Lower dietary and circulating vitamin C in middle and older aged men and women are associated with lower estimated skeletal muscle mass

Lucy Lewis, Richard Hayhoe, Angela Mulligan, Robert Luben, K. T. Khaw, Ailsa Welch (Lead Author)

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)
18 Downloads (Pure)


Background: Age-related loss of skeletal muscle mass contributes to poor outcomes including sarcopenia, physical disability, frailty, type 2 diabetes, and mortality. Vitamin C has physiological relevance to skeletal muscle and may protect it during aging, but few studies have investigated its importance in older populations. Objectives: We aimed to investigate cross-sectional associations of dietary and plasma vitamin C with proxy measures of skeletal muscle mass in a large cohort of middle- and older-aged individuals. Methods: We analyzed data from >13,000 men and women in the European Prospective Investigation into Cancer and Nutrition–Norfolk cohort, aged 42–82 y. Fat-free mass (FFM), as a proxy for skeletal muscle mass, was estimated using bioelectrical impedance analysis and expressed as a percentage of total mass (FFM%) or standardized by BMI (FFM BMI). Dietary vitamin C intakes were calculated from 7-d food diary data, and plasma vitamin C was measured in peripheral blood. Multivariable regression models, including relevant lifestyle, dietary, and biological covariates, were used to determine associations between FFM measures and quintiles of dietary vitamin C or insufficient compared with sufficient plasma vitamin C (<50 μmol/L and ≥50 μmol/L). Results: Positive trends were found across quintiles of dietary vitamin C and FFM measures for both sexes, with interquintile differences in FFM% and FFM BMI of 1.0% and 2.3% for men and 1.9% and 2.9% for women, respectively (all P < 0.001). Similarly, FFM% and FFM BMI measures were higher in participants with sufficient than with insufficient plasma vitamin C: by 1.6% and 2.0% in men, and 3.4% and 3.9% in women, respectively (all P < 0.001). Associations were also evident in analyses stratified into <65-y and ≥65-y age groups. Conclusions: Our findings of positive associations, of both dietary and circulating vitamin C with measures of skeletal muscle mass in middle- and older-aged men and women, suggest that dietary vitamin C intake may be useful for reducing age-related muscle loss. J Nutr 2020;150:2789–2798.

Original languageEnglish
Pages (from-to)2789–2798
Number of pages10
JournalJournal of Nutrition
Issue number10
Early online date27 Aug 2020
Publication statusPublished - 12 Oct 2020


  • ascorbic acid
  • frailty
  • sarcopenia
  • skeletal muscle
  • vitamin C

Cite this