In 2014, there was an outbreak of beriberi on Kuria, a remote atoll in Kiribati, a small Pacific Island nation. A thiamine-poor diet consisting mainly of rice, sugar, and small amounts of fortified flour was likely to blame. We aimed to design a food fortification strategy to improve thiamine intakes in Kuria. We surveyed all 104 households on Kuria with a pregnant woman or a child 0–59 months. Repeat 24-h dietary recalls were collected from 90 men, 17 pregnant, 44 lactating, and 41 other women of reproductive age. The prevalence of inadequate thiamine intakes was >30% in all groups. Dietary modeling predicted that rice or sugar fortified at a rate of 0.3 and 1.4 mg per 100 g, respectively, would reduce the prevalence of inadequate thiamine intakes to <2.5% in all groups. Fortification is challenging because Kiribati imports food from several countries, depending on price and availability. One exception is flour, which is imported from Fiji. Although resulting in less coverage than rice or sugar, fortifying wheat flour with an additional 3.7 mg per 100 g would reduce the prevalence of inadequacy to under 10%. Kiribati is small and has limited resources; thus, a regional approach to thiamine fortification is needed.

中文翻译：

---

硫胺素强化建模：基里巴斯共和国库里亚环礁的案例研究

2014年，太平洋小岛国基里巴斯的偏远环礁库里亚爆发了脚气病。主要由大米、糖和少量强化面粉组成的缺乏硫胺素的饮食可能是罪魁祸首。我们旨在设计一种食品强化策略，以提高 Kuria 的硫胺素摄入量。我们调查了 Kuria 的所有 104 户家庭，其中有孕妇或 0-59 个月大的孩子。从 90 名男性、17 名孕妇、44 名哺乳期妇女和 41 名其他育龄妇女中收集了重复的 24 小时饮食回忆。在所有组中，硫胺素摄入不足的发生率 > 30%。膳食模型预测，分别以每 100 克 0.3 和 1.4 毫克的比例强化大米或糖，可将所有组中硫胺素摄入不足的发生率降低至 <2.5%。强化具有挑战性，因为基里巴斯从多个国家进口食品，具体取决于价格和供应情况。一种例外是面粉，它是从斐济进口的。虽然覆盖率低于大米或糖，但每 100 克额外添加 3.7 毫克小麦粉可将不足的发生率降低至 10% 以下。基里巴斯很小，资源有限；因此，需要对硫胺素强化采取区域办法。