A retrospective investigation of thiamin and energy intakes following an outbreak of beriberi in The Gambia

D. I. Thurnham, A.E. Cathcart, Barbara Livingstone

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    In the early part of the rainy season in 1988, an outbreak of beriberi occurred infree-living adults in a relatively small area in the North Bank region of The Gambia.In 1995 we selected two compounds in a village called Chilla situated within the affecteddistrict to retrospectively examine dietary factors potentially contributing to the outbreak.There had previously been cases of beriberi in one compound (BBC) but not in theother (NBC). We measured energy and thiamin intakes for four days on six occasionsduring the year. We calculated energy and thiamin intakes of people living in thetwo compounds and foods were collected for thiamin analysis through the year.Thiamin:Energy ratios only met international recommendations in the immediatepost-harvest season when energy and thiamin intakes were highest and then fell throughthe year. In the rainy season when food was short and labour was heaviest, energy intakeswere lower in the NBC but thiamin:energy ratios were lower in BBC. Records of rainfall in1988 collected near the village indicated that the amount in August was twice the average.We suggest the heavy rainfall may have increased farm workload and reduced incomefrom outside-village work activity. The lower energy intakes in the NBC may have forcedadults to rest thus sparing thiamin demands and delaying onset of beriberi. In contrast, thehigher energy intake of adults in the BBC may have enabled them to continue working,thus increasing demands for thiamin and inducing the earlier onset of beriberi.
    LanguageEnglish
    Pages135-151
    JournalNutrients
    Volume3
    Issue number1
    Publication statusPublished - 2011

    Fingerprint

    beriberi
    Beriberi
    Gambia
    Thiamine
    thiamin
    Energy Intake
    Disease Outbreaks
    energy intake
    energy
    villages
    wet season
    rain
    Food
    harvest date
    Workload
    labor

