The impact of fortified foods on total dietary consumption in Europe

Godfrey, David; Tennant, David R.; Davidson, Julia

doi:10.1111/j.1467-3010.2004.00442.x

Cited by 10 publications

(5 citation statements)

References 2 publications

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“…15,16 The susceptibility of humans to thiamine deficiency is well-established, and many countries actively fortify foods such as bread and grains with thiamine. 17,18 Although healthy people are susceptible to thiamine deficiency, certain medical conditions can increase the chances of developing thiamine deficiency and WE. These conditions are associated with decreased access, absorption, storage capability, impaired cellular utilization of thiamine, or increased metabolism or loss of thiamine.…”

Section: Epidemiologymentioning

confidence: 99%

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Don’t seek, don’t find: The diagnostic challenge of Wernicke’s encephalopathy

Kohnke

Meek

2020

Ann Clin Biochem

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Wernicke’s encephalopathy is caused by thiamine deficiency and has a range of presenting features, including gait disturbance, altered cognitive state, nystagmus and other eye movement disorders. In the past, Wernicke’s encephalopathy was described almost exclusively in the alcohol-dependent population. However, in current times, Wernicke’s encephalopathy is also well recognized in many other patient groups, including patients following bariatric surgery, gastrointestinal surgery, cancer and pancreatitis. Early recognition of Wernicke’s encephalopathy is vital, as prompt treatment can restore cognitive or ocular function and can prevent permanent disability. Unfortunately, Wernicke’s encephalopathy is often undiagnosed – presumably because it is relatively uncommon and has a variable clinical presentation. Clinical biochemists have a unique role in advising clinicians about potential nutritional or metabolic causes of unexplained neurological symptoms and to prompt consideration of thiamine deficiency as a potential cause in high-risk patient groups. The aim of this review is to summarize the clinical features, diagnosis and treatment of Wernicke’s encephalopathy and to highlight some non-traditional causes, such as after bariatric surgery.

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Section: Epidemiologymentioning

confidence: 99%

“…15,16 The susceptibility of humans to thiamine deficiency is well-established, and many countries actively fortify foods such as bread and grains with thiamine. 17,18…”

Section: Thiamine Deficiency and Human Diseasementioning

confidence: 99%

Don’t seek, don’t find: The diagnostic challenge of Wernicke’s encephalopathy

Kohnke

Meek

2020

Ann Clin Biochem

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“…Since this time, fortification of some foods has remained mandatory, such as fortifying bread with calcium and margarine with vitamin A and D (see Nugent & McKevith 2004). Today foods are commonly fortified to restore levels of nutrients lost during storage, handling and manufacture, and for the purpose of enrichment, irrespective of their original nutrient levels (Godfrey et al . 2004), as would be the case for the fortification of foods (namely flour) with folic acid – a debate that has been on the public health agenda for over 15 years (Malcolm 2002; SACN 2006).…”

