From the Guidelines
Thiamine deficiency in India is commonly associated with diets lacking whole grains, legumes, nuts, and meat, particularly in economically disadvantaged populations. Examples of thiamine-deficient diets in India include those consisting primarily of milled rice with few complementary foods, especially in states like Kerala, Tamil Nadu, and West Bengal 1. Diets heavily dependent on polished white rice as the staple food are also at risk, as the thiamine-rich outer layers are removed during processing. Chronic alcoholism, which is increasing in some Indian populations, further depletes thiamine levels 2. Traditional cooking practices involving prolonged boiling or washing rice multiple times can leach out remaining thiamine. During periods of food insecurity or seasonal shortages, especially in rural areas, diets may become restricted to carbohydrate-rich but micronutrient-poor foods. Populations consuming primarily processed foods while lacking fresh fruits, vegetables, and animal products are also at risk. Thiamine deficiency manifests as beriberi, with symptoms including weakness, nerve damage, and in severe cases, heart failure 1. Ensuring dietary diversity with whole grains, legumes, and fresh foods is essential for preventing thiamine deficiency in the Indian context. Some key points to consider include:
- The main nutritional sources of thiamine are whole grains, legumes, meats, nuts, and fortified foods 2
- Insufficient dietary intake, especially in combination with increased metabolic needs due to oxidative stress and systemic inflammation, can quickly generate a state of thiamine deficiency 2
- Early suspicion and recognition of thiamine deficiency are needed to enable immediate initiation of therapy, as thiamine reserves are depleted as early as 20 days of inadequate oral intake 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Thiamine Deficiency in India
There is limited information available on thiamine deficient diets in India. However, some studies provide insight into thiamine deficiency in low- and middle-income countries, including those in Southeast Asia.
Prevalence of Thiamine Deficiency
- Thiamin deficiency is a major public health concern in several low- and middle-income countries, including those in Southeast Asia 3.
- Thiamin insufficiency is endemic among several Southeast Asian countries, but there is no specific data available for India 3.
- Exclusively breastfed infants of thiamin-deficient mothers are at highest risk for thiamin-deficiency disorders and related death 3.
Intervention Strategies
- Intervention strategies that have been employed to combat thiamin deficiency include food processing, fortification, supplementation, dietary diversification, and dietary behaviors 3.
- Universal thiamin-fortification of context-specific staple-foods in low- and middle-income countries is recommended as a promising solution, as well as thiamin supplementation, particularly for pregnant and lactating women 3.
Thiamine Deficiency Disorders
- Wernicke's encephalopathy is an acute neuropsychiatric state caused by thiamine deficiency, which can lead to coma or death if left untreated 4.
- Thiamine deficiency is also associated with beriberi and other thiamin-deficiency disorders 5.
Treatment and Prevention
- The optimum thiamine dose to treat or prevent Wernicke's encephalopathy or Wernicke-Korsakoff syndrome is still unclear, with no significant differences observed between different dosage conditions in some studies 6.
- Thiamine supplementation, particularly for pregnant and lactating women, is recommended to prevent thiamin-deficiency disorders 3.