    Keywords

    • thiamin intake
    • energy intake
    • seasonality
    • beriberi

    Cite this

    @article{79806a8fe2994d768ff9d13505dc4ae5,
    title = "A retrospective investigation of thiamin and energy intakes following an outbreak of beriberi in The Gambia",
    abstract = "In the early part of the rainy season in 1988, an outbreak of beriberi occurred infree-living adults in a relatively small area in the North Bank region of The Gambia.In 1995 we selected two compounds in a village called Chilla situated within the affecteddistrict to retrospectively examine dietary factors potentially contributing to the outbreak.There had previously been cases of beriberi in one compound (BBC) but not in theother (NBC). We measured energy and thiamin intakes for four days on six occasionsduring the year. We calculated energy and thiamin intakes of people living in thetwo compounds and foods were collected for thiamin analysis through the year.Thiamin:Energy ratios only met international recommendations in the immediatepost-harvest season when energy and thiamin intakes were highest and then fell throughthe year. In the rainy season when food was short and labour was heaviest, energy intakeswere lower in the NBC but thiamin:energy ratios were lower in BBC. Records of rainfall in1988 collected near the village indicated that the amount in August was twice the average.We suggest the heavy rainfall may have increased farm workload and reduced incomefrom outside-village work activity. The lower energy intakes in the NBC may have forcedadults to rest thus sparing thiamin demands and delaying onset of beriberi. In contrast, thehigher energy intake of adults in the BBC may have enabled them to continue working,thus increasing demands for thiamin and inducing the earlier onset of beriberi.",
    keywords = "thiamin intake, energy intake, seasonality, beriberi",
    author = "Thurnham, {D. I.} and A.E. Cathcart and Barbara Livingstone",
    note = "Reference text: 1. Tang, C.M.; Rolfe, M.; Wells, J.C.; Cham, K. Outbreak of beri-beri in the Gambia. Lancet 1989, 334, 206–207. 2. The Africa Rice Center (WARDA). Rice Trends in Sub-Saharan Africa, 3rd ed.; WARDA: Cotonou, Benin, 2005. Available online: http://www.warda.org/publications/Rice{\%}20Trends.pdf (accessed on 10 January 2011). 3. Delgado, C.L.; Miller, C.P.J. Changing food patterns in West Africa, implications for policy research. Food Policy 1985, 10, 63–74. 4. Thurnham, D.I. Beriberi. In Encyclopedia of Human Nutrition; Caballero, B., Allen, L., Prentice, A., Eds.; Elsevier: Oxford, UK, 2005; pp. 269–278. 5. McGready, R.; Simpson, J.A.; Cho, T.; Dubowitz, L.; Changbumrung, S.; B{\"o}hm, V.; Munger, R.G.; Sauberlich, H.E.; White, N.J.; Nosten, F. Postpartum thiamine deficiency in a Karen displaced population. Am. J. Clin. Nutr. 2001, 74, 808–813. 6. Soukaloun, D.; Kounnavong, S.; Pengdy, B.; Boupha, B.; Durondej, S.; Olness, K.; Newton, P.N.; White, N.J. Dietary and socio-economic factors associated with beriberi in breastfed Lao infants. Ann. Trop. Paediatr. 2003, 23, 181–186. 7. Lima, H.C.; Porto, E.A.; Marins, J.R.; Alves, R.M.; Machado, R.R.; Braga, K.N.; de Paiva, F.B.; Carmo, G.M.; Silva e Santelli, A.C.; Sobel, J. Outbreak of beriberi in the state of Maranh{\~a}o, Brazil: Revisiting the mycotoxin aetiologic hypothesis. Trop. Doct. 2010, 40, 95–97. 8. Ahoua, L.; Etienne, W.; Fermon, F.; Godain, G.; Brown, V.; Kadjo, K.; Bouaffou, K.; Legros, D.; Guerin, P.J. Outbreak of beriberi in a prison in C{\^o}te d’Ivoire. Food Nutr. Bull. 2007, 28, 283–290. 9. De Montmollin, D.; MacPhail, J.; McMahon, J.; Coninx, R. Outbreak of beri-beri in a prison in West Africa. Trop. Doct. 2002, 32, 234–236. 10. Ibner, F.L.; Blass, J.P.; Brin, M. Thiamin in the elderly, relation to alcoholism and to neurological degenerative disease. Am. J. Clin. Nutr. 1982, 36, 1067–1082. 11. Department of Health, Committee on Medical Aspects of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom; Report on Health and Social Subjects 41; HMSO: London, UK, 1991; pp. 1–210. 12. Paul, A.A.; Southgate, D.A.T. McCance and Widdowson’s the Composition of Foods; HMSO: Oxford, UK, 1978; pp. 1–420. 13. Paul, A.A.; Muller, E.M. Seasonal variations in dietary intake in pregnant and lactating women in a rural Gambian village. In Maternal Nutrition during Pregnancy and Lactation; Aebi, H., Whitehead, R., Eds.; Hans Huber: Bern, Switzerland, 1980; pp. 105–116. 14. Mengistu, M.; Maru, M. Dry beriberi: a clinical report from north-west Ethiopia. Ethiop. Med. J. 1979, 17, 29–32. 15. Neumann, C.G.; Swendseid, M.E.; Jacob, M.; Stiehm, E.R.; Diringe, O.V. Biochemical evidence of thiamin deficiency in young Ghanian children. Am. J. Clin. Nutr. 1979, 32, 99–104. 16. Osuntokun, B.O.; Aladetoyinbo, A.; Bademosi, O. Vitamin B nutrition in the Nigerian tropical ataxic neuropathy. J. Neurol. Neurosurg. Psychiatry 1985, 48, 154–156. 17. Meurin, P. Shoshin beriberi. A rapidly curable hemodynamic disaster. Presse Med. 1996, 25, 1115–1118. 18. Hudson, G.J. Food intake in a west African village. Estimation of food intake from a shared bowl. Br. J. Nutr. 1995, 73, 551–569. 19. Platt, B.S. Tables of Representative Values of Foods Commonly Used in Tropical Countries; Privy Council, Medical Research Council Special Report Series No. 302; Her Majesty’s Stationery Office: London, UK, 1962. 20. West, C.E.; Pepping, F.; Scholte, I.; Jansen, W.; Albers, H.F.F. Food Composition Tables for Energy and Eight Nutrients of Foods Commonly Eaten in East Africa; CTA/ESCA: Wageningen, The Netherlands, 1987. 21. Bailey, A.L.; Finglas, P.M. A normal phase high performance liquid chromatographic method for the determination of thiamin in blood and tissue samples. J. Micronutr. Anal. 1990, 7, 147–157. 22. Food and Agriculture Organization, World Health Organization, United Nations University. Report of a Joint Expert Consultation on Energy and Protein Requirements; World Health Organization Technical Report Series 724; World Health Organisation: Geneva, Switzerland, 1985. 23. Ball, F.M. Vitamins in Foods: Analysis, Bioavailability and Stability; CRC Press: Boca Raton, FL, USA, 2005. 24. Annual Report 1995; Department of Water Resources: Banjul, Republic of the Gambia, 1995. 25. Paul, A.A.; Muller, E.M. Seasonal variations in dietary intake in pregnant and lactating women in a rural Gambian village. In Maternal Nutrition during Pregnancy and Lactation; Aebi, H., Whitehead, R., Eds.; Hans Huber: Bern, Switzerland, 1979; pp. 105–116. 26. Food and Agriculture Organization, World Health Organization. In Requirements of Vitamin A, Thiamine, Riboflavin and Niacin; FAO/WHO Expert Groups Technical Report Series No. 362; FAO/WHO: Geneva, Switzerland, 1967. 27. Moore, S.E.; Cole, T.J.; Poskitt, E.M.E.; Sonko, B.; Whitehead, R.G.; McGregor, I.A.; Prentice, A.M. Season of birth predicts mortality in rural Gambia. Nature 1997, 388, 434. 28. World Food Program. Thiamin content of corn-soya-flour blend nutritional supplement. Available online: http://www.wfp.org/nutrition/special-nutritional-products (accessed on 10 January 2011). 29. Consolazio, C.F.; Johnson, H.L.; Krywicki, J.; Daws, T.A.; Barnhart, R.A. Thiamin, riboflavin and pyridoxine excretion during acute starvation and calorie restriction. Am. J. Clin. Nutr. 1971, 24, 1060–1067.",
    year = "2011",
    language = "English",
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    pages = "135--151",
    journal = "Nutrients",
    issn = "2072-6643",
    publisher = "MDPI",
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    }

    A retrospective investigation of thiamin and energy intakes following an outbreak of beriberi in The Gambia. / Thurnham, D. I.; Cathcart, A.E.; Livingstone, Barbara.

    In: Nutrients, Vol. 3, No. 1, 2011, p. 135-151.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - A retrospective investigation of thiamin and energy intakes following an outbreak of beriberi in The Gambia

    AU - Thurnham, D. I.

    AU - Cathcart, A.E.

    AU - Livingstone, Barbara

    N1 - Reference text: 1. Tang, C.M.; Rolfe, M.; Wells, J.C.; Cham, K. Outbreak of beri-beri in the Gambia. Lancet 1989, 334, 206–207. 2. The Africa Rice Center (WARDA). Rice Trends in Sub-Saharan Africa, 3rd ed.; WARDA: Cotonou, Benin, 2005. Available online: http://www.warda.org/publications/Rice%20Trends.pdf (accessed on 10 January 2011). 3. Delgado, C.L.; Miller, C.P.J. Changing food patterns in West Africa, implications for policy research. Food Policy 1985, 10, 63–74. 4. Thurnham, D.I. Beriberi. In Encyclopedia of Human Nutrition; Caballero, B., Allen, L., Prentice, A., Eds.; Elsevier: Oxford, UK, 2005; pp. 269–278. 5. McGready, R.; Simpson, J.A.; Cho, T.; Dubowitz, L.; Changbumrung, S.; Böhm, V.; Munger, R.G.; Sauberlich, H.E.; White, N.J.; Nosten, F. Postpartum thiamine deficiency in a Karen displaced population. Am. J. Clin. Nutr. 2001, 74, 808–813. 6. Soukaloun, D.; Kounnavong, S.; Pengdy, B.; Boupha, B.; Durondej, S.; Olness, K.; Newton, P.N.; White, N.J. Dietary and socio-economic factors associated with beriberi in breastfed Lao infants. Ann. Trop. Paediatr. 2003, 23, 181–186. 7. Lima, H.C.; Porto, E.A.; Marins, J.R.; Alves, R.M.; Machado, R.R.; Braga, K.N.; de Paiva, F.B.; Carmo, G.M.; Silva e Santelli, A.C.; Sobel, J. Outbreak of beriberi in the state of Maranhão, Brazil: Revisiting the mycotoxin aetiologic hypothesis. Trop. Doct. 2010, 40, 95–97. 8. Ahoua, L.; Etienne, W.; Fermon, F.; Godain, G.; Brown, V.; Kadjo, K.; Bouaffou, K.; Legros, D.; Guerin, P.J. Outbreak of beriberi in a prison in Côte d’Ivoire. Food Nutr. Bull. 2007, 28, 283–290. 9. De Montmollin, D.; MacPhail, J.; McMahon, J.; Coninx, R. Outbreak of beri-beri in a prison in West Africa. Trop. Doct. 2002, 32, 234–236. 10. Ibner, F.L.; Blass, J.P.; Brin, M. Thiamin in the elderly, relation to alcoholism and to neurological degenerative disease. Am. J. Clin. Nutr. 1982, 36, 1067–1082. 11. Department of Health, Committee on Medical Aspects of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom; Report on Health and Social Subjects 41; HMSO: London, UK, 1991; pp. 1–210. 12. Paul, A.A.; Southgate, D.A.T. McCance and Widdowson’s the Composition of Foods; HMSO: Oxford, UK, 1978; pp. 1–420. 13. Paul, A.A.; Muller, E.M. Seasonal variations in dietary intake in pregnant and lactating women in a rural Gambian village. In Maternal Nutrition during Pregnancy and Lactation; Aebi, H., Whitehead, R., Eds.; Hans Huber: Bern, Switzerland, 1980; pp. 105–116. 14. Mengistu, M.; Maru, M. Dry beriberi: a clinical report from north-west Ethiopia. Ethiop. Med. J. 1979, 17, 29–32. 15. Neumann, C.G.; Swendseid, M.E.; Jacob, M.; Stiehm, E.R.; Diringe, O.V. Biochemical evidence of thiamin deficiency in young Ghanian children. Am. J. Clin. Nutr. 1979, 32, 99–104. 16. Osuntokun, B.O.; Aladetoyinbo, A.; Bademosi, O. Vitamin B nutrition in the Nigerian tropical ataxic neuropathy. J. Neurol. Neurosurg. Psychiatry 1985, 48, 154–156. 17. Meurin, P. Shoshin beriberi. A rapidly curable hemodynamic disaster. Presse Med. 1996, 25, 1115–1118. 18. Hudson, G.J. Food intake in a west African village. Estimation of food intake from a shared bowl. Br. J. Nutr. 1995, 73, 551–569. 19. Platt, B.S. Tables of Representative Values of Foods Commonly Used in Tropical Countries; Privy Council, Medical Research Council Special Report Series No. 302; Her Majesty’s Stationery Office: London, UK, 1962. 20. West, C.E.; Pepping, F.; Scholte, I.; Jansen, W.; Albers, H.F.F. Food Composition Tables for Energy and Eight Nutrients of Foods Commonly Eaten in East Africa; CTA/ESCA: Wageningen, The Netherlands, 1987. 21. Bailey, A.L.; Finglas, P.M. A normal phase high performance liquid chromatographic method for the determination of thiamin in blood and tissue samples. J. Micronutr. Anal. 1990, 7, 147–157. 22. Food and Agriculture Organization, World Health Organization, United Nations University. Report of a Joint Expert Consultation on Energy and Protein Requirements; World Health Organization Technical Report Series 724; World Health Organisation: Geneva, Switzerland, 1985. 23. Ball, F.M. Vitamins in Foods: Analysis, Bioavailability and Stability; CRC Press: Boca Raton, FL, USA, 2005. 24. Annual Report 1995; Department of Water Resources: Banjul, Republic of the Gambia, 1995. 25. Paul, A.A.; Muller, E.M. Seasonal variations in dietary intake in pregnant and lactating women in a rural Gambian village. In Maternal Nutrition during Pregnancy and Lactation; Aebi, H., Whitehead, R., Eds.; Hans Huber: Bern, Switzerland, 1979; pp. 105–116. 26. Food and Agriculture Organization, World Health Organization. In Requirements of Vitamin A, Thiamine, Riboflavin and Niacin; FAO/WHO Expert Groups Technical Report Series No. 362; FAO/WHO: Geneva, Switzerland, 1967. 27. Moore, S.E.; Cole, T.J.; Poskitt, E.M.E.; Sonko, B.; Whitehead, R.G.; McGregor, I.A.; Prentice, A.M. Season of birth predicts mortality in rural Gambia. Nature 1997, 388, 434. 28. World Food Program. Thiamin content of corn-soya-flour blend nutritional supplement. Available online: http://www.wfp.org/nutrition/special-nutritional-products (accessed on 10 January 2011). 29. Consolazio, C.F.; Johnson, H.L.; Krywicki, J.; Daws, T.A.; Barnhart, R.A. Thiamin, riboflavin and pyridoxine excretion during acute starvation and calorie restriction. Am. J. Clin. Nutr. 1971, 24, 1060–1067.

    PY - 2011

    Y1 - 2011

    N2 - In the early part of the rainy season in 1988, an outbreak of beriberi occurred infree-living adults in a relatively small area in the North Bank region of The Gambia.In 1995 we selected two compounds in a village called Chilla situated within the affecteddistrict to retrospectively examine dietary factors potentially contributing to the outbreak.There had previously been cases of beriberi in one compound (BBC) but not in theother (NBC). We measured energy and thiamin intakes for four days on six occasionsduring the year. We calculated energy and thiamin intakes of people living in thetwo compounds and foods were collected for thiamin analysis through the year.Thiamin:Energy ratios only met international recommendations in the immediatepost-harvest season when energy and thiamin intakes were highest and then fell throughthe year. In the rainy season when food was short and labour was heaviest, energy intakeswere lower in the NBC but thiamin:energy ratios were lower in BBC. Records of rainfall in1988 collected near the village indicated that the amount in August was twice the average.We suggest the heavy rainfall may have increased farm workload and reduced incomefrom outside-village work activity. The lower energy intakes in the NBC may have forcedadults to rest thus sparing thiamin demands and delaying onset of beriberi. In contrast, thehigher energy intake of adults in the BBC may have enabled them to continue working,thus increasing demands for thiamin and inducing the earlier onset of beriberi.

    AB - In the early part of the rainy season in 1988, an outbreak of beriberi occurred infree-living adults in a relatively small area in the North Bank region of The Gambia.In 1995 we selected two compounds in a village called Chilla situated within the affecteddistrict to retrospectively examine dietary factors potentially contributing to the outbreak.There had previously been cases of beriberi in one compound (BBC) but not in theother (NBC). We measured energy and thiamin intakes for four days on six occasionsduring the year. We calculated energy and thiamin intakes of people living in thetwo compounds and foods were collected for thiamin analysis through the year.Thiamin:Energy ratios only met international recommendations in the immediatepost-harvest season when energy and thiamin intakes were highest and then fell throughthe year. In the rainy season when food was short and labour was heaviest, energy intakeswere lower in the NBC but thiamin:energy ratios were lower in BBC. Records of rainfall in1988 collected near the village indicated that the amount in August was twice the average.We suggest the heavy rainfall may have increased farm workload and reduced incomefrom outside-village work activity. The lower energy intakes in the NBC may have forcedadults to rest thus sparing thiamin demands and delaying onset of beriberi. In contrast, thehigher energy intake of adults in the BBC may have enabled them to continue working,thus increasing demands for thiamin and inducing the earlier onset of beriberi.

    KW - thiamin intake

    KW - energy intake

    KW - seasonality

    KW - beriberi

    M3 - Article

    VL - 3

    SP - 135

    EP - 151

    JO - Nutrients

    T2 - Nutrients

    JF - Nutrients

    SN - 2072-6643

    IS - 1

    ER -