Browsing by Subject "ascorbic acid"

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  • Hemilä, Harri; Chalker, Elizabeth (2021)
    A Commentary on: The Long History of Vitamin C: From Prevention of the Common Cold to Potential Aid in the Treatment of COVID-19. A review of the effects of vitamin C on the immune system and respiratory tract infections was recently published (1). We are the authors of a review of vitamin C and the common cold (2), which was cited in the article. We consider that some of the authors’ statements are inaccurate and here we describe the issues on which we disagree.
  • Gursoy, Oguz; Munsch-Alatossava, Patricia; Ertan, Kubra; Yilmaz, Yusuf; Alatossava, Tapani (2017)
    Continuous nitrogen gas (N-2) flushing extends the shelf life of raw milk (RM) during cold storage. The effect of N-2 treatment on the total antioxidant capacity (TAC) and ascorbic acid (AA) content of RM was determined during cold storage. TAC of RM or deproteinized RM was determined by ABTS and DPPH methods, while L(+)-AA content of RM was determined chromatographically on days 0, 4 and 7 during storage at 6 +/- 1 degrees C. With the ABTS method, the TAC of RM decreased from 472.33 +/- 16.70 to 369.47 +/- 62.06 mu M TEAC while it reduced from 13.30 +/- 0.84 to 8.20 +/- 0.66 mu M TEAC with DPPH method during cold storage. TAC of RM determined with ABTS method decreased after 4 day-storage; however, they remained statistically similar for N-2-treated samples during 7 day-storage. The AA content of RM ranged from 14.06 to 10.76 mg/L during storage but N-2-treatment did not influence AA content significantly. Deproteinization reduced TAC values of milk samples significantly, and the reduction with the ABTS method was about 47.50 % for control samples cold-stored for four days, while it was 11.67 % for N-2-treated deproteinized RM. In conclusion, N-2-flushing through the headspace of milk containing vessels showed a significant protective effect on the antioxidant components of RM during cold storage.
  • Knuutila, Kaisa (Helsingfors universitet, 2010)
    As the development of new active ingredients is becoming more expensive and difficult, the development of new and better dosage forms, like multiparticulate systems, has become more attractive. Multiparticulate systems can be defined as oral dosage forms consisting of small discrete units together providing desired dose. Usually the small units are round pellets approximately 0.5-1.5mm in size. Multiparticulate systems can enhance the properties of already existing active ingredients or reduce the unwanted side effects. The properties can be alternated also by preparing the system as the enteric formulation, which resists the acidic environment of the stomach and releases the active ingredients in the small intestine due to the pH change. The enteric delivery is used mainly to enhance the absorption of acid-labile drugs or to reduce the side-effects of stomach irritating drugs, like iron. Prepared pellets contained iron in sulphate form and they were pelletized with Nica extruder/spheronization system. The pellets contained also ascorbic acid to maintain the iron in its reduced form during iron release and absorption. Microcrystalline cellulose enabled the pellet formation and Eudragit L 30 D-55 was used in the coating to protect the drug containing pellets from the stomach's acidic environment. Some of the pellets were subcoated before the enteric coating. The subcoating contained part of the ascorbic acid and iron sulphate and the film forming water soluble hydroxypropyl methylcellulose, HPMC. Other pellets were coated directly with the enteric coat while 100% of the ascorbic acid and iron sulphate were located in the core pellets. The coating was performed in fluidized bed. The iron concentration was determined with UV-Vis spectrophotometer. Iron itself did not absorb light but with o-phenanthroline it formed orange-red complex which absorbed visible light absorption maximum being at the wavelength of 510 nm. In order to ensure the full absorption the enteric iron products need to release the iron rabidly after they enter the small intestine. Approximately 15-20% (w/w) of enteric coating was needed to fulfill the 5% release limit per hour in dissolution test in 0.1 HCl defined by authorities. The release rate was comparable to a commercially available product. The subcoating did not have a considerable effect to the release rate. The iron precipitated to the pellet surface either during extrusion/spheronization process or drying. 1% Tween 80, 3% Kollidon K-25 and 5 and 10% Eudragit L 30 D-55 solutions were used as pelletizing liquid in order to reduce the precipitation. The 3% Kollidon K-25 produced visually best pellets but some pellets were clued together during the process. The possible retardation in release was not tested.
  • Mattila, Markus; Hakola, Leena; Niinisto, Sari; Tapanainen, Heli; Takkinen, Hanna-Mari; Ahonen, Suvi; Ilonen, Jorma; Toppari, Jorma; Veijola, Riitta; Knip, Mikael; Virtanen, Suvi M. (2021)
    Our aim was to study the associations between maternal vitamin C and iron intake during pregnancy and the offspring's risk of developing islet autoimmunity and type 1 diabetes. The study was a part of the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) prospective birth cohort including children genetically at risk of type 1 diabetes born between 1997-2004. The diets of 4879 mothers in late pregnancy were assessed with a validated food frequency questionnaire. The outcomes were islet autoimmunity and type 1 diabetes. Cox proportional hazards regression analysis adjusted for energy, family history of diabetes, human leukocyte antigen (HLA) genotype and sex was used for statistical analyses. Total intake of vitamin C or iron from food and supplements was not associated with the risk of islet autoimmunity (vitamin C: HR 0.91: 95% CI (0.80, 1.03), iron: 0.98 (0.87, 1.10)) or type 1 diabetes (vitamin C: 1.01 (0.87, 1.17), iron: 0.92 (0.78, 1.08)), neither was the use of vitamin C or iron supplements associated with the outcomes. In conclusion, no association was found between maternal vitamin C or iron intake during pregnancy and the risk of islet autoimmunity or type 1 diabetes in the offspring.
  • Hemilä, Harri; Virtamo, Jarmo; Albanes, Demetrius; Kaprio, Jaakko (2003)
  • Hemilä, Harri; Douglas, R M (1999)
  • Hemila, Harri; de Man, Angelique M. E. (2021)
    In numerous animal studies, vitamin C has prevented and alleviated viral and bacterial infections. In a few dozen placebo-controlled trials with humans, vitamin C has shortened infections caused by respiratory viruses, which indicates that the vitamin can also influence viral infections in humans. In critically ill patients, plasma vitamin C levels are commonly very low. Gram doses of vitamin C are needed to increase the plasma vitamin C levels of critically ill patients to the levels of ordinary healthy people. A meta-analysis of 12 trials with 1,766 patients calculated that vitamin C reduced the length of ICU stay on average by 8%. Another meta-analysis found that vitamin C shortened the duration of mechanical ventilation in ICU patients. Two randomized placebo-controlled trials found statistically significant reduction in the mortality of sepsis patients. The effects of vitamin C on acute respiratory distress syndrome (ARDS) frequently complicating COVID-19 pneumonia should be considered. Vitamin C is a safe and inexpensive essential nutrient.
  • Hemilä, Harri (2003)
  • Hemilä, Harri (1997)
    Three controlled trials have reported the number of pneumonia cases in a vitamin C group and a control group, each trial finding a considerably lower incidence of pneumonia in the group given vitamin C. Each of these three trials found a > or = 80% lower incidence of pneumonia in the vitamin C group. It is highly unlikely that the differences reported between the study groups in favor of the vitamin C groups would have occurred purely by chance (P = 0.00002).
  • Hemilä, Harri (1997)
    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 (> or = 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.
  • Hemilä, Harri; Carr, Anitra; Chalker, Elizabeth (2021)
    Given the previous research on vitamin C, we read with great interest the report on the COVID A to Z Randomized Clinical Trial (COVID A to Z trial) which investigated the effects of 8 g/day vitamin C on the recovery from outpatient SARS-CoV-2 infection (9). However, we unfortunately found several methodological shortcomings in the trial. Here we describe our major concerns and statistical reanalysis of the findings.
  • Hemilä, Harri (1996)
    In 1971, Linus Pauling carried out a meta-analysis of four placebo-controlled trials and concluded that it was highly unlikely that the decrease in the "integrated morbidity of the common cold" in vitamin C groups was caused by chance alone (P < 0.00003). Studies carried out since then have consistently found that vitamin C (> or = 1 g/d) alleviates common cold symptoms, indicating that the vitamin does indeed have physiologic effects on colds. However, widespread conviction that the vitamin has no proven effects on the common cold still remains. Three of the most influential reviews drawing this conclusion are considered in the present article. Two of them are cited in the current edition of the RDA nutritional recommendations as evidence that vitamin C is ineffective against colds. In this article, these three reviews are shown to contain serious inaccuracies and shortcomings, making them unreliable sources on the topic. The second purpose is to suggest possible conceptual reasons for the persistent resistance to the notion that vitamin C might have effects on colds. Although placebo-controlled trials have shown that vitamin C does alleviate common cold symptoms, important questions still remain.
  • Hemilä, Harri (1997)
    In 1970 Linus Pauling claimed that vitamin C prevents and alleviates the episodes of the common cold. Pauling was correct in concluding from trials published up till then, that in general vitamin C does have biological effects on the common cold, but he was rather over-optimistic as regards the size of benefit. His quantitative conclusions were based on a single placebo-controlled trial on schoolchildren in a skiing camp in the Swiss Alps, in which a significant decrease in common cold incidence and duration in the group administered 1 g/day of vitamin C was found. As children in a skiing camp are not a representative sample of the general population, Pauling's extrapolation to the population at large was too bold, erring as to the magnitude of the effect. Nevertheless, Pauling's general conclusion that vitamin C has physiological effects on the common cold is of major importance as it conflicts with the prevailing consensus that the only physiological effect of vitamin C on human beings is to prevent scurvy.
  • Hemilä, Harri (1996)
    A large number of placebo-controlled studies have shown that vitamin C supplementation alleviates the symptoms of the common cold, but widespread skepticism that vitamin C could have any significant effect remains. One of the most influential common cold studies, published in 1975, was carried out by Thomas Karlowski et al, at the National Institutes of Health. Their placebo consisted of lactose, which can easily be distinguished from ascorbic acid by taste. Karlowski et al, found a 17% decrease in the duration of cold episodes in the group administered vitamin C (6 g/day); however, they suggested that the decrease was entirely due to the placebo effect. In this article it will be shown that the placebo effect is not a valid explanation for the results of the Karlowski study, as it is inconsistent with their results. This is an important conclusion for two reasons. First, the placebo explanation becomes even more unreasonable as regards the reported benefits found in several other studies with valid placebo tablets. Second, as the results from the Karlowski study are not due to the placebo effect, their results can be used to assess the quantitative effects of vitamin C supplementation. The most important conclusions from Karlowski's study are that therapeutic vitamin C supplementation during a common cold episode appears to be as effective as regular supplementation, and that there appears to be linear dose dependency at least up to 6 g/day. These findings suggest that large therapeutic vitamin C doses might alleviate the symptoms of the common cold substantially.
  • Hemilä, Harri; Kaprio, Jaakko; Albanes, Demetrius; Heinonen, Olli P.; Virtamo, Jarmo (2002)
  • Hemilä, Harri (2020)
    The Dietary Reference Intakes (DRI)-monograph (USA/Canada) states that the estimated average requirement (EAR) of vitamin E for men and women of any age is 12 mg/day. The EAR value is based on in vitro hemolysis in young males; a surrogate endpoint without any direct validity. The EAR is then extrapolated to females and older males. The validity of the EAR level is therefore questionable. Total mortality is an outcome of direct clinical relevance. Investigating the effect of long-term dietary vitamin E intake level on mortality in a randomized trial is, however, not feasible. Nevertheless, the effect of dietary vitamin E intake can be investigated indirectly from the effects of a fixed-level vitamin E supplement administered to participants on variable levels of dietary vitamin E intake. If vitamin E intake below the EAR is harmful, then vitamin E supplement should be beneficial to those people who have dietary vitamin E intake level below the EAR. The purpose of this study was to analyze the association between dietary vitamin E intake and the effect of 25 mg/day of vitamin E supplement on total mortality in Finnish male smokers aged 50–69 years in the Alpha-Tocopherol-Beta-Carotene (ATBC) Study. The effect of vitamin E supplement was estimated by Cox regression. Among participants who had dietary vitamin C intake of 90 mg/day and above, vitamin E supplement increased mortality by 19% (p = 0.006) in those aged 50–62 years, but decreased mortality by 41% (p = 0.0003) in those aged 66–69 years. No association between vitamin E supplement effect and dietary vitamin E intake was found in these two groups, nor in participants who had dietary vitamin C intake less than 90 mg/day. There is no evidence in any of the analyzed subgroups that there is a difference in the effect of the 25 mg/day vitamin E supplement on males on dietary vitamin E intakes below vs. above the EAR of 12 mg/day. This analysis of the ATBC Study found no support for the ‘estimated average requirement' level of 12 mg/day of vitamin E for older males.Trial registration:ClinicalTrials.gov, identifier: NCT00342992.