Thiamine deficiency and poverty

Abstract

Thiamine is a water-soluble vitamin, essential for normal cellular functions and energy production. As it is not synthesized by the human organism, it must be obtained by exogenous sources. A reduction in thiamine tissue concentration may interfere with numerous cellular mechanisms triggering off neurodegenerative processes with consequent changes in brain functions. Thiamine deficiency is common in certain groups like alcohol chronic users, pregnant woman, and people living in food insecurity situation. The low offer of thiamine for newborn and infants can compromise the correct maturation of the central nervous system and development of the cognition as explained by animal models studies. Thiamine deficiency during pregnancy and breastfeeding induces dysfunctions in the learning and consolidation of spatial abilities of offspring that can compromise the access of children living in food insecurity situations to formal job and education. Observed from this perspective, thiamine deficiency in vulnerable populations plays a more important role than the manifestation of clinical syndromes: the thiamine deficiency can be understood as a mechanism for perpetuating the poverty condition. Based on favorable risk/benefit profile, we recommend the fortification of easily accessible foods (such as wheat flour) with thiamine and oral replacement for alcohol dependent people, pregnant women, and infants living in situations of food insecurity.