Overview of Selenium Deficiency and Toxicity Worldwide: Affected Areas, Selenium-Related Health Issues, and Case Studies

Abstract

Selenium (Se) is an essential micronutrient for human and animal healthy due to its capabilities to support antioxidant defence systems. However, problems related to the deficiency of Se are emerging issue for human health worldwide and plant species differ considerably in their susceptibility to high concentrations of Se, and certain plant species can be able to accumulate Se to astonishingly high concentrations. Many factors can affect the content of Se in different foods, including different uptake rate by plants, which can be related to plant type, soil, pH, microbial activity, rainfall and a number of other biogeochemical parameters. Humans Se intake and Se status in the population depends firstly on Se concentrations in soils, and hence the Se concentrations in the harvested edible plants in these soils. Thus, this chapter aims to compile some information about research work on essentiality of Se for humans and other mammals, and the need for a sufficient daily Se intake.

Full text

209© Springer International Publishing AG 2017
E.A.H. Pilon-Smits et al. (eds.), Selenium in plants, Plant Ecophysiology 11,
DOI10.1007/978-3-319-56249-0_13
Chapter 13
Overview ofSelenium Deciency andToxicity
Worldwide: Affected Areas, Selenium-Related
Health Issues, andCase Studies
AndréRodrigues dosReis, HassanEl-Ramady, ElcioFerreiraSantos,
PriscilaLupinoGratão, andLutzSchomburg
Abstract Selenium (Se) is an essential micronutrient for human and animal healthy
due to its capabilities to support antioxidant defence systems. However, problems
related to the deciency of Se are emerging issue for human health worldwide and
plant species differ considerably in their susceptibility to high concentrations of Se,
and certain plant species can be able to accumulate Se to astonishingly high concen-
trations. Many factors can affect the content of Se in different foods, including dif-
ferent uptake rate by plants, which can be related to plant type, soil, pH, microbial
activity, rainfall and a number of other biogeochemical parameters. Humans Se
intake and Se status in the population depends rstly on Se concentrations in soils,
and hence the Se concentrations in the harvested edible plants in these soils. Thus,
this chapter aims to compile some information about research work on essentiality
of Se for humans and other mammals, and the need for a sufcient daily Se intake.
Keywords Agronomic bio-fortication • Human health • Oxidative stress •
Selenium toxicity • Keshan disease
A.R. dos Reis (*)
UNESP– São Paulo State University, Tupã, SP 17602-496, Brazil
e-mail: andrereis@tupa.unesp.br
H. El-Ramady
Faculty of Agriculture, Kafrelsheikh University, Kafr el-Sheikh 33516, Egypt
e-mail: ramady2000@gmail.com
E.F. Santos
Center of Energy in Agriculture, University of São Paulo, Piracicaba, SP 13416-000, Brazil
e-mail: elciokw@yahoo.com.br
P.L. Gratão
UNESP– São Paulo State University, Jaboticabal, SP 14884-900, Brazil
e-mail: plgratao@fcav.unesp.br
L. Schomburg
Institute for Experimental Endocrinology, Charité– University Medical School,
Suedring 10, CVK, D-13353 Berlin, Germany
e-mail: lutz.schomburg@charite.de

210
13.1 Introduction
Selenium (Se) is an essential micronutrient for human and animal health due to its
capabilities to support antioxidant defence systems, but is harmful in excess
(Fordyce 2013; Mora etal. 2015; Wrobel etal. 2016). Compared to other micronu-
trients, Se has one of the narrowest ranges between its toxic dose (> 400 μg/day)
and dietary deciency (< 40 μg/day), as reviewed by Kabata-Pendias and Mukherjee
(2007) and Fordyce (2013). Therefore, both deciency and toxicity of Se are global
emerging problems. Several studies have investigated Se deciency and toxicity in
humans (Sah etal. 2013; Sun etal. 2014; Yang and Jia 2014; Zhu etal. 2015; Nagy
et al. 2015; Oropeza-Moe et al. 2015; Krohn et al. 2016; Wrobel et al. 2016;
Manzanares and Hardy 2016), algae (Gojkovic etal. 2015), yeast (Kieliszek etal.
2016), bacteria (Nancharaiah and Lens 2015; Ye etal. 2016; Lampis etal. 2016) and
higher plants (Saidi etal. 2014a, b; Yusuf etal. 2016). Recently, two comprehensive
books were published that reviewed the diversity of Se functions in health and dis-
ease (Brigelius-Flohé and Sies 2016) and global advances in Se research, from
theory to application (Bañuelos etal. 2016).
While it is clear that Se is required for several essential biological functions for
human health, many questions still need to be answered. The most important Se
research ndings are summarized below, along with some attempts to answer
remaining urging questions: (1) Selenium is required by humans and other mam-
mals. It is well established that Se is an essential nutrient for human health (Rayman
2000; Combs 2001; Surai 2006), and an insufcient supply causes or predisposes to
disease; