UPSC MainsMEDICAL-SCIENCE-PAPER-I202115 Marks
Q12.

Describe the sources, RDA and biochemical significance of vitamin C. Write a note on clinical manifestations of vitamin C deficiency.

How to Approach

This question requires a detailed understanding of Vitamin C, encompassing its sources, recommended daily allowance (RDA), biochemical roles, and the clinical consequences of its deficiency. The answer should be structured logically, starting with an introduction defining Vitamin C and its importance. The body should then be divided into sections addressing sources, RDA, biochemical significance, and clinical manifestations. Specific examples of deficiency diseases and their symptoms should be included. A concise conclusion summarizing the key points is essential.

Model Answer

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Introduction

Vitamin C, also known as ascorbic acid, is an essential nutrient for humans. Unlike most mammals, humans cannot synthesize Vitamin C endogenously, making dietary intake crucial. It’s a water-soluble vitamin acting as a potent antioxidant and playing a vital role in various physiological processes. Its discovery and subsequent understanding revolutionized the prevention and treatment of scurvy, a historically devastating deficiency disease. This answer will detail the sources, RDA, biochemical significance, and clinical manifestations of Vitamin C deficiency, providing a comprehensive overview of this essential nutrient.

Sources of Vitamin C

Vitamin C is abundantly found in fruits and vegetables. Excellent sources include:

  • Citrus fruits: Oranges, lemons, grapefruits, limes
  • Berries: Strawberries, blueberries, raspberries, cranberries
  • Vegetables: Bell peppers (especially red and yellow), broccoli, spinach, kale, tomatoes, potatoes
  • Other sources: Acerola cherries, guava, papaya

The Vitamin C content in food can be affected by storage, cooking methods, and processing. Prolonged storage and high-temperature cooking can lead to significant losses.

Recommended Daily Allowance (RDA) of Vitamin C

The RDA for Vitamin C varies based on age, sex, and physiological status. According to the National Institutes of Health (NIH) (as of knowledge cutoff 2021):

Age/Group RDA (mg/day)
Infants (0-6 months) 40
Infants (7-12 months) 50
Children (1-3 years) 15
Children (4-8 years) 25
Children (9-13 years) 45
Adolescents (14-18 years) 65-75
Adults (19+ years) 75 (women), 90 (men)
Pregnant women 85
Breastfeeding women 120
Smokers +35 mg/day

These recommendations are designed to ensure adequate intake for preventing deficiency and maintaining optimal health. Higher doses may be recommended in certain clinical situations.

Biochemical Significance of Vitamin C

Vitamin C plays a crucial role in several biochemical processes:

  • Collagen Synthesis: It is an essential cofactor for the enzymes prolyl hydroxylase and lysyl hydroxylase, which are required for the hydroxylation of proline and lysine residues in collagen. This hydroxylation is critical for collagen stability and proper formation of connective tissues.
  • Antioxidant Activity: Vitamin C is a potent water-soluble antioxidant, scavenging free radicals and protecting cells from oxidative damage. It regenerates vitamin E, another important antioxidant.
  • Neurotransmitter Synthesis: It is involved in the synthesis of norepinephrine from dopamine.
  • Carnitine Synthesis: Vitamin C is required for the synthesis of carnitine, which is essential for the transport of fatty acids into mitochondria for energy production.
  • Immune Function: It enhances immune cell function, including neutrophil chemotaxis and phagocytosis.
  • Iron Absorption: Vitamin C enhances the absorption of non-heme iron from plant-based foods.

Clinical Manifestations of Vitamin C Deficiency (Scurvy)

Prolonged deficiency of Vitamin C leads to scurvy, characterized by a range of symptoms:

  • Early Symptoms: Weakness, fatigue, malaise, muscle aches.
  • Gingivitis and Tooth Loss: Inflammation and bleeding of the gums, leading to tooth loosening and eventual loss.
  • Petechiae and Ecchymoses: Small, pinpoint hemorrhages under the skin (petechiae) and larger bruises (ecchymoses) due to capillary fragility.
  • Impaired Wound Healing: Delayed wound healing due to compromised collagen synthesis.
  • Joint Pain and Swelling: Bleeding into joints can cause pain and swelling.
  • Anemia: Impaired iron absorption can lead to iron-deficiency anemia.
  • Severe Scurvy: Hemorrhage, edema, neuropathy, and ultimately, death if left untreated.

In infants, scurvy can present with irritability, pseudoparalysis (painful reluctance to move), and bone abnormalities.

Conclusion

Vitamin C is an indispensable nutrient vital for numerous physiological functions, ranging from collagen synthesis and antioxidant defense to immune competence and iron absorption. Maintaining adequate intake through a balanced diet rich in fruits and vegetables is crucial for preventing scurvy and ensuring optimal health. While severe deficiency is rare in developed countries, vulnerable populations, such as those with limited dietary access or certain medical conditions, remain at risk and require careful monitoring and intervention.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Ascorbic Acid
Ascorbic acid is the chemical name for Vitamin C, a water-soluble vitamin with a molecular formula of C6H8O6.
Antioxidant
An antioxidant is a molecule that inhibits the oxidation of other molecules. Oxidation is a chemical reaction that can produce free radicals, leading to cell damage. Vitamin C acts as an antioxidant by donating electrons to stabilize free radicals.

Key Statistics

According to the World Health Organization (WHO), an estimated 5.7% of children aged 6-23 months worldwide are deficient in Vitamin C.

Source: WHO, 2023

The tolerable upper intake level (UL) for Vitamin C is 2000 mg per day. Intakes above this level may increase the risk of gastrointestinal distress, such as diarrhea and nausea.

Source: National Institutes of Health (NIH), 2021

Examples

Historical Scurvy in Sailors

During the Age of Exploration, scurvy was a major cause of death among sailors on long voyages. Captain James Cook famously prevented scurvy among his crew by mandating the consumption of sauerkraut and citrus fruits during his voyages in the 18th century.

Frequently Asked Questions

Can I get enough Vitamin C from supplements?

While supplements can provide Vitamin C, obtaining it from whole foods is generally preferred. Whole foods offer a broader range of nutrients and phytochemicals that work synergistically to promote health. However, supplements can be beneficial for individuals with limited dietary intake or increased needs.

Topics Covered

BiochemistryNutritionVitaminsAntioxidantsScurvy