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A Brief History of Nutritional Medicine and the Emergence of Nutrition as a Medical Subspecialty
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Beriberi had been shown to be a debilitating and potentially fatal illness. It could leave half a ship’s crew incapacitated with a substantial number succumbing. In the early 1880s, the problem was severe enough that the Japanese navy commissioned a physician named Kanehiro Takaki (1849–1920) to solve it. Eventually, Takaki believed he had found an anti-beriberi remedy. He was aware of the work in Europe on protein intake and realized that Japanese sailors ate much less dietary protein than their western counterparts. His plan was to increase the sailors’ dietary protein in lieu of white rice. He had successfully tested this concept on a training mission with naval cadets. His approach of adding meat, condensed milk, bread and vegetables was adopted throughout the fleet, virtually eliminating the disease. The report of this work was published (in Japanese) in 1885.
Nutritional Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Chelsea Kesty, Madeline Hooper, Erin McClure, Emily Chea, Cynthia Bartus
Course: Early recognition and treatment of beriberi results in a favorable prognosis; nerve and cardiac function is responsive to thiamine supplementation. Wernicke encephalopathy is usually reversible with prompt therapy; however, Korsakoff-related changes are irreversible.
Nutritional Deficiencies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Deepa Bhupali, Fernando D. Testai
Thiamine deficiency causes a range of subtle and nonspecific symptoms that may be easily overlooked. In its more severe form, it causes a neurocardiogenic syndrome called beriberi. Nonendemic thiamine deficiency can be seen in association with alcoholism where it manifests with Wernicke–Korsakoff syndrome. Wernicke's disease (or thiamine-deficient encephalopathy) is characterized by a rather abrupt onset of any combination of nystagmus, gait ataxia, conjugate gaze palsy, and global confusional state. Korsakoff's psychosis is a chronic amnestic disorder with both antegrade and retrograde components in an otherwise responsive patient.
Peripapillary Retinal Haemorrhages in Wernicke’s Encephalopathy Following Bariatric Surgery in a Young Patient
Published in Neuro-Ophthalmology, 2022
Motazz A. Alarfaj, Nada H. Almadhi, Mohammad Al-Amry, Abdullah I. Almater, Majed Al-Obailan
Vitamin B1, or thiamine, is a water-soluble vitamin that functions as a cofactor for energy production. There is a limited intracellular reserve so constant cellular resupply is needed.1 Thiamine deficiency can manifest with two clinical phenotypes: Wernicke-Korsakoff’s syndrome and beriberi. Wernicke’s encephalopathy is characterised classically by a triad of ophthalmoplegia, confusion, and ataxia. Korsakoff’s syndrome (KS) occurs as a late complication of WE and is defined by memory impairment associated with confabulation. KS has a mortality rate of 20% if left untreated. Beriberi may present with congestive cardiac failure (wet beriberi) or polyneuropathy (dry beriberi).1 WE can occur in the setting of poor nutrition or absorption, for example, after bariatric surgery. Whenever there is clinical suspicion, thiamine replacement should be started immediately because of the cognitive consequences of any delay. Herein, we describe a case of WE following laparoscopic sleeve gastrectomy in a young male patient who presented with binocular horizontal diplopia and was found to have preretinal peripapillary haemorrhages.
Thiamine and phosphate esters concentrations in whole blood and serum of patients with alcohol use disorder: a relation with cognitive deficits
Published in Nutritional Neuroscience, 2021
Laurent Coulbault, Ludivine Ritz, François Vabret, Coralie Lannuzel, Céline Boudehent, Marie Nowoczyn, Hélène Beaunieux, Anne Lise Pitel
Many pathological situations can induce thiamine deficiency (TD). It occurs classically in case of malnutrition and may be responsible for Beriberi, which is characterised by cardiac failure. TD is also classically found in AUD patients with a decrease of TDP in whole blood and in red blood cells [3]. A study suggested a relationship between the extent of TD and the development of alcohol-related neuropsychological deficits with correlations between levels of TDP in whole blood and memory deficits in AUD patients [4]. Combining the neurotoxic effect of alcohol (or its metabolite acetaldehyde) and TD, AUD patients can develop Wernicke’s encephalopathy (WE) characterised by ataxia, ophtalmoplegia, nystagmus and mental confusion. WE is often underdiagnosed, but when recognised, treatment with thiamine can result in a rapid clinical improvement. Early thiamine supplementation is required in WE to avoid progression toward severe and irreversible brain lesions observed in Korsakoff’s syndrome, and sometimes, even to the death [5–8]. If inappropriately treated, 85% of patients with WE develop Korsakoff’s syndrome, and the mortality rate reaches 20% [6].
From Food for Survival to Food for Personalized Optimal Health: A Historical Perspective of How Food and Nutrition Gave Rise to Nutrigenomics
Published in Journal of the American College of Nutrition, 2019
In another aspect of nutrition research, Japanese physician Takaki Kanehiro in the 1870s showed that beriberi is a disease due to malnutrition and not an infectious one (2). At that point many scientists started suspecting that there were constituents in foods found in small amounts, without conferring energy, necessary however to prevent certain diseases (2, 5). Polish biochemist Casimir Funk in 1912, while studying beriberi, discovered thiamine and called it a vital-amine; this term he coined, later gave rise to the term “vitamin” (2, 5, 6). While the first vitamin (vitamin A), was discovered in 1912 by E. V. McCollum, a U.S. Department of Agriculture researcher at the University of Wisconsin at Madison, most vitamins were discovered and isolated in the 1900s and the concept of supplementation for better health and disease prevention was born (6). In the 1930s, the first vitamin pills were marketed in the United States, and this signified the time point at which a new industry, that of nutrition-based health products and claims, was initiated, while by 1945 most of the micronutrients had been discovered (5–7). As technologies developed in the early and middle 20th century, they allowed the manufacture and distribution of canned food and chilled and frozen foods while, gradually, consumers became equipped with electric-powered refrigerators and freezers, thus increasing the output of the food industry and its involvement in the provision of food to the average household. Prior to that, the vast majority of foods in the world were prepared locally and consumers basically had to visit butchers, bakeries, dairies, green grocers, and other purveyors within limiting close proximity to their households and purchase, in bulk, mainly unbranded goods of questionable quality and often safety.