Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Beriberi is a disease caused by a lack of thiamin (vitamin B1) in the diet. In infants, beriberi presents with symptoms of heart failure and is deadly unless treated immediately. Beriberi is common in Southeast Asia; in Cambodia it kills more than 680 infants each year. We recently found that nearly 60% of rural Cambodian women of childbearing age have suboptimal thiamin levels. This deficiency in turn causes women's breast milk to be low in thiamin. Since infants are entirely dependent on their mother's breast milk for nutrition, Cambodian infants are at high risk for beriberi. Improving pregnant and breastfeeding women's thiamin intake is essential for preventing beriberi. Fortification of a food staple is ideal for increasing thiamin because, unlike taking a pill, it requires little behaviour change. Fish sauce is a good vehicle for thiamin fortification: it is consumed daily in consistently high quantities and is produced in centralized factories, so is distributed nationwide. I aim to formulate and test a thiamin-fortified fish sauce that can be used to improve the thiamin status of pregnant and breastfeeding women in Cambodia. To accomplish this, I will develop a thiamin-fortified fish sauce. In addition to an appropriate 'dose' of thiamin, the fortified fish sauce must be culturally acceptable, low cost, have a long shelf life, and be designed for mass production and distribution. I will then conduct a randomized controlled trial of thiamin-fortified fish sauce. Pregnant and breastfeeding Cambodian women will eat either thiamin-fortified or placebo fish sauce for 6 months. Blood and breast milk samples will be measured to determine whether the thiamin-fortified sauce increases mother's and baby's thiamin levels. Infantile beriberi is a significant, often-overlooked, cause of infant death in Cambodia and Southeast Asia. Thiamin fortified fish sauce has the potential to dramatically reduce thiamin deficiency, prevent beriberi, and save infant lives.