Consumption of novel thiamin-fortified fish sauce improves the thiamin status of rural Cambodian women of childbearing age and their children < 5 years

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dc.contributor.authorWhitfield, K.C.
dc.contributor.authorKarakochuk, C.D.
dc.contributor.authorKroeun, H.
dc.contributor.authorChan, B.
dc.contributor.authorBorath, M.
dc.contributor.authorLynd, L.D.
dc.contributor.authorLi-Chan, E.C.Y.
dc.contributor.authorKitts, D.D.
dc.contributor.authorGreen, T.J.
dc.contributor.conferenceExperimental Biology Meeting (2 Apr 2016 - 6 Apr 2016 : San Diego, CA)
dc.date.issued2016
dc.description.abstract<jats:p>Infantile beriberi, a disease caused by thiamin deficiency, remains a public health concern in Cambodia and other Southeast Asian countries that rely on thiamin‐poor white polished rice as a dietary staple. Infantile beriberi presents in exclusively breastfed infants of thiamin‐deficient mothers, and is often fatal if not treated within ~24 hours. Infantile beriberi has been nearly eradicated in regions where dietary diversity is high, or staple foods are fortified with thiamin. Food fortification is an inexpensive, sustainable, and passive means of improving the diet when micronutrients are lacking. We formulated a novel thiamin‐fortified fish sauce (a traditional condiment consumed daily by rural Cambodians) to determine whether <jats:italic>ad libitum</jats:italic> consumption over six months could improve erythrocyte thiamin diphosphate concentrations (TDP) among women of childbearing age and their youngest child aged 12–59 m, compared to a control sauce.</jats:p><jats:p>In this double‐blind, randomized controlled efficacy trial 276 non‐pregnant, non‐lactating women aged 18–45 y and their families in Prey Veng, Cambodia, were randomized to receive one of three fish sauce formulations: low concentration thiamin (LC; ~2g/L), higher concentration thiamin (HC; ~8g/L), or control (C; no thiamin). TDP was analyzed using HPLC‐FLD.</jats:p><jats:p>Women were 30 ± 6 y, and 71% of women had a normal BMI (18.5–25 kg/m<jats:sup>2</jats:sup>). Children were 30 ± 15 m at baseline. Women's baseline mean (95% CI) TDP for HC (<jats:italic>n</jats:italic>=91), LC (<jats:italic>n</jats:italic>=93), and C (<jats:italic>n</jats:italic>=92) was 179 nM (167, 191), 172 nM (162, 183), and 150 nM (142, 158), respectively. Children's baseline mean (95% CI) TDP for HC (<jats:italic>n</jats:italic>=87), LC (<jats:italic>n</jats:italic>=88), and C (<jats:italic>n</jats:italic>=87) was 211 nM (197, 225), 194 nM (183, 206), and 172 nM (163, 181), respectively.</jats:p><jats:p>Fish sauce consumption was not significantly different between groups (p=0.186). In intent‐to‐treat analysis, women's endline TDP (adjusted for baseline) significantly increased among women in HC (53 nM) and LC (49 nM) groups compared to C (p&lt;0.001). Similarly, at endline children's (baseline adjusted) TDP was 47 nM and 36 nM higher in the HC and LC groups, respectively, compared to C (p&lt;0.001).</jats:p><jats:p>Consumption of thiamin‐fortified fish sauce at concentrations of 2g/L and 8g/L over six months significantly improved biochemical thiamin status of Cambodian women of childbearing age and young children under 5 years. Effectiveness trials, as well as further research to identify the optimal dose for thiamin fortification, are needed.</jats:p><jats:p><jats:bold>Support or Funding Information</jats:bold></jats:p><jats:p>Research supported by Grand Challenges Canada Stars in Global Health Grant (Round VI), Canadian Institutes of Health Research (CIHR) Doctoral Award, and International Development Research Centre (IDRC) Doctoral Research Award.</jats:p>
dc.description.statementofresponsibilityKyly C Whitfield, Crystal D Karakochuk, Hou Kroeun, Benny Chan, Mam Borath, Larry D Lynd, Eunice CY Li Chan, David D Kitts, Timothy J Green
dc.identifier.citationThe FASEB Journal, 2016, vol.30, iss.Suppl. 1, pp.891.9-1-891.9-1
dc.identifier.doi10.1096/fasebj.30.1_supplement.891.9
dc.identifier.issn0892-6638
dc.identifier.issn1530-6860
dc.identifier.orcidGreen, T.J. [0000-0002-0667-4300]
dc.identifier.urihttp://hdl.handle.net/2440/126053
dc.language.isoen
dc.publisherFederation of American Societies for Experimental Biology
dc.rights© FASEB
dc.source.urihttps://doi.org/10.1096/fasebj.30.1_supplement.891.9
dc.titleConsumption of novel thiamin-fortified fish sauce improves the thiamin status of rural Cambodian women of childbearing age and their children < 5 years
dc.typeConference paper
pubs.publication-statusPublished

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