In order to understand superior bioavailability between Acerola, other natural vitamin C and synthetic vitamin C for humans, we turn our attention to the many scientific comparative human studies that have been conducted.  [A P-VALUE OF LESS THAN 0.05 IS CONSIDERED DEMONSTRATION OF A STRONG, SIGNIFICANT CONCLUSION]

1.  ACEROLA SUPERIOR TO ASCORBIC ACID STUDIES:

2.  OTHER NATURAL VITAMIN C SOURCES VS ASCORBIC ACID STUDIES

3.  ANIMAL VITAMIN C STUDIES 

 

 1.  ACEROLA SUPERIOR TO ASCORBIC ACID STUDIES:

Acerola and Ascorbic Acid comparison studies that currently exist have been conclusive with no contradiction to our knowledge –ACEROLA WAS FOUND TO BE SIGNIFICANTLY MORE BIOAVAILABLE than synthetic ascorbic acid in each experiment with very strong conclusions drawn from the clinical data.

• “According to a double-blind randomised experiment, concentrated ascorbic acid Acerola powder was found to be 1.63 times more bio-available and better synthesised by the human body than U.S. Pharmacopeia ascorbic acid which is synthetically produced (p < 0.0254).”  Tang L. 1995. Comparative study of the bioavailability of ascorbic acid in commercially produced products. [dissertation].  1995: University of Pensylvania, Department of Chemistry.

• “In Comparison with synthetic ascorbic acid, the vitamin C produced by Acerola is better absorbed by the human body.  In fact, the human body can only absorb 50% of synthetic vitamin intake compared to that of natural vitamins (Byrne, 1993).  In a study reported by Johnson (2003), it was found that infants consuming apple juice supplemented with acerola showed average or above average growth and development for their age and weight. Vitamin C levels in the blood were higher for all infants after the acerola/apple juice was introduced into the diet.” Postharvest biology and technology of tropical and subtropical fruits volume 2 – Acerola – M. Mohammed, University of the West Indies St Augustine Campus, Trinidad).

• “Absorption and excretion of ascorbic acid alone and in Acerola (Malpighia emarginata) juice:  Abstract:  It has been suggested that some food components, such as bioflavonoids, affect the bioavailability of ascorbic acid in humans. Since little is known in Japan about the effective intake of this dietary requirement, we tested young Japanese males after the ingestion of commercial ascorbic acid or acerola (Malpighia emarginata DC.) juice to compare the quantities absorbed and excreted. Healthy Japanese subjects received a single oral dose of ascorbic acid solution (50, 100, 200 or 500 mg) and received distilled water as a reference at intervals of 14 d or longer. All subjects were collected blood and urine until 6 h after ingestion and evaluated for time-dependent changes in plasma and urinary ascorbic acid levels. Predictably, the area under the curve (AUC) values in plasma and urine after ingestion increased dose-dependently. Next, each subject received diluted acerola juice containing 50 mg ascorbic acid. Likewise, their plasma and urinary ascorbic acid concentrations were measured. In plasma, the AUC value of ascorbic acid after ingestion of acerola juice tended to be higher than that from ascorbic acid alone. In contrast, the urinary excretion of ascorbic acid at 1, 2 and 5 h after ingestion of acerola juice were significantly less than that of ascorbic acid. These results indicate that some component of acerola juice favorably affected the absorption and excretion of ascorbic acid.”  https://www.ncbi.nlm.nih.gov/pubmed/22040889

• “Vitamin C produced by Acerola is better absorbed by humans:  When compared with synthetic ascorbic acid, the vitamin C produced by this fruit is better absorbed by the human organism.  We can only absorb 50% of synthetic vitamin intake in opposition to that of natural vitamins.”  Araújo P.S.R., Minami K., Acerola, Fundação Cargill, Campinas, SP, Brazil, 1994, 81 p.  Acerola: importance, culture conditions, production and biochemical aspects Sandra Aparecida de ASSIS1,2, Fernandes PEDRO FERNANDES2, Antônio Baldo Geraldo MARTINS3, Olga Maria Mascarenhas de FARIA OLIVEIRA1

2.  OTHER NATURAL VITAMIN C SOURCES VS ASCORBIC ACID STUDIES:

Unfortunately human studies comparing bioavailablility between synthetic ascorbic acid and other natural sources like citrus fruits and alternative foods (exclusive of Acerola) have been unclear and contradicting.  Some studies have found ascorbic acid to be equally bioavailable to natural sources, whilst many others have concluded that natural sources are more bioavailable.  Study outcomes are impacted by specific study models, design and the individual influences of each study group.

