Understanding the Nutrition Diet: What is the cause of the beriberi disease?

October 24, 2025 •

4 min read

Historically, beriberi was a widespread health problem, particularly in East Asia during the 19th century, linked directly to the consumption of polished white rice that lacked essential nutrients. Today, the main reason for the deficiency leading to the beriberi disease is a lack of sufficient thiamine (vitamin B1) in the body.

Quick Summary

Beriberi is a disorder resulting from insufficient thiamine (vitamin B1). Causes stem from poor diet, particularly refined grains, alcoholism, malabsorption conditions, increased metabolic demands, and certain medical treatments.

Key Points

Thiamine Deficiency: Beriberi is directly caused by a severe lack of thiamine, also known as vitamin B1, which is crucial for metabolism and nerve function.
Dietary Causes: Historically linked to diets reliant on polished white rice, modern cases can stem from high consumption of refined carbohydrates or malnutrition.
Alcoholism: Chronic alcohol misuse is a major cause in developed countries, as it impairs the body's ability to absorb and store thiamine.
Medical Risk Factors: Conditions like bariatric surgery, certain gastrointestinal diseases, and the use of diuretics can lead to thiamine deficiency.
Two Forms: The disease manifests as either wet beriberi (affecting the heart) or dry beriberi (affecting the nervous system), each with distinct, severe symptoms.
Prevention and Treatment: Beriberi is preventable with a balanced diet rich in thiamine and treatable with supplements, though some advanced damage can be irreversible.

The Primary Cause: Thiamine Deficiency

Beriberi is fundamentally a condition caused by a severe deficiency of thiamine, also known as vitamin B1. Thiamine is a water-soluble vitamin essential for numerous bodily functions, including carbohydrate metabolism, which turns food into energy, and the proper functioning of the nervous and cardiovascular systems. When the body lacks sufficient thiamine, critical cellular processes are disrupted, leading to the debilitating symptoms of beriberi.

Dietary and Historical Factors

Historically, the link between diet and beriberi was most prominent in populations where highly milled, or polished, white rice was the dietary staple. This process removes the outer husk and bran, which contain the majority of the grain's thiamine.

In modern times, while food fortification has made the disease rare in many developed countries, poor dietary habits remain a significant cause. This includes diets high in refined carbohydrates and sugar, and a general lack of dietary variety.

Non-Dietary Risk Factors for Thiamine Deficiency

Beyond poor dietary intake, several other factors can increase a person's risk of developing beriberi:

Alcohol Misuse: Chronic and heavy alcohol consumption is a leading cause of thiamine deficiency in industrialized nations. Alcohol interferes with the absorption and storage of thiamine in the body.
Malabsorption Disorders: Conditions that affect nutrient absorption, such as Crohn's disease, celiac disease, or chronic diarrhea, can lead to a deficiency.
Bariatric Surgery: Surgical procedures that alter the digestive tract can impair the body's ability to absorb thiamine.
Increased Thiamine Requirements: Certain physiological states demand a higher intake of thiamine, and if not met, can trigger a deficiency. These include pregnancy, breastfeeding, periods of high physical stress, and conditions like hyperthyroidism.
Kidney Dialysis: Patients undergoing kidney dialysis are at increased risk due to potential loss of water-soluble vitamins during the procedure.
Genetic Factors: In very rare cases, a genetic condition can prevent the body from effectively absorbing thiamine from food.
Infantile Beriberi: Infants breastfed by mothers with a thiamine deficiency can develop beriberi, as the mother's milk will also be low in the vitamin.

The Diverse Manifestations of Beriberi

Beriberi is not a single disease but rather a syndrome with different forms affecting various body systems.

Wet Beriberi: This form primarily affects the cardiovascular system. Symptoms include shortness of breath, rapid heart rate, and swelling (edema), especially in the lower legs. In severe cases, it can cause heart failure, which can be life-threatening.
Dry Beriberi: This form impacts the nervous system and can cause neurological damage. Symptoms include decreased muscle function, tingling, or loss of sensation in the extremities, pain, confusion, and difficulty speaking. Without treatment, it can lead to paralysis and is often associated with Wernicke-Korsakoff syndrome, particularly in those with chronic alcoholism.

