Vitamin C has been in the public eye for a long time. Even before its discovery in 1932, nutrition experts recognized that something in citrus fruits could prevent scurvy, a disease that killed as many as two million sailors between 1500 and 1800. In the 1970s, Chemistry and Peace Nobel laureate Linus Pauling promoted daily megadoses of vitamin C (the amount in 12 to 24 oranges) as a way to prevent colds and some chronic diseases.

There’s no question that vitamin C plays a role in controlling infections. It’s also a powerful antioxidant that can neutralize harmful free radicals, and it helps make collagen, a tissue needed for healthy bones, teeth, gums, and blood vessels. The question is, do you need lots of vitamin C to keep you healthy?

No. Vitamin C’s cold-fighting potential certainly hasn’t panned out. Small trials suggest that the amount of vitamin C in a typical multivitamin taken at the start of a cold might ease symptoms, but for the average person, there’s no evidence that megadoses make a difference, or that they prevent colds. Studies of vitamin C supplements and heart disease, cancer, and eye diseases such as cataract and macular degeneration also show no clear patterns.

References

1. Carpenter KJ. The history of scurvy and vitamin C. Cambridge: Cambridge University Press, 1986.

2. Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, DC: National Academy Press, 2000.

3. Douglas RM, Hemila H, Chalker E, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2007:CD000980.

One of the advances that changed the way we look at vitamins was the discovery that too little folate, one of the eight B vitamins, is linked to birth defects such as spina bifida and anencephaly.

Fifty years ago, no one knew what caused these birth defects, which occur when the early development of tissues that eventually become the spinal cord, the tissues that surround it, or the brain goes awry. More than three decades ago, British researchers found that mothers of children with spina bifida had low vitamin levels. Eventually, two large trials in which women were randomly assigned to take folic acid (the form of folate added to multivitamins or fortified foods) or a placebo showed that getting too little folate increased a woman’s chances of having a baby with spina bifida or anencephaly and that getting enough folate could prevent these birth defects.

Timing of folate is critical: For folate to be effective, it must be taken in the first few weeks after conception, often before a woman knows she is pregnant.

Enough folate, at least 400 micrograms a day, isn’t always easy to get from food. That’s why women of childbearing age are urged to take extra folic acid as a supplement. It’s also why the US Food and Drug Administration now requires that folic acid be added to most enriched breads, flour, cornmeal, pastas, rice, and other grain products, along with the iron and other micronutrients that have been added for years.

Since the advent of mandatory folate fortification in 1998, neural tube birth defects have dropped by 20 to 30 percent, and studies have shown that far fewer people have low levels of folate in their blood.

The other exciting discovery about folate and two other B vitamins, vitamin B6 and vitamin B12, is that they may help fight heart disease and some types of cancer. It’s too early to tell if there’s merely an association between increased intake of folate, vitamin B6, and vitamin B12 and heart disease or cancer, or if high intakes prevent these chronic diseases.

B Vitamins and Heart Disease

In 1968, a Boston pathologist investigated the deaths of two children from massive strokes. Both had inherited conditions that caused them to have extremely high levels of a protein breakdown product in their blood, and both had arteries as clogged with cholesterol as those of a 65-year-old fast-food addict. Putting one and one together, he hypothesized that lower, but still elevated levels of homocysteine would contribute to the artery-clogging process of atherosclerosis. Since then, most—but not all—studies have linked high levels of this breakdown product, called homocysteine, with increased risks of heart disease and stroke. However, linking higher levels of homocysteine with heart disease risk does not necessarily mean that lowering homocysteine levels will lower risk. That requires testing in randomized trials.