2.1  Natural sources better bioavailable:

“The inadequacy of synthetic ascorbic acid as an antiscorbutic agent:  Summary:  IN 1928-35 Szent-Gyorgyi demonstrated the presence of ascorbic acid in all antiscorbutic substances. Later, when it was found that the synthetically prepared ascorbic acid also had an antiscorbutic effect, the conclusion was generally accepted that synthetic ascorbic acid and vitamin C were absolutely identical. Recently, however, we have been impressed by the fact that some patients presenting typical prescorbutic and scorbutic conditions have not reacted to the administration of synthetic ascorbic acid in the manner that would be expected if this were the case. As one of us (A. E.)’ has provided data (to be published later) concerning the absorption and elimination of ascorbic acid, this clinical observation was subjected to closer investigation. For a time the capillary resistance test of Gothlin was applied to all patients admitted to the service, and, in addition, the rhagic diathesis together with a low ascorbic acid concentration in the serum, and each of them was given 300 mg. of ascorbic acid daily by mouth for ten days. In all but 3 this led to disappearance of the tendency to haemorrhage and a return of the serum ascorbic acid to normal. (In passing, it may be observed that one patient, not included in this list, had to be given ascorbic acid by the intravenous route before he was cured.) Three patients, however, differed from the others in that the haemorrhagic condition was not cured, and the serum ascorbic acid not increased by the oral administration of ascorbic acid. They had all received by mouth a total of 3 grammes, and they were now given an additional 300 mg. of ascorbic acid intravenously every day for ten days. But even then the haemorrhagic condition was not abolished, nor was the serum ascorbic acid brought up to normal. After these 3 patients had taken a total of 6 g. of ascorbic acid, they were given the juice of ten lemons every day for ten days. (By the Lund-Lieck method each lemon was found to contain from 20 to 40 mg. of ascorbic acid.) With this change in treatment the haemorrhagic condition disappeared and the serum ascorbic acid returned to normal.”  BY ALF ELMBY, M.D. AND PROF. ERIK WARBURG, M.D. (From Medical Department B and the University Clinic in Rigshospitalet, Copenhagen, and from the University Institute for Hygiene, Copenhagen)  Elmby, A.; Warburg, E. The inadequacy of synthetic ascorbic acid as an antiscorbutic agent. Lancet 1937, 230, 1363–1365.  http://www.sciencedirect.com/science/article/pii/S0140673600889692

“Comparative bioavailability to humans of ascorbic acid alone or in a citrus extract.  Abstract:  This study was performed to determine whether synthetic ascorbic acid (AA) alone or in a natural citrus extract containing bioflavonoids, proteins, and carbohydrates was more bioavailable to human subjects. The effect of a single 500-mg ascorbate dose of the two forms and a placebo citrus extract on plasma ascorbate was examined in eight fasting subjects. A comparison of the areas under the plasma concentration-time curves showed that the citrus extract was 35% more absorbed than AA (p less than 0.001) and was more slowly absorbed than AA (p less than 0.001). In six ascorbate-saturated male subjects the ascorbate in the citrus extract produced a greater ascorbate excretion than AA alone in 24-h post-dose urine (p less than 0.05). Citrus extract ascorbate was less excreted than AA (p less than 0.05) in 12 nonsaturated subjects. Ascorbate in the citrus extract was found to be more bioavailable than AA alone in human subjects.”  https://www.ncbi.nlm.nih.gov/pubmed/3414575  

