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As is clear from the passage, undernourished people ----.
People who fail to eat enough food to meet energy
needs risk nutrient deficiencies, including thiamin
deficiency. Inadequate thiamin intakes have been
reported among malnourished and homeless people.
Similarly, people who derive most of their energy
from empty-kcalorie items, like alcohol, risk thiamin
deficiency. Alcohol contributes energy, but provides
few, if any, nutrients and often displaces food. In
addition, alcohol enhances thiamin excretion in the
urine, doubling the risk of deficiency. Prolonged
thiamin deficiency can result in the disease “beriberi,”
which was first observed in East Asia when the
custom of polishing rice became widespread. Rice
provided 80 per cent of the energy intake of the
people of that area, and rice hulls (the outer skin of
rice) were their principal source of thiamin. When the
hulls were removed, beriberi spread like wildfire.
Because thiamin participates in nerve processes,
paralysis sets in when it is lacking. The symptoms of
beriberi include damage to the nervous system as
well as to the heart and other muscles.