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from page 7)
SELENIUM IN FOODS
We know that poor eating
habits contribute to selenium deficiency. Many of the factors that contribute
to a poor quality diet, such as low income, poor food choices, loneliness,
reduced taste sensation, poor health and unemployment are prominent in
PLWHIV. The dietary assessment to determine if adequate levels of selenium
are consumed is the most important consideration in establishing selenium
status.
The selenium content of
foods is dependent largely on the selenium content of the soil where the
food was grown. Selenium is taken up to a varying degree by plants then
concentrated up the food chain. Generally, therefore, selenium concentrations
are highest in meats, poultry, fish and seafood (Table
4). (68)
The exception is Brazil
nuts, which are produced in selenium-rich regions, on trees that concentrate
the mineral. One Brazil nut contains 50-120 µg selenium, a range
similar to that in a three-ounce serving of flesh foods. (72) Sunflower
seeds, grown on selenium-rich North American soils, are one of the few
other good plant sources of selenium. Vegetarians, especially lacto-ovo
vegetarians, are unlikely to consistently achieve this intake and should
consider supplementation. A recommendation to eat a variety of food each
day including whole wheat products, milk, oats and barley can help to increase
selenium intake.
| TABLE
4. GOOD SOURCES OF SELENIUM |
| Fish |
Seafood |
Organ and muscle meat |
Brazil nuts |
| Barley |
Oats |
Meats and Poultry |
Walnuts |
| Milk |
Wheat germ |
Sunflower seeds |
Whole wheat |
CONSIDERATIONS
Besides assessing dietary
selenium intake, it's vital to determine if supplemental sources of selenium
are used on a regular basis. PLWHIV take supplements without discussing
their alternative treatments with their doctor. It is notable that selenium
may be supplied alone or in combination with other supplements. Few patients
tally the total amount of each micronutrient they take so it's likely that
duplicate supplement ingredients are consumed. Supplements taken in conjunction
with selenium may be multivitamin/minerals, zinc, copper, magnesium, and
NAC. It's also important to remember that based on current research, too
much selenium supplementation can be harmful. People who supplement their
diet with selenium should not take more than 400 µg/day. As with
other micronutrients, post-HAART the question is whether our body's utilization
of selenium reverts to non-HIV status after the virus goes undetectable.
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References
1. Facts About Dietary
Supplements. Selenium,
Fact Sheet. Office of Dietary Supplements, National Institutes of Health,
Dec 9, 2002. WWW: (accessed 2 Jan 2003).
2. Taylor EW. Selenium
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227-239.
3. Holben DH, Smith AM.
The Diverse Role Of Selenium Within Selenoproteins: A Review. J Am Diet
Assoc 1999;99:836-43.
4. Sunde RA. Selenium.
In: Bowman BA, Russell RM, Editors. Present Knowledge in Nutrition, Eighth
edition. Washington, D.C: International Life Sciences Institute Press;
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5. Friis H, Kaestel P,
Iverson ANK, Bugel S. Selenium And HIV Infection. In: Friis H, Editor.
Micronutrients & HIV Infection. Boca Raton, FL:CRC Press 2002;183-200.
6. Beach RS, Mantero-Atienza
E, Shor-Posner G, et al. Specific Nutrient Abnormalities In Asymptomatic
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