Household Consumption of Thiamin-Fortified Fish Sauce Increases Erythrocyte Thiamin Concentrations among Rural Cambodian Women and Their Children Younger Than 5 Years of Age: A Randomized Controlled Efficacy Trial

Whitfield, Kyly C.; Karakochuk, Crystal D; Kroeun, Hou; Ly, Sokhoing; Chan, Benny B.; Borath, Mam; Sophonneary, Prak; Moore, Kirsten; Tong, Jeffery; McLean, J.; Talukder, Aminuzzaman; Lynd, Larry D.; Li‐Chan, Eunice C.Y.; Kitts, David D.; Green, Timothy

doi:10.1016/j.jpeds.2016.10.066

Cited by 17 publications

(29 citation statements)

References 22 publications

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“…Finally, Cambodians have been responsive to increased thiamine intakes, both through diet, as from randomized controlled trials by Whitfield et al . of thiamine‐fortified fish sauce showing increases in eThDP and breastmilk thiamine, and through thiamine supplementation, as shown in a recent pharmacokinetics study by Coats et al . Improvements to thiamine status upon supplementation are indicative of initial suboptimal status, as similar increases have not been observed among thiamine‐replete individuals.…”

Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 85%

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

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

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234

335

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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.

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Section: Prevalence Of Thiamine Deficiency and Burden Of Tddsmentioning

confidence: 85%

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

Whitfield

Bourassa

Adamolekun

et al. 2018

Annals of the New York Academy of Sciences

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234

335

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“…There are few reports of lipid profiles in the pediatric TS population. Ross et al [13] reported increased TC independent of age, BMI Z -score, or karyotype in TS females aged 5–14 years. Our TS cohort yielded a greater prevalence for atherogenic risk using the non-HDL-C measurement compared to TC and LDL-C combined and also independent of age and BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Hypercholesterolemia has been reported in 37–50% of women with TS over 21 years of age, a prevalence 2-fold higher than that found in the general female population [10-12]. In the pediatric TS population, evaluation of lipid profiles has demonstrated increased total cholesterol (TC), independent of age, body mass index (BMI), or karyotype in females aged 5–14 years [13]. Current clinical guidelines recommend screening for these risk factors initially at adolescence, with continued screening throughout adulthood [13-16].…”

Section: Introductionmentioning

confidence: 99%

“…In the pediatric TS population, evaluation of lipid profiles has demonstrated increased total cholesterol (TC), independent of age, body mass index (BMI), or karyotype in females aged 5–14 years [13]. Current clinical guidelines recommend screening for these risk factors initially at adolescence, with continued screening throughout adulthood [13-16]. …”

Section: Introductionmentioning

confidence: 99%

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Increased Non-High-Density Lipoprotein Cholesterol in Children and Young Adults with Turner Syndrome Is Not Explained By BMI Alone

et al. 2017

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Background: Turner syndrome (TS) is associated with an increased risk of cardiovascular disease. Non-high-density lipoprotein cholesterol (non-HDL-C) is a convenient measure of atherogenicity (normal concentration <120 mg/dL) but has not been investigated in TS. We aim to evaluate non-HDL-C patterns in a cohort of pediatric and young adult females with TS. Methods: A retrospective chart review was used to obtain demographics, body composition, genetic reports, and lipid profiles in females with TS. Results: Lipid profiles were assessed in 158 females (mean age 13.6 years). Mean non-HDL-C was 118.9 mg/dL (±32.0); the prevalence of high non-HDL-C (≥144 mg/dL) was 17.7% (n = 28). In TS females aged 8–17 years (n = 46), the prevalence of high non-HDL-C was 23.9% (95% CI 11.1–36.7; n = 11) between 2011 and 2012, compared to 9.2% (95% CI 5.6–14.1) in females of the same age in the general population reported in the National Health and Nutrition Examination Survey (NHANES) dataset (p < 0.005). Body mass index (BMI) accounted for only 6% of variance in non-HDL-C values (β coefficient = 1.31, p < 0.05). Conclusions: Children and adolescents aged 8–17 years with TS appear to have a greater prevalence of adverse non-HDL-C levels compared to the general adolescent population. The prevalence of high non-HDL-C was not fully explained by BMI.

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“…Due to lack of dietary diversity, Cambodian children have a high prevalence of thiamin deficiency (Whitfield et al., ), making fish sauce a practical target for thiamin fortification. In a field trial in rural Cambodia, thiamin‐fortified fish sauce was efficacious in improving thiamin status in pregnant women, breastfed children, and nonpregnant woman and their children (Whitfield et al., , ).…”

Section: Thiamin (Vitamin B1)mentioning

confidence: 99%

Global Concerns with B Vitamin Statuses: Biofortification, Fortification, Hidden Hunger, Interactions, and Toxicity

Titcomb

Tanumihardjo

2019

Comp Rev Food Sci Food Safe

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The prevalence of undernutrition due to insufficient energy intake has been reduced by nearly 50% since 1990. This reduction is largely attributed to improved yields of staple crops, such as wheat, rice, and maize; however, these improvements did little for micronutrient deficiencies that affect an estimated two billion people worldwide. Starchy staple crops are energy dense but are often lacking in one or more B vitamins, making resource‐constrained people who consume monotonous diets comprised predominantly of these staples at risk for developing deficiency. B vitamin deficiencies occur due to a poor overall nondiversified diet and rarely occur alone. Many B vitamins are essential cofactors involved in the metabolism of other nutrients, including other B vitamins, whereby the deficiency of one B vitamin affects the metabolism and status measurements of another. Food fortification efforts have nearly eradicated diseases of extreme B vitamin deficiency, such as beriberi from thiamin deficiency and pellagra from niacin deficiency. However, subclinical deficiency, sometimes referred to as hidden hunger, is still common especially in low‐income countries. Most dietary B vitamins, due to their water‐soluble nature, are not a concern for excessive intakes, but synthetic forms used for fortification and supplements sometimes can have adverse effects when consumed in high amounts. Biofortified crops offer a long‐term sustainable method to increase the amount of dietary B vitamins for people who rely on staple crops for most of their caloric intake. Efforts have been made to improve B vitamin content of crops, especially for thiamin, vitamin B6, and folate, but none have undergone human feeding trials; therefore, more research is needed to provide sustainable and scalable solutions in many parts of the world.

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Household Consumption of Thiamin-Fortified Fish Sauce Increases Erythrocyte Thiamin Concentrations among Rural Cambodian Women and Their Children Younger Than 5 Years of Age: A Randomized Controlled Efficacy Trial

Abstract: ClinicalTrials.gov: NCT02221063.

Cited by 17 publications

References 22 publications

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

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

Increased Non-High-Density Lipoprotein Cholesterol in Children and Young Adults with Turner Syndrome Is Not Explained By BMI Alone

Global Concerns with B Vitamin Statuses: Biofortification, Fortification, Hidden Hunger, Interactions, and Toxicity

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