Crook, Jennifer

Abstract Background: Vitamin C has long been recognized for its plethora of immune system and anti-inflammatory properties. Various cancers have been identified to have similarities in epigenetic inflammatory components. Because rates of prostate cancer have exhibited significant disparities in Black men with increased incidence and mortality, an examination of the intersection of diet, inflammation, and cancer and chronic disease diagnoses necessitates researchers to consider vitamin C. This study utilized data collected from the Prostate Cancer Transatlantic Consortium (CaPTC) Familial Cohort Study, an ongoing longitudinal cohort study initiated in 2017 which explores risk factors of prostate cancer among African Black men in Nigeria, Cameroon, and the United States (U.S.). Aim: The aim of this study was to examine the consumption habits of vitamin C-rich foods in African Black men and determine if dietary patterns influenced risk of cancer diagnosis. Methodology: Descriptive analyses compared vitamin C-rich food consumption among the countries of Nigeria, Cameroon, and the U.S. Unadjusted logistic regression models were used to identify association of cancer diagnosis with consumption of vitamin C fruits and vegetables. Odds ratios and 95% confidence intervals were estimated. Results: From 803 unique participants included in this study, most resided in Nigeria (82.6%), were married (92.9%) with a median age of 50.7 years. Chi square tests revealed significant differences in dietary consumption of vitamin C-rich fruits and vegetables among the three countries. Men in Nigeria presented with the highest weekly fruit consumption (p < 0.001). Men in the U.S. exhibited the greatest weekly vegetable consumption (p < 0.001), while men in Cameroon showed the least weekly consumption of both fruits and vegetable (p < 0.001). Fourteen Cameroon and zero U.S. men reported a cancer diagnosis. Logistic regression models were significant only for Nigeria where age (p < 0.001), leafy vegetable (0.04), berries (p = 0.05), and citrus fruit consumption (p = 0.04) were identified to be significant predictors of increased risk of cancer diagnoses. Conclusion: Regular consumption of vitamin C rich foods assists with reduction of inflammatory components that may contribute to cancer genesis. Dietary consumption patterns of vitamin C rich fruits and vegetables show significant disparities in Nigeria, Cameroon and the U.S. with men in Cameroon reporting the least weekly consumption of both vitamin C-rich fruits and vegetables. Future investigation into revisiting these associations as well as including an assessment of access to quality nutrition in both cost and availability should be explored, as regular consumption of leafy vegetables, berries, and citrus fruit were found to significantly decrease risk of cancer diagnosis in this study. Citation Format: Jennifer M. Crook, Emeka Iweala, Ademola Popoola, Paul Jibrin, Mohammed Faruk, Anthonia Sowumi, Omolara Fatiregun, Nkegoum Blaise, Catherine Oladoyinbo, Ifeoma Okoye, Abdulkadir Ayo Salako, Abidemi Omonisi, Iya Eze Bassey, Kayode Adeniji, Nggada Haruna Asura, Ernest Kaninjing, Oluwole Kukoyi, Parisa Fathi, Ruth Enuka, Oluwaseyi Toye, CaPTC Investigators, Folakemi Odedina. Vitamin C prediction of cancer diagnosis in men of African ancestry in Nigeria, Cameroon, and the United States: An analysis of the CaPTC prostate cancer study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C068.

Although undisputed for its anti-inflammatory and immune system boosting properties, vitamin C remains an inconsistently investigated nutrient in the United States. However, subclinical inadequacies may partly explain increased inflammation and decreased immune function within the population. This secondary analysis cross-sectional study used the 2003–2006 NHANES surveys to identify more clearly the association between plasma vitamin C and clinical biomarkers of acute and chronic inflammation C-reactive protein (CRP) and red cell distribution width (RDW). From plasma vitamin C levels separated into five defined categories (deficiency, hypovitaminosis, inadequate, adequate, and saturating), ANOVA tests identified significant differences in means in all insufficient vitamin C categories (deficiency, hypovitaminosis, and inadequate) and both CRP and RDW in 7607 study participants. There were also statistically significant differences in means between sufficient plasma vitamin C levels (adequate and saturating categories) and CRP. Significant differences were not identified between adequate and saturating plasma vitamin C levels and RDW. Although inadequate levels of vitamin C may not exhibit overt signs or symptoms of deficiency, differences in mean levels identified between inflammatory biomarkers suggest a closer examination of those considered at risk for inflammatory-driven diseases. Likewise, the subclinical levels of inflammation presented in this study provide evidence to support ranges for further clinical inflammation surveillance.

Vitamin C, well-established in immune function and a key factor in epigenetic inflammatory modifications, is only obtained through consistent dietary intake. Identifying individuals at risk for Vitamin C insufficiency may guide prevention and treatment, however, national surveillance has not been evaluated in the United States since 2006. A descriptive, cross-sectional secondary analysis was performed utilizing data from the 2003–2006 National Health and Nutrition Examination Surveys (NHANES) assessing non-institutionalized adults. Five categories of plasma Vitamin C were delineated: deficiency (<11 μmol/L), hypovitaminosis (11–23 μmol/L), inadequate (23–49 μmol/L), adequate (50–69 μmol/L), and saturating (≥70 μmol/L). Results indicated 41.8% of the population possessed insufficient levels (deficiency, hypovitaminosis, and inadequate) of Vitamin C. Males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty to income ratio and food insecurity were significantly associated with insufficient Vitamin C plasma levels. Plasma Vitamin C levels reveal a large proportion of the population still at risk for inflammatory driven disease with little to no symptoms of Vitamin C hypovitaminosis. Recognition and regulation of the health impact of Vitamin C support the goal of Nutrition and Healthy Eating as part of the Healthy People 2030.