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Suboptimal Thiamin Status Is Common Among Women Of Reproductive Age And Children ≤ 5 y In Cambodia: Findings From The National Micronutrient Survey
Author(s) -
Whitfield Kyly C,
Smith Geoffry,
Chamnan Chhoun,
Karakochuk Crystal D,
Kuong Khov,
Dijkhuizen Marjoleine A,
Hong Rathavuth,
Berger Jacques,
Green Tim J,
Wieringa Frank T
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.786.11
Subject(s) - micronutrient , medicine , pediatrics , population , demography , micronutrient deficiency , public health , beriberi , environmental health , nursing , pathology , sociology
Thiamin deficiency is thought to be an issue in Cambodia because case reports of beriberi are not uncommon, and several studies across Southeast Asia have reported low thiamin concentrations among women of reproductive age (WRA), children <5 y, and breastfed infants. However, due to a lack of population‐representative data, the magnitude of this public health issue is currently unknown. The objective of this study was to assess biochemical thiamin status using erythrocyte thiamin diphosphate (eTDP) concentrations among a nationally representative sample of WRA (15–49 y) and children ≤ 5 y, and to classify thiamin status using various cut‐offs from the literature. Non‐fasting venous blood samples were collected as part of a National Micronutrient Survey linked to the 2014 Cambodian Demographic and Health Survey, and eTDP was measured among 719 women and 761 children using HPLC‐FLD. The median (SD) age of women was 30 (6) y, and children (46% girls) were 42 (17) mo. Women had lower mean (95% CI) eTDP of 150 nmol/L (146–153) compared to children, 174 nmol/L (171–179; P < 0.001). Thiamin status was assessed using 10 different cut‐offs from the literature, none of which were developed in relation to clinical presentation of beriberi. Thiamin status varied dramatically depending on the cut‐off employed (70 nmol/L and 180 nmol/L): from 2% to 78% among women, and <1% to 58% among children. Deficiency was most prevalent among infants aged 6–12 mo ( n =50); even using the most conservative cut‐offs (from the Institute of Medicine), 4% were deficient (<70 nmol/L) and 14% had marginal status (70–90 nmol/L). More research is required to develop more useful, clinically meaningful thiamin status cut‐offs to define thiamin status and to attain global consensus on their use. Immediate action is required, however, to develop interventions to increase thiamin intake, and thus improve thiamin status, among women and children in Cambodia and throughout Southeast Asia.