Diseases
National Institutes of Health
Bethesda, Maryland

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