Abstract
OBJECTIVES: Thiamine acts as a coenzyme (prosthetic group) after converting to thiamine pyrophosphate in crucial metabolic enzymes of pyruvate dehydrogenase, α-ketoglutarate dehydrogenase and transketolase. Theoretically, thiamine should not be consumed by an increase in the number of substrates for those enzymes. However, thiamine is often described to be consumed by excessive carbohydrate intake. Such a possible misunderstanding is assessed in the relevant literature. METHODS: The original paper (Elmadfa, et al. Int J Vitam Nutr Res 2001), which seems to mislead the reader into considering an increase in thiamine requirement for excessive carbohydrate intake, and the relevant papers were reviewed. RESULTS: The original paper demonstrated that increases in carbohydrate intake from 55% to 65% and 75% of total energy caused decreases in plasma and urine concentrations of thiamine, while erythrocyte transketolase activity remained unchanged. This seems to misleadingly support the idea that excessive carbohydrate intake increases the thiamine requirement for carbohydrate metabolism. It could be interpreted as the decreases of thiamine concentrations were observed only during an adaptation period. It was reported that diabetic patients had low plasma thiamine levels in association with increased renal clearance and fractional excretion of thiamine, without a decrease in erythrocyte transketolase activity (Thornalley, et al. Diabetologia 2007). As a similar case of possible misinterpretation, a case report (Watson, et al. Ir J Med Sci 1981) demonstrated that glucose loading precipitated thiamine deficiency in malnourished patients with latent thiamine deficiency. CONCLUSIONS: From the relevant literature, it is inferred that excessive carbohydrate intake in people without hyperglycemia could lead to a small increase, if any, in urinary thiamine excretion, but not to an increase in thiamine requirement for glucose metabolism. Even in the academic field, it seems that thiamine is often misunderstood to be consumed by excessive carbohydrate intake. FUNDING SOURCES: None.