02 June 2004

Beriberi, White Rice, and Vitamin B

Danny Yee has posted an interesting review of Beriberi, White Rice, and Vitamin B by Kenneth Carpenter (U. California Press, 2000).
As we now know, beriberi is caused by nutritional deficiency of thiamin (vitamin B1), most commonly associated with reliance on polished white rice. But establishing this, isolating the "vitamin" responsible, and implementing appropriate public health measures was a long and complex process. In Beriberi, White Rice, and Vitamin B Kenneth Carpenter makes of it a fine "medical detective story"....

Regimented groups such as soldiers, sailors, and prisoners were common sufferers; with standardised diets and centralised records, these were also the target of most studies. The Japanese Navy largely eliminated beriberi (kakké) around 1895; naval doctor Kanehiro Takaki thought protein deficiency was the problem, but the measures he implemented worked anyway. The army, however, was convinced beriberi was an infectious disease and suffered over 90,000 cases in the 1905 war against Russia.

The name "beriberi" originated in Southeast Asia, where it had become widespread with the colonial introduction of machine milling of rice. Work on the disease was done by the Dutch in Java, most notably by Christiaan Eijkman, who shared the 1929 Nobel prize for studies using chickens, and by the British in Malaysia and the Americans in the Philippines. Some kind of consensus was reached at the first meetings of the Far Eastern Association of Tropical Medicine in 1910 and 1912....

There were disagreements over how much thiamin is needed, whether extra amounts had any beneficial effect, and what public health measures should be implemented. There were various modifications to the production and preparation of rice in Japan and Southeast Asia, while the United States and Britain made addition of thiamin to white bread compulsory during WWII. Australia mandated enrichment of bread and flour in 1991, but in 1998 was still considering the compulsory addition of thiamin to beer, to reduce the incidence in alcoholics of Korsakoff's syndrome.

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