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Subclinical beriberi polyneuropathy in the low income group: an investigation with special tools on possible patients
W Djoenaidi1, S L Notermans, A L Verbeek
1Department of Neurology, Airlangga University, Faculty of Medicine, Dr Soetomo Hospital, Surabaya, Indonesia.
Insights
Subclinical beriberi polyneuropathy (PNP) is highly prevalent in low-income populations due to inadequate thiamine intake. Early detection methods are crucial for this at-risk group.
Area of Science:
- Neurology
- Nutritional Science
- Public Health
Background:
- Subclinical beriberi polyneuropathy (PNP) poses a significant health risk, particularly in vulnerable populations.
- Dietary deficiencies, specifically thiamine (vitamin B1), are strongly linked to PNP development.
Purpose of the Study:
- To determine the prevalence of subclinical beriberi polyneuropathy (PNP) in a low-income demographic.
- To introduce novel methods for the early detection of subclinical beriberi polyneuropathy (PNP).
Main Methods:
- A prospective, randomized observational study was conducted involving family members of non-PNP patients.
- Dietary analysis, blood thiamine level determination, and comprehensive neurologic examinations were performed on 53 low-income and 56 mid/high-income participants.
Main Results:
- The prevalence of subclinical beriberi PNP was significantly higher in the low-income group (66%) compared to the mid/high-income groups (12.5%).
- Low-income individuals had a 13.6 times greater risk of developing beriberi PNP, highlighting a substantial socioeconomic disparity.
Conclusions:
- Inadequate dietary thiamine intake is a primary factor contributing to beriberi PNP in low-income populations.
- Diets rich in carbohydrates, particularly steamed milled rice, with low thiamine and fat intake, may precipitate beriberi.
- Early detection and nutritional intervention are essential for managing subclinical beriberi PNP in at-risk communities.
Objective:
To determine the prevalence rate of subclinical beriberi polyneuropathy (PNP) in the low income group and to present new methods for early detection.
Design:
We conducted a prospective, randomized observational study on all patients from family members of non-PNP patients presenting to the outpatient neurologic clinic of the Dr Soetomo Hospital in 1989 in Surabaya, Indonesia.
Material And Methods:
The 53 group I patients belonged to the low income series, whereas the 56 group II patients were from the mid- and high-income groups. We analyzed their diets and determined their blood thiamine levels. Neurologic, internal, psychiatric as well as neurophysiologic examinations were performed on all patients.
Results:
The prevalence rate of subclinical beriberi PNP of the apparently healthy subjects of the low income group was 66% compared with 12.5% among the mid and high income groups. The exposure odds ratio was 13.6 (95% Cl, 2.78 to 8.04) indicating that the low income group ran a greater risk of developing beriberi PNP than the mid and high income groups.
Conclusion:
Most of our low income group patients had an inadequate diet, especially concerning deficient thiamine intake. Analysis of the diets revealed, that they were usually rich in carbohydrate especially steamed milled rice, whereas intake of fat and thiamine was low, protein was just sufficient. The calorie intake was marginal. Carbohydrate rich and non fat calories in the diet with low thiamine intake may provoke beriberi.