Thiamin in beer: a health promotion perspective.

Wernicke's encephalopathy (WE) is a serious disease resulting from excessive alcohol intake. As well as the disastrous consequences for the individual, patients with WE place a heavy burden for continuing care on the community. Australia appears to have a higher rate of WE than other western countries, probably due to differences in the consumption patterns of alcoholic beverages. Unlike most other western countries, Australia does not fortify flour with thiamin. On the other hand the USA does fortify flour and has higher thiamin intakes and lower rates of WE. In Australia it has been proposed that thiamin be added to alcoholic beverages. Given that technical problems related to stability, taste and absorption can be solved, the fortification of a substance which is potentially harmful, raises serious problems for health educators. The labeling of alcoholic beverages as 'vitamin enriched' could result in changes in the community's beliefs about alcohol and in increased alcohol consumption. The nutrition and education implications of this proposal are discussed. The conclusion is drawn that Australia should follow the example of other western countries and fortify flour with thiamin.