Household Consumption of Thiamin-Fortified Fish Sauce Increases Erythrocyte Thiamin Concentrations among Rural Cambodian Women and Their Children Younger Than 5 Years of Age: A Randomized Controlled Efficacy Trial

Objectives To assess whether ad libitum consumption of thiamin-fortified fish sauce over 6 months yields higher erythrocyte thiamin diphosphate concentrations (eTDP) among women of childbearing age and their children aged 12- 59 months compared with control sauce containing no thiamin. Study design In this double-blind, randomized controlled efficacy trial, 276 nonpregnant, nonlactating women (18-45 years of age) and their families in Prey Veng, Cambodia, were randomized to receive 1 of 3 fish sauce formulations: low thiamin concentration (low, 2 g/L), high thiamin concentration (high, 8 g/ L), or a control (no thiamin) fish sauce. Baseline (t = 0) and endline (t = 6 months) eTDP were measured with the use of high- performance liquid chromatography with a fluorescence detector. Results Fish sauce consumption did not differ between treatment groups (P = .19). In intent-to-treat analysis, women's baseline- adjusted endline eTDP (mean; 95% CI) was higher among women in the low (259; 245-274 nmol/ L) and high (257; 237-276 nmol/L) groups compared with control (184; 169-198 nmol/ L; P < .001); low and high groups did not differ (P =.83). Similarly, children's baseline-adjusted eTDP was higher in the low (259; 246-271 nmol/ L) and high (257; 243-270 nmol/L) groups compared with control (213; 202-224 nmol/ L; P < .001). Conclusion Fortified fish sauce appears to be an efficacious means of improving biochemical thiamin status in nonpregnant, nonlactating women and their children (1-5 years of age) living in rural Cambodia.