“Comparative Bioavailability to Humans of Ascorbic Acid Alone or in Citrus Extract.  Summary:  A study was performed to determine whether synthetic Ascorbic Acid (AA) alone or in a natural citrus extract containing bioflavonoids, proteins and carbohydrates was more bioavailable to human subjects. The effect of a single 500 mg ascorbate dose of the two forms and a placebo citrus extract on plasma concentration-time curves showed that the citrus extract was 35% more absorbed than AA (p < 0.001) and was more slowly absorbed than AA (p < 0.001). In six ascorbate-saturated male subjects the ascorbate in the citrus extract produced a greater ascorbate excretion than AA alone in 24-h post dose urine (p< 0.05). Citrus extract ascorbate was less excreted than AA (p < 0.05) in 12 non saturated subjects. Ascorbate in the citrus extract was found to be more bioavailable than AA alone in human subjects.”  Department of Chemistry, University of Scranton, Scranton, PA, 18510, USA.  Joe A. Vinson, PhD Pratima Bose, PhD.  Reprinted from the AMERICAN JOURNAL OF CLINICAL NUTRITION Vol. 48, No. 3, pp 601-604. September 1988.

“Citrus extract has been shown to be more absorbed than ascorbic acid:  Citrus Extract has been shown in guinea pigs and humans to be more absorbed than Ascorbic Acid and to remain in the body for a longer period of time. Citrus Extract is thus the preferred form of ascorbate for supplementation.”   Vinson J.A.; Bose P., “Bioavailability of Synthetic Ascorbic Acid and a Citrus Extract”, Annals of the New York Academy of Sciences, 3rd Conference on Vitamin C, 1987, 498, 525-526. 

“Citrus extract was 1210% more bioavailable than USP Ascorbic Acid.”   Vinson J.A., “Bioavailability of Vitamin C”, 1991. (Citrus extract was 1210% more bioavailable than USP (United States Pharmacopoeia) Ascorbic Acid.)  Vinson J.A., “Citrus Extract and Human Lipids”, 1988, Unpublished Data

“The availability for human nutrition of the vitamin C in raw cabbage and home-canned tomato juice:  Abstract : One female and 3 male college students ate during February, March and April, 1942, a basal diet neutral in reaction containing about 10 mg. ascorbic acid. For 3 periods of 7 to 9 days the diet was supplemented with 200 mg. ascorbic acid daily; each of these periods was succeeded by another of 9 days during which the diet was supplemented daily with 75 mg. synthetic ascorbic acid, or 25 mg. ascorbic acid with raw cabbage providing an. additional 50 mg., or 25 mg. ascorbic acid with tomato juice providing an additional 50 mg. Vitamin, C was estimated in the urine by indophenol titration, and in the blood by a modification of Ingalls’ method (Abst. 2453, Vol. 7) The pH of the urine was determined by the quinhydrone electrode method. The percentage of the vitamin C [ascorbic acid] intake excreted in the urine during the last 5 days of each 9 day period in which the supplements were ascorbic acid, ascorbic acid with cabbage, and ascorbic acid with tomato juice averaged, respectively, 44.4, 40.8 and 41.8. The pH of the urine did not change significantly throughout the experiment. It is concluded that the vitamin. C of raw cabbage and tomato are utilised as well as, and possibly better than, synthetic ascorbic acid.”  J. M. Witt. Clayton, M.M.; Borden, R.A. The availability for human nutrition of the vitamin C in raw cabbage and home-canned tomato juice. J. Nutr. 1943, 25, 349–369.  https://www.cabdirect.org/cabdirect/abstract/19431401629

