title: Vitamin C prophylaxis in marine recruits. Vitamin C prophylaxis in a boarding school. The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. The clinical and biochemical effects of vitamin C supplementation in short-stay hospitalized geriatric patients. 158 Efficacy of Immnunotherapy with an Oral Bacterial Lysate and Vitamin C in the Primary Prevention of Acute Respiratory Tract Infections in Children Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial Vitamins, selenium, iron, and coronary heart disease risk in Indians, Malays, and Chinese in Singapore.
abstract: A prospect i ve , r and omized , double-blind study was carried out to determine whether vitamin C prophylaxis , 2.0 g/day , vs placebo prophylaxis would reduce the incidence or morbidity of the common cold  and other respiratory illnesses in 674 marine recruits during an eight-week period . Whole-blood ascorbic acid levels measured six weeks after initiation of the study were significantly higher in the vitamin C group . There was no difference between the two groups in the incidence or duration of colds . The vitamin C group rated their colds as being less severe , but this was not reflected in different symptom complexes or in fewer sick-call visits or training days lost . This study and the literature do not support the prophylactic use of vitamin C to prevent the common cold Abstract A double-blind study to evaluate vitamin C supplements for  respiratory-Infection prophylaxis  was conducted among 641 children at a Navajo boarding school over a 14-week period . Supplements A r and omised double-blind trial involving vitamin C/placebo supplementation was conducted on 57 elderly patients admitted to hospital with acute respiratory infections ( bronchitis and bronchopneumonia ) . Patients were assessed clinical ly and biochemically on admission and again at 2 and 4 weeks after admission having received either 200 mg vitamin C per day , or placebo . This relatively modest oral dose led to a significant increase in plasma and white cell vitamin C concentration even in the presence of acute respiratory infection . Using a clinical scoring system based on major symptoms of the respiratory condition , patients supplemented with the vitamin fared significantly better than those on placebo . This was particularly the case for those commencing the trial most severely ill , many of whom had very low plasma and white cell vitamin C concentrations on admission . Various mechanisms by which vitamin C could assist this type of patient are discussed A double-blind placebo trial has been undertaken on 199 elderly patients admitted to an " acute " geriatric assessment ward . Clinical and biochemical assessment was made on admission ( 0 ) and at 2 , 4 , 8 , 16 and 24 weeks ( after admission ) . Ninety-four patients were supplemented with  vitamin C ( 200 mg per day ) and 105 had placebo tablets .  Biochemical assessment included estimations of plasma and leucocyte ( buffy layer ) vitamin C , plasma folate , vitamin B12 , cortisol and total white cell count . Plasma and leucocyte vitamin C levels remained low for several weeks in a substantial proportion of the non-supplemented patients , whereas low levels were virtually eliminated in the supplemented group . The results from this study suggest that the leucocyte vitamin C levels may give some indication of prognosis in this category of patients ( ie . " acute " geriatric admissions ) as evidence d by : i ) the significantly higher mortality rate during the trial period of patients who started with low initial leucocyte vitamin C levels compared with those starting with higher levels , despite similar mean initial " severity of illness scores " between the two groups . ii ) the marked trend , amongst placebo subjects , for those commencing the study with higher leucocyte vitamin C levels to fare better , in terms of progression to " well " , than those starting with low levels . Amongst subjects starting with low leucocyte vitamin C levels , there was a trend for " vitamin C " subjects to have fared better by 8 weeks than " placebo " subjects . This again occurred despite similar mean initial " severity scores " between the two groups . Amongst subjects diagnosed with respiratory infections there was some tendency for supplemented patients to fare better than unsupplemented patients . Low leucocyte vitamin C levels , on admission , appear to be predictive of poor subsequent prognosis in elderly hospitalised patients . Results from this trial suggest that supplementation with a moderate dose of vitamin C may improve this prognosis and larger trials with greater numbers appear to be merited to confirm or deny this hypothesis Background Airway infections are of great importance worldwide and nearly half of the pediatric consultations in industrialized countries are caused by respiratory tract infections ( RTIs ) . Acute respiratory tract infections ( ARTIs ) are among the main causes of morbidity and mortality in children and recurrent infections of the respiratory tract are the most frequent cause of pharmacotherapy in pediatric practice . The aim of this study was to evaluate the efficacy and tolerability of immunotherapy with oral bacterial lysates + vitamin C in the prevention of ARTIs in children . Methods 109 children with ages between 4 and 16 years with frequent respiratory tract infections ( 2–5 infections the previous winter ) were evaluated . Participants were r and omly allocated in 2 groups : 52 patients ( mean age 6.8 ± 2.9 years ; 20 males 32 females ) received no preventive therapy ( NPT group ) and 57 ( mean age 9.0 ± 3.3 years ; males 36 females 21 ) received