Preventing Beriberi Through Proper Nutrition

Preventing beriberi is primarily a matter of ensuring adequate thiamine intake through a balanced diet. Many foods are naturally rich in thiamine, and in many countries, staple foods like cereals and bread are enriched or fortified with the vitamin. For those at higher risk, such as individuals recovering from bariatric surgery or with alcohol dependency, supplementation may be necessary.

Thiamine-rich food sources include:

Pork: Lean cuts of pork are one of the best sources of thiamine.
Whole Grains: Brown rice, oats, and whole-wheat bread are excellent sources of the vitamin.
Legumes: Lentils, black beans, and other legumes contain good amounts of thiamine.
Nuts and Seeds: Sunflower seeds, macadamia nuts, and flaxseeds are healthy options.
Fish and Seafood: Certain fish like trout, tuna, and salmon provide thiamine.
Fortified Foods: Many breakfast cereals, bread, and pasta are fortified with B vitamins, including thiamine.

Beriberi Causes: Dietary vs. Other Factors


Factor	Dietary	Other Factors
Primary Mechanism	Inadequate consumption of thiamine-rich foods.	Impaired absorption, increased excretion, or increased metabolic demand for thiamine.
Associated Habits/Conditions	Diets consisting heavily of polished white rice or refined carbohydrates; malnutrition; limited access to diverse food.	Alcohol misuse; malabsorption disorders (e.g., Crohn's disease); bariatric surgery; chronic diarrhea; kidney dialysis; hyperthyroidism.
Historical Context	Dominant cause in East Asia with the introduction of mechanical milling of rice.	Historically less common, but now a primary driver in developed nations, especially in association with chronic alcoholism.
Typical Patient Profile	Individuals in regions of food insecurity or those with severely restricted diets (e.g., eating disorders).	Individuals with chronic alcohol use disorder, post-surgery patients, pregnant women with severe nausea and vomiting, or those on certain medications.

Conclusion

While a severe and prolonged deficiency of thiamine is the root cause of beriberi, its underlying origins are diverse, encompassing poor dietary choices, various medical conditions, and lifestyle factors like chronic alcohol consumption. The modern approach to prevention emphasizes not only a healthy, balanced diet rich in thiamine-containing foods but also addressing the specific risk factors for individuals most susceptible to the deficiency. Early detection and thiamine supplementation are critical for a positive prognosis, as untreated beriberi can lead to irreversible nerve damage or fatal heart failure. Anyone with symptoms or elevated risk factors should seek medical advice promptly.

For more information on the functions and sources of thiamine, you can consult the NIH's fact sheet on Thiamin.

Frequently Asked Questions

The primary cause of beriberi is a severe deficiency of thiamine, or vitamin B1, which is vital for the body's energy production and cellular function.

Polished white rice, a dietary staple in many regions, has the thiamine-rich outer layers removed during processing. Populations that relied heavily on this unenriched grain were at high risk of developing the disease.

Beriberi is rare in developed countries due to food fortification programs. When it does occur, it is most often linked to chronic alcoholism, which impairs thiamine absorption.

Yes, medical conditions can increase risk. Malabsorption disorders (e.g., Crohn's disease), bariatric surgery, kidney dialysis, hyperthyroidism, and the use of certain diuretics can all contribute to thiamine deficiency.

Wet beriberi primarily affects the cardiovascular system, causing symptoms like shortness of breath and swelling. Dry beriberi damages the nervous system, leading to muscle weakness, paralysis, and confusion.

Infantile beriberi occurs in breastfed infants whose mothers have a thiamine deficiency, as the mother's milk will be low in the vitamin.

Beriberi is treated with thiamine supplementation, which can be administered orally, via injection, or intravenously for severe cases. A balanced diet rich in thiamine is also crucial.