“Tropical fruit camu-camu (Myrciaria dubia) has anti-oxidative and anti-inflammatory properties.  Abstract:  Background:  Oxidative stress as well as inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Although, various anti-oxidative dietary supplements have been evaluated for their ability to prevent atherosclerosis, no effective ones have been determined at present. “Camu-camu” (Myrciaria dubia) is an Amazonian fruit that offers high vitamin C content. However, its anti-oxidative property has not been evaluated in vivo in humans.  Methods:  To assess the anti-oxidative and anti-inflammatory properties of camu-camu in humans, 20 male smoking volunteers, considered to have an accelerated oxidative stress state, were recruited and randomly assigned to take daily 70 ml of 100% camu-camu juice, corresponding to 1050 mg of vitamin C (camu-camu group; n=10) or 1050 mg of vitamin C tablets (vitamin C group; n=10) for 7 days.  Results:  After 7 days, oxidative stress markers such as the levels of urinary 8-hydroxy-deoxyguanosine (P<0.05) and total reactive oxygen species (P<0.01) and inflammatory markers such as serum levels of high sensitivity C reactive protein (P<0.05), interleukin (IL)-6 (P<0.05), and IL-8 (P<0.01) decreased significantly in the camu-camu group, while there was no change in the vitamin C group.  Conclusions:  Our results suggest that camu-camu juice may have powerful anti-oxidative and anti-inflammatory properties, compared to vitamin C tablets containing equivalent vitamin C content. These effects may be due to the existence of unknown anti-oxidant substances besides vitamin C or unknown substances modulating in vivo vitamin C kinetics in camu-camu.”  https://www.ncbi.nlm.nih.gov/pubmed/18922386

2.2  No difference in bioavailability:

“The availability of ascorbic acid in papayas and guavas.  Abstract : Ascorbic acid was estimated by indophenol titration in plasma and coloured extracts with the aid of a photo-electric colorimeter. The ascorbic acid content of papaya ranged from 60 to 100 mg. per 100 g. and of guava juice, a watery extract from cooked guavas, from 60 to 90 mg. per 100 ml. Eight male and 6 female subjects took part in two tests on the availability of ascorbic acid from papaya and guava.
In the first, before the experiment began, 4 females and 5 males received 300 mg. ascorbic acid daily for 3 days. During the experiment the routine consisted of consecutive weekly periods which included a saturation day when 300 mg. synthetic ascorbic acid was taken, followed by 6 days on a basal diet very low in vitamin C [ascorbic acid], supplemented by 75 mg. ascorbic acid daily, supplied in different weeks by the synthetic vitamin or papayas or guava juice. The amount of ascorbic acid excreted varied greatly from day to day and between individuals, but the average amount excreted for the last 5 days of the period by the 9 subjects did not vary significantly with the source of the vitamin. Values for vitamin C [ascorbic acid] excretion were always low at the start of menstruation, and were therefore excluded from the average values.
Before the second teat the 3 male and 3 female subjects received 100 mg. synthetic ascorbic acid daily for 4 days. A further adjustment period of 13 days, during which each subject received the basal diet supplemented by 75 mg. daily of ascorbic acid, was followed by 3 periods of 1 week in each of which the equivalent of 75 mg. ascorbic acid was supplied by papaya, synthetic vitamin or guava juice. During these 3 weeks no significant variations in excretion of ascorbic acid were observed, and this result was confirmed by the steadiness in the plasma value for ascorbic acid.”  V. E. Pond. Hartzler, E.R. The availability of ascorbic acid in papayas and guavas. J. Nutr. 1945, 30, 355–365.  https://www.cabdirect.org/cabdirect/abstract/19451403646

“Comparison of the utilization by college women of equivalent amounts of ascorbic acid (vitamin C) in red raspberries and in crystalline form.  Abstract : The test substances were given after the subject had been saturated with vitamin C [ascorbic acid]. For each of the 7 subjects, the urinary excretion and blood plasma value for ascorbic acid, and the utilization index calculated from Sendroy’s formula (Abst. 4039, Vol. 6) were the same, whether ascorbic acid was administered in crystalline form or as red raspberries.”  M. A. B. Fixsen. Todhunter, E.N.; Fatzer, A.S. A comparison of the utilization by college women of equivalent amounts of ascorbic acid (vitamin C) in red raspberries and in crystalline form. J. Nutr. 1940, 19, 121–130.  https://www.cabdirect.org/cabdirect/abstract/19401400867

