Consumption of Novel Thiamin‐Fortified Fish Sauce Improves the Thiamin Status of Rural Cambodian Women of Childbearing Age and Their Children <5 Years
Bibliographic record
Abstract
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 ad libitum 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. 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. Women were 30 ± 6 y, and 71% of women had a normal BMI (18.5–25 kg/m 2 ). Children were 30 ± 15 m at baseline. Women's baseline mean (95% CI) TDP for HC ( n =91), LC ( n =93), and C ( n =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 ( n =87), LC ( n =88), and C ( n =87) was 211 nM (197, 225), 194 nM (183, 206), and 172 nM (163, 181), respectively. 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<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<0.001). 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. Support or Funding Information 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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".