Levine · JAMA 1999 · narrative review and guideline proposal · n=?

Criteria and recommendations for vitamin C intake.

Cited 560 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and expert guideline recommendation without original human trial data

PubMed 10217058 · doi:10.1001/jama.281.15.1415 · record verified 2026-08-30

What was done

The authors evaluated biochemical, molecular, pharmacokinetic, epidemiological, and clinical data across 9 criteria (dietary availability, plasma steady-state concentrations, tissue steady-state concentrations, bioavailability, urinary excretion, adverse effects, biochemical/molecular function, direct beneficial and epidemiologic effects, and deficiency prevention) to propose updated Dietary Reference Intake values for vitamin C.

What was found

Using an estimated average requirement (EAR) of 100 mg/d, the authors proposed an updated recommended dietary allowance (RDA) of 120 mg/d (up from the 1989 recommendation of 60 mg/d). They estimated adequate intake (AI) at 200 mg/d from 5 daily servings of fruits and vegetables, or 100 mg/d to prevent deficiency with a margin of safety. The tolerable upper intake level was proposed to be less than 1 g/d, noting potential adverse consequences at intakes of 1 g or more daily.

Why it matters

This paper provided a mechanistic and pharmacokinetic framework that shifted vitamin C intake recommendations from merely avoiding scurvy to optimizing plasma and tissue saturation for general health.

Limits

The abstract represents a narrative synthesis and policy proposal rather than a primary trial or systematic review. Specific sample sizes, individual study designs, effect sizes, and detailed risk profiles underlying the 1 g/d threshold are not detailed in the abstract.

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