“Orange Juice Ingestion and Supplemental Vitamin C Are Equally Effective at Reducing Plasma Lipid Peroxidation in Healthy Adult Women.  Abstract:  Objective: To directly examine the contribution of vitamin C to the antioxidant potential of fruits and vegetables, the antioxidant effect of orange juice consumption (8 and 16 fl. oz.) was compared to the antioxidant effect of supplemental vitamin C (dosage equivalent to that supplied by 8 fl. oz. of orange juice).  Methods: Subjects (n = 11; 28.6 ± 2.1 years) received each treatment in a 3 × 3 randomized crossover design, and each two-week treatment was preceded by a two-week washout. During the entire trial, subjects restricted fruit and vegetable consumption to ≤3 servings per day except the vitamin C-rich foods (items containing >20 mg/serving), which were restricted to ≤3 servings per week. A fasting blood sample was collected at the end of each washout and each treatment period.  Results: Following washouts, plasma vitamin C and lipid peroxidation (plasma TBARS) were similar by treatment group and averaged 25.4 ± 3.6 µmol/L and 3.82 ± 0.10 nmol/mL respectively. Plasma vitamin C concentrations were similar following each treatment period, 37.9 ± 8.1, 45.8 ± 9.4, and 38.3 ± 12.4 µmol/L for the 8 and 16 fl. oz. orange juice treatments and the supplement treatment, respectively. All intervention treatments reduced plasma TBARS as compared to pretreatment values: −47% (p = 0.013), −40% (p = 0.083), and −46% (p = 0.015) for the 8 and 16 fl. oz. orange juice treatments and supplement treatment respectively.  Conclusions: These data indicate that the regular consumption of 8 fl. oz. orange juice or supplemental vitamin C (-70 mg/day) effectively reduced a marker of lipid peroxidation in plasma.”  Johnston, C.S.; Dancho, C.L.; Strong, G.M. Orange juice ingestion and supplemental vitamin C are equally effective at reducing plasma lipid peroxidation in healthy adult women. J. Am. Coll. Nutr. 2003, 22, 519–523.  http://www.tandfonline.com/doi/abs/10.1080/07315724.2003.10719330

“A randomized steady-state bioavailability study of synthetic versus natural (kiwifruit-derived) vitamin C.  Abstract:  Whether vitamin C from wholefoods has equivalent bioavailability to a purified supplement remains unclear. We have previously showed that kiwifruit provided significantly higher serum and tissue ascorbate levels than synthetic vitamin C in a genetically vitamin C-deficient mouse model, suggesting a synergistic activity of the whole fruit. To determine if these results are translatable to humans, we carried out a randomized human study comparing the bioavailability of vitamin C from kiwifruit with that of a vitamin C tablet of equivalent dosage. Thirty-six young non-smoking adult males were randomized to receive either half a gold kiwifruit (Actinidia Chinensis var. Hort 16A) per day or a comparable vitamin C dose (50 mg) in a chewable tablet for six weeks. Ascorbate was monitored weekly in fasting venous blood and in urine, semen, leukocytes, and skeletal muscle (vastus lateralis) pre- and post-intervention. Dietary intake of vitamin C was monitored using seven day food and beverage records. Participant ascorbate levels increased in plasma (P < 0.001), urine (P < 0.05), mononuclear cells (P < 0.01), neutrophils (P < 0.01) and muscle tissue (P < 0.001) post intervention. There were no significant differences in vitamin C bioavailability between the two intervention groups in any of the fluid, cell or tissue samples tested. Overall, our study showed comparable bioavailability of synthetic and kiwifruit-derived vitamin C.”  https://www.ncbi.nlm.nih.gov/pubmed/24067392

