(P10-005-24) Dietary Vitamin C, Serum Ascorbate, and Substance Use Among Women of Reproductive Age: National Health and Nutrition Examination Survey 1999-2018

Objectives: Substance use may affect dietary intake and further exacerbate risk for suboptimal serum ascorbate. The objective of this study was to evaluate the differences in dietary vitamin C and serum ascorbate between substance use categories among pregnant and nonpregnant women of reproductive age in the U.S.

Methods: This secondary analysis of the National Health and Nutrition Examination Survey (NHANES) 1999–2018 included women of reproductive age (20–44y) who provided at least 1 reliable dietary recall (n = 11,129). Dietary vitamin C intake was collected using 1 to 2, non-consecutive, 24-hour dietary recalls via the automated multiple-pass method. Serum ascorbate was collected using isocratic ultra-high performance liquid chromatography for three of the ten NHANES cycles. Usual vitamin C intake from foods, beverages, and supplements was assessed using the NCI method. The proportion who consumed below the estimated average requirement was assessed using the cut-point approach. Serum ascorbate deficiency was considered < 11 μmol/L.

Results: Those who currently smoke were more likely to have inadequate vitamin C intake compared to those who never smoked for both pregnant (33.0 [4.6]% vs 10.4 [1.6]%; p < .001 ) and nonpregnant women (53.5 [1.5]% vs 26.3 [1.0]%; p < .001 ). Among nonpregnant women, those with moderate alcohol consumption were less likely to have inadequate vitamin C intake compared to those with no or light alcohol intake (27.0 [1.6]% vs. 35.2 [1.0]%; p < .001 and 33.6 [1.2]%; p < .001, respectively). Those who affirmed marijuana use were more likely to have inadequate vitamin C intake compared to those who denied using marijuana (42.2 [2.6]% vs. 33.4 [1.1]%; p = .002).

The prevalence of vitamin C deficiency was greater among nonpregnant women who currently smoke (16.4 [1.9]%) compared to former (3.3[1.3]%; p < .001) and never (3.2[0.6]%; p < .001 smokers). There were no significant differences in serum ascorbate according to marijuana or illicit drug use.

Conclusions: These analyses showed vitamin C intake and serum ascorbate were significantly lower among those who smoked while differences among marijuana and alcohol consumption categories varied. Suboptimal vitamin C intake and serum ascorbate can negatively influence iron status and reproductive outcomes.

Funding Sources: None