We study thiamine (vitamin B1) status among lactating women and their predominately breastfed infants in rural Cambodia. Thiamine is an essential vitamin required for normal growth and development, and energy metabolism. It’s found in pork, whole grains, legumes, and in Canada, all pre-natal supplements. Thiamine is very low in the typical Cambodian diet, which consists mostly of thiamine-poor white, polished rice.
Our previous work identified that thiamine deficiency remains an often-overlooked cause of infant mortality throughout Southeast Asia. Unlike many other micronutrients, maternal thiamine intake directly impacts human milk thiamine concentrations: mothers with low dietary thiamine intake produce thiamine-poor milk, putting their breastfed infants at risk of developing a potentially fatal deficiency disease called infantile beriberi.
Although we know that breastfed infants of well-nourished mothers in North America don’t develop beriberi, it is still unclear how much thiamine mothers need to consume to prevent the disease in their infants. In addition, we previously showed that fortification, or adding nutrients to commonly consumed foods, is an inexpensive, culturally-appropriate, and efficacious means of improving thiamine intake and status, but new evidence indicates that salt may be a better fortification vehicle than previously-investigated fish sauce.
We’re currently conducting a double-blind, four-parallel arm randomized controlled trial designed to determine the optimal thiamine dose, and also track maternal and household-level intakes of salt, to allow for future modeling of thiamine-fortified salt. We are working closely with the Cambodian Ministry of Health and Ministry of Planning to ensure that, if successful, the fortification ‘recipe’ produced from this dose response study will be put to use in a salt fortification program in Cambodia.
This study is funded by the Bill & Melina Gates Foundation and Sackler Institute for Nutrition Science at the New York Academy of Sciences.