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Ann N Y Acad Sci. 2018 Oct;1430(1):3-43. doi: 10.1111/nyas.13919. Epub 2018 Aug 27.

Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs.

Author information

1
Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
2
The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, New York.
3
University of Tennessee Health Science Center, Memphis, Tennessee.
4
Laboratory of Neurophysiology, GIGA-Neurosciences, University of Liège, Liège, Belgium.
5
Bill & Melinda Gates Foundation, Seattle, Washington.
6
Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom.
7
Tel Aviv Medical Center, Dana-Dwek Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
8
Mayo Clinic, Rochester, Minnesota.
9
University of Utah and ARUP Laboratories, Salt Lake City, Utah.
10
Doctors without Borders (MSF), Barcelona, Spain.
11
National Nutrition Center, Ministry of Health and Sports, Myanmar.
12
Centers for Disease Control and Prevention, Atlanta, Georgia.
13
Independent contractor, New York, New York.
14
The Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR.
15
Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts.
16
Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
17
Diagnostics for All Inc., Salem, Massachusetts.
18
Institut de Recherche pour le Developpment, Montpellier, France.
19
Jean Mayer USDA Human Nutrition Research Center, Tufts University, Boston, Massachusetts.

Abstract

Thiamine is an essential micronutrient that plays a key role in energy metabolism. Many populations worldwide may be at risk of clinical or subclinical thiamine deficiencies, due to famine, reliance on staple crops with low thiamine content, or food preparation practices, such as milling grains and washing milled rice. Clinical manifestations of thiamine deficiency are variable; this, along with the lack of a readily accessible and widely agreed upon biomarker of thiamine status, complicates efforts to diagnose thiamine deficiency and assess its global prevalence. Strategies to identify regions at risk of thiamine deficiency through proxy measures, such as analysis of food balance sheet data and month-specific infant mortality rates, may be valuable for understanding the scope of thiamine deficiency. Urgent public health responses are warranted in high-risk regions, considering the contribution of thiamine deficiency to infant mortality and research suggesting that even subclinical thiamine deficiency in childhood may have lifelong neurodevelopmental consequences. Food fortification and maternal and/or infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of infantile beriberi in regions where thiamine deficiency is prevalent, but trial data are limited. Efforts to determine culturally and environmentally appropriate food vehicles for thiamine fortification are ongoing.

KEYWORDS:

LMIC; beriberi; erythrocyte transketolase; nutrition; thiamine deficiency; thiamine diphosphate

PMID:
30151974
PMCID:
PMC6392124
DOI:
10.1111/nyas.13919
[Indexed for MEDLINE]
Free PMC Article

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