immunotherapy with oral bacterial lysates + vitamin C ( VC group ) at the recommended dosage . Patients were followed up for 6 months , including the administration period . Primary end points were the type and number of ARTIs . Secondary end points ( after the infection occured ) included : time to clinical cure , severity of infection , absenteeism from school due to an ARTI , number of antibiotic courses or other drugs prescribed , and duration of concomitant drug treatment . Results There were significant differences between groups in the cumulative number of acute infectious episodes : 170 in NPT group ( 141 upper ARTIs , 29 lower ARTI , and 26 otitis episodes ) vs 55 in VC group ( 50 upper ARTIs , 5 lower ARTI and 4 otitis episodes ) . Patients in the NPT group received 127 antibiotic courses compared to 28 in the VC group ( P < 0.0001 ) . Patients in the NPT group had 475 days of absenteeism from school compared to 100 days in the VC group ( P < 0.0001 ) . No adverse events related to the trial medications were reported . Conclusions Immunotherapy with oral bacterial lysates and vitamin C appears to be very effective in the prevention of infectious episodes in pediatric patients with frequent respiratory tract infections . Future studies are needed to further explore the role of oral bacteroial lysates in ARTIs prevention Objective : To evaluate the effect of antioxidant Vitamins E and C as adjunct therapy of severe acute lower respiratory infection ( ALRI ) in children . Design : R and omized double-blind placebo-controlled clinical trial . Setting : A large childrens ' hospital serving the urban poor in Kolkata , India . Subjects : Children aged 2–35 months admitted with severe ALRI.Intervention : In total , 174 children were r and omly assigned to receive α-tocopherol 200 mg and ascorbic acid 100 mg twice daily or placebo for 5 days . All children received st and ard treatment for severe ALRI . Outcome measures were : time taken to recover from a very ill status , fever , tachypnoea , and feeding difficulty ; and improvement in oxidative stress and immune response indicated by thiobarbituric acid reacting substances ( TBARS ) and response to skin antigens , respectively . Results : Recovery rate ratios ( 95 % CI ) using proportional hazards model were 0.89 ( 0.64–1.25 ) , 1.01 ( 0.72–1.41 ) , 0.86 ( 0.57–1.29 ) , and 1.12 ( 0.77–1.64 ) for very ill status , feeding difficulty , fever , and tachypnoea , respectively . TBARS values were high and similar in the two groups at admission , discharge , and at 2 weeks follow-up . Serum α-tocopherol significantly increased in treated group at discharge . Immune response to skin antigens were very poor at admission and after 2 weeks , in both groups . Conclusion : Infants with severe ALRI failed to benefit from two antioxidant nutrients as adjunct therapy . Severe ALRI in infants may cause cell-mediated immune dysfunction . We need a better underst and ing of oxidative processes in growing infants to help us better design interventions with antioxidant therapy STUDY OBJECTIVE : To examine the hypothesis that the higher rates of  coronary heart disease ( CHD ) in Indians ( South Asians ) compared with Malays and Chinese is partly because of differences in antioxidants ( vitamins A , C , and E , and selenium ) and pro-oxidants ( iron ) . DESIGN : Cross sectional study of the general population . SETTING : Singapore . PARTICIPANTS : R and om sample of 941 persons aged 30 to 69 years . MAIN RESULTS : There were moderate correlations between vitamin A and vitamin E , and between these vitamins and selenium .  Mean plasma vitamins A and E were similar by ethnic group . Vitamin A concentration for Indians were ( men 0.66 and women 0.51 mg/l ) , Malays ( men 0.67 and women 0.54 mg/l ) , and Chinese ( men 0.68 and women 0.52 mg/l ) . Vitamin E concentrations for Indians were ( men 12.9 and women 12.8 mg/l ) , Malays ( men 13.6 and women 13.3 mg/l ) , and Chinese ( men 12.6 and women 12.6 mg/l ) . In contrast , mean plasma vitamin C concentrations were lower in Indians ( men 5.7 and women 6.9 mg/l ) and Malays ( men 5.1 and women 6.4 mg/l ) than Chinese ( men 6.3 and women 8.4 mg/l ) . Mean serum selenium  was lower in Indians ( men 117 and women 115 micrograms/l ) than Malays ( men 122 and women 122 micrograms/l ) and Chinese ( men 126 and women 119 micrograms/l ) . Mean serum ferritin was much lower in Indians ( men 132 and women 50 micrograms/l ) than Malays ( men 175 and women 85 micrograms/l ) and Chinese ( men 236 and women 92 micrograms/l ) . MAIN CONCLUSIONS : Lower vitamin C and selenium  in Indians , particularly in combination , could play a part in their increased risk of CHD . Vitamins A and E , and ferritin ( iron ) have no such role . Lower vitamin C in Indians and Malays is probably because of its destruction by more prolonged cooking . In Indians , lower selenium is probably because of a lower dietary intake and the much lower ferritin to a lower dietary intake of iron and its binding by phytates
target: Due to the small number of included studies and very low quality of the existing evidence , we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia .
background: BACKGROUND According to the Global Burden of Disease Study 2015 , lower respiratory tract infection is the leading cause of infectious disease death , and the fifth most common cause of death overall .
  Vitamin C has a role in modulating resistance to infectious agents , therefore vitamin C supplementation may be important in preventing and treating pneumonia .
  OBJECTIVES To assess the impact of vitamin C supplementation to prevent and treat pneumonia in children and adults .