The interaction between vitamin C and bone health: a narrative review

Introduction: High intakes of fruits and vegetables have been associated with improvements in skeletal health, suggesting a potential role of vitamin C. Osteoporosis affects millions of people worldwide, causing decrease in bone strength and higher fracture rate. Vitamin C has antioxidant effects in humans, and oxidative stress could represent an important pathogenetic factor of age-related bone loss and fragility. Although some evidences of a potential role of vitamin C in osteoporosis and fracture prevention have been published, an overall consensus has not been reached. Areas covered: The role of vitamin C on bone metabolism, covering general biochemical, molecular, and cell biology concepts, with particular attention to bone/collagen pathophysiology is discussed. Experimental studies in animal models and human clinical studies are described. A specific chapter on vitamin C and mitochondria, including issues on oxidative states, is included. Expert commentary: Uncertainties, limitations, and open questions on the role of vitamin C in human skeletal health still remain. Therefore, indications or recommendations on vitamin C supplementation to improve bone health, or prevent osteoporosis, are not currently appropriate.