A recent review of global vitamin C status has indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here, we provide a narrative review of potential factors influencing vitamin C status globally. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use, with those who supplement having a higher mean status and a lower prevalence of deficiency. Dietary intake can be influenced by cultural aspects such as traditional cooking practices and staple foods, with many staple foods, such as grains, contributing negligible vitamin C to the diet. Environmental factors can also affect vitamin C intake and status; these include geographic region, season, and climate, as well as pollution, the latter partly due to enhanced oxidative stress. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects can affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various noncommunicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time; therefore, we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global dietary intake recommendations for vitamin C.

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影响维生素C状况和缺乏症患病率的因素：全球健康角度

最近对全球维生素C状况的回顾表明，维生素C缺乏症的患病率很高，尤其是在低收入和中等收入国家以及高收入国家的特定亚组中。在这里，我们对全球范围内影响维生素C状况的潜在因素进行叙述性综述。维生素C的体内状况主要受饮食摄入和补充剂使用的影响，补充者的平均状况较高，缺乏症的患病率较低。饮食摄入可能会受到文化因素的影响，例如传统的烹饪方法和主食，以及许多主食（例如谷物）对饮食中维生素C的贡献可忽略不计。环境因素也会影响维生素C的摄入量和状况；其中包括地理区域，季节和气候以及污染，后者部分归因于氧化应激的增强。众所周知，诸如性别，年龄和种族之类的人口因素会影响维生素C的状况，诸如贫困，教育和社会阶层以及制度化等社会经济因素也会影响维生素C的状况。健康的各个方面都会影响维生素C的状况；其中包括体重，妊娠和哺乳，遗传变异，吸烟和疾病状态，包括严重感染以及各种非传染性疾病，例如心血管疾病和癌症。其中一些因素已随着时间而改变；因此，我们还探讨了维生素C的状态是否显示出时间变化。总体而言，在世界各地，有许多因素可以不同程度影响维生素C的状况。