Thiamin deficiency and fortification in poorer countries
What it found
Low levels of thiamin are common in parts of Southeast Asia, and thiamin deficiency is linked to many infant deaths in Cambodia, Laos and Myanmar.
The authors say fortifying staple foods with thiamin is a promising fix.
What they found
Studies in people
Low thiamin in Cambodia
Low blood thiamin was found in 70 to 100 percent of infants and 27 to 100 percent of women of reproductive age in Cambodia.
Low thiamin in Laos
In Laos, 13 percent of infants in hospital had low blood thiamin.
Low thiamin in Thailand
In Thailand, low blood thiamin was found in 16 to 25 percent of children and 30 percent of elderly adults.
Deaths in infants
Thiamin deficiency accounts for up to 45 percent of deaths in children under 5 in Cambodia, 34 percent of infant deaths in Laos, and 17 percent of infant deaths in Myanmar.
Risk to breastfed babies
Babies who are only breastfed by mothers who lack thiamin are at highest risk of thiamin-deficiency disorders and related death.
Other findings
Interventions tried
Approaches used to tackle thiamin deficiency include food processing, fortification, supplements, eating a wider range of foods, and changing dietary habits. These have worked to varying degrees.
What the authors conclude
“We recommend universal thiamin-fortification of context-specific staple-foods in LMICs as a promising solution, as well as thiamin supplementation, particularly for pregnant and lactating women.”
Also in their conclusions
- They recommend fortifying staple foods with thiamin in low- and middle-income countries as a promising solution.
- They also recommend thiamin supplements, particularly for pregnant and breastfeeding women.
- They say food processing rules, dietary diversification and changes to eating habits may help in some situations, especially in countries without universal fortification programs or among people who depend on food aid.
How it was done
Thiamin deficiency is a major public health concern in several low- and middle-income countries, and the authors say current attention to the problem is lacking.
What it can’t tell you
- We summarised it from the abstract only.
- This is a review of existing data, so it cannot prove that fortifying foods or giving supplements would prevent these deaths.
- It also cannot show cause and effect between low thiamin and death in any single person.
Who paid
- Authors work at
- 1 Mayo Clinic School of Medicine, USA; 5 The Sackler Institute for Nutrition Science, USA; Tufts University, USA
The paper
- Title
- Thiamin deficiency in low- and middle-income countries: Disorders, prevalences, previous interventions and current recommendations
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Johnson CR, Fischer PR, Thacher TD, Topazian MD, Bourassa MW, Combs GF (2019). Thiamin deficiency in low- and middle-income countries: Disorders, prevalences, previous interventions and current recommendations. Nutrition and health. doi:10.1177/0260106019830847PubMed 30798767DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error