“The bioavailability to humans of ascorbic acid from oranges, orange juice and cooked broccoli is similar to that of synthetic ascorbic acid.  Abstract:  The relative bioavailability of ascorbic acid from several sources was compared in 68 male non-smokers. Subjects underwent two 8-wk ascorbic acid depletion-repletion cycles. In repletion, subjects were randomized to receive 108 mg/d ascorbic acid as tablets with or without iron, as orange segments or juice, or as raw or cooked broccoli with a crossover within each major treatment group (e.g., cooked to raw broccoli) for the second repletion. Relative ascorbic acid bioavailability was estimated based on the slope obtained from linear regression of plasma ascorbic acid on time during each repletion. In the first repletion, slopes for all groups were similar except for the group consuming raw broccoli (20% lower response, P < 0.01). Second repletion responses were attenuated, but were similar to the first repletion. Ascorbic acid ingested as cooked broccoli, orange juice or fruit, or in synthetic form seems to be equally bioavailable. The lower relative bioavailability of ascorbic acid from raw broccoli is unlikely to be of practical importance in mixed diets.”  https://www.ncbi.nlm.nih.gov/pubmed/8505665

“Ascorbic acid bioavailability in foods and supplements.  Abstract:  The bioavailability of ascorbic acid from food has been assumed to be high, but little quantitative information has been available to substantiate this assumption because of the limited precision and low statistical power of previous studies. A recent depletion-repletion study with a more effective experimental design has shown clearly that ascorbic acid bioavailability is equivalent in ascorbic acid tablets (with and without iron), orange juice, whole orange sections, and cooked broccoli. The bioavailability of ascorbic acid in raw broccoli was 20% lower, although this difference would probably have little nutritional significance in typical mixed diets.”  https://www.ncbi.nlm.nih.gov/pubmed/8302486

“Synthetic or food-derived vitamin C-–are they equally bioavailable?  Abstract:  Vitamin C (ascorbate) is an essential water-soluble micronutrient in humans and is obtained through the diet, primarily from fruits and vegetables. In vivo, vitamin C acts as a cofactor for numerous biosynthetic enzymes required for the synthesis of amino acid-derived macromolecules, neurotransmitters, and neuropeptide hormones, and is also a cofactor for various hydroxylases involved in the regulation of gene transcription and epigenetics. Vitamin C was first chemically synthesized in the early 1930s and since then researchers have been investigating the comparative bioavailability of synthetic versus natural, food-derived vitamin C. Although synthetic and food-derived vitamin C is chemically identical, fruit and vegetables are rich in numerous nutrients and phytochemicals which may influence its bioavailability. The physiological interactions of vitamin C with various bioflavonoids have been the most intensively studied to date. Here, we review animal and human studies, comprising both pharmacokinetic and steady-state designs, which have been carried out to investigate the comparative bioavailability of synthetic and food-derived vitamin C, or vitamin C in the presence of isolated bioflavonoids. Overall, a majority of animal studies have shown differences in the comparative bioavailability of synthetic versus natural vitamin C, although the results varied depending on the animal model, study design and body compartments measured. In contrast, all steady state comparative bioavailability studies in humans have shown no differences between synthetic and natural vitamin C, regardless of the subject population, study design or intervention used. Some pharmacokinetic studies in humans have shown transient and small comparative differences between synthetic and natural vitamin C, although these differences are likely to have minimal physiological impact. Study design issues and future research directions are discussed.”  https://www.ncbi.nlm.nih.gov/pubmed/24169506

3.  ANIMAL VITAMIN C STUDIES:

Animal studies have also shown differences in comparative bioavailability of synthetic vs natural vitamin c from certain human studies.

“Guinea pig vitamin C study:  Summary:  In a study on guinea pigs the bioavailability of the natural vitamin C was significantly greater (148%, p<0.001) than that of the synthetic ascorbic acid.”  Nutritional reports international, comparative bioavailability of synthetic and natural vitamin C in guinea pigs. J.A. Vinson and P. Bose – department of chemistry, university of Scranton.

”The bio availability of the natural Vitamin C was significantly greater than that of the synthetic Ascorbic Acid.”  Vinson J.A., “Comparative Bioavailability of Synthetic and Natural Vitamin C in Guinea Pigs”, Nutrition Reports International, 1983, 27, 4, 875-880. 

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