Section: Section 4: Factors Influencing Food Access and Availabilitymentioning

confidence: 99%

40th Anniversary Briefing Paper: Food availability and our changing diet

Foster

Lunn

2007

Nutrition Bulletin

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Forewords Timeline Introduction Section 1: The interaction between diet and public health Section 2: The role of government Section 3: Trends in dietary patterns and nutrient intake Section 4: Factors influencing food access and availability Conclusions Acknowledgements References Summary Throughout the 20th century, average life expectancy has been increasing. This is primarily a result of a change in disease patterns, as infectious diseases have declined, and chronic diseases have become the nation's main killers. A number of factors are recognised to influence the risk of chronic disease, including diet and lifestyle. Therefore, dietary guidelines have been developed to help people follow a diet that can maximise their health and longevity. These guidelines complement more detailed dietary reference values, which were first established in 1950. Since then, these values have stayed much the same, and today they are used to asses thenutritional adequacy of the diet using data from dietary surveys, such as the National Diet and Nutrition Survey. The National Food Survey is another important source of information about what the population are eating. This survey has collected data on food purchased for consumption in the home since 1940 and therefore can provide invaluable information on trends in estimated food, energy and nutrient intake for the general population. Figures estimated from the National Food Survey suggest that since the 1970s, total energy intake has been falling in line with falling levels of energy expenditure. Nevertheless, this decline in energy expenditure has left individuals prone to gaining weight, yet the dietary guidelines in use today still focus on the need to monitor intake of fat and saturates. On the face of it, the British diet has been remarkably stable over the past 60 years. However, what has been evident is a shift towards a lower fat diet with lower fat meats, such as poultry overtaking beef, pork and lamb as the most popular meats and semi‐skimmed milk dominating the milk category since its introduction in the 1980s. There are a number of factors that have affected the trends in food consumption, some of which can be attributed to specific events; for example, the drought from 1975 to 1976 caused a shortage of potatoes, resulting in a high market price, which in turn led to a decline in potato consumption. It is beyond the scope of this Briefing Paper to explain all of the variations and changes in food intake over the past 60 years. However, this paper does provide an overview of the factors (namely government policies, advances and innovations of the food industry and consumer‐led changes) that have influenced food availability and access since the 1940s. For example, a significant policy that has had influence is the Common Agricultural Policy (CAP), which was devised by six nations of the European Economic Community in response to the effects of war, in particular world food shortages. Many of the original objectives of CAP had been met by the time the UK joined in 1...

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“…The mandatory enrichment of staple food with thiamine is operative in the United States, the United Kingdom, and parts of Europe. [ 32 ] In Australia, the enrichment of bread flour with thiamine has caused a 40% reduction of the incidence of Wernicke's encephalopathy and Korsakoff's syndrome. [ 33 34 ] Furthermore, gastroenterologists and physicians should be made well aware of this condition as many patients present initially with gastrointestinal symptoms and timely intervention can help in preventing the development of Wernicke's encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic Wernicke’s Encephalopathy: A Retrospective Study from a Tertiary Care Center in Northern India

Shah

Asimi

Kawoos

et al. 2017

Journal of Neurosciences in Rural Practice

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Objective:The objective of this study was to describe the demographic features, clinical presentation, and management and outcome of fifty cases of nonalcoholic Wernicke's encephalopathy from a tertiary care hospital of a region with reported incidence of thiamine deficiency disorders.Materials and Methods:In a retrospective study, fifty adult cases of Wernicke's encephalopathy were analyzed. The diagnosis of Wernicke's encephalopathy was made according to the European federation of neurological societies guidelines 2010. Response to thiamine replacement and associated brain magnetic resonance imaging (MRI) findings were also considered as supportive evidence.Results:The mean age of patients was 50.38 years with 20 males and 30 females. The most common clinical manifestations were alteration in sensorium in 30 (60%), ataxia in 18 (36%), memory impairment in 15 (30%), nystagmus in 35 (70%), ophthalmoparesis in 11 (22%), and seizures in 4 (8%). A total of 42 patients had a history of recurrent vomiting. All patients had polished rice as their staple diet. Thirty-five patients had associated polyneuropathy and 15 had a gastrointestinal disorder. Twenty patients underwent MRI which showed both typical and atypical lesions. Majority of patients showed partial or complete response to intravenous thiamine. On discharge, the most common residual symptoms were lower limb weakness, ataxia, and memory impairment.Conclusion:The study shows high incidence of nonalcoholic Wernicke's encephalopathy in the region with predominant causative factor being a thiamine deficient diet. Recurrent vomiting can be a prominent early symptom of thiamine deficiency and its recognition can help in the early diagnosis of Wernicke's encephalopathy and related thiamine deficiency disorders. Thiamine fortification of food should be done in areas with reported incidence of thiamine deficiency disorders.

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The impact of fortified foods on total dietary consumption in Europe

Cited by 10 publications

References 2 publications

Don’t seek, don’t find: The diagnostic challenge of Wernicke’s encephalopathy

Don’t seek, don’t find: The diagnostic challenge of Wernicke’s encephalopathy

40th Anniversary Briefing Paper: Food availability and our changing diet

Nonalcoholic Wernicke’s Encephalopathy: A Retrospective Study from a Tertiary Care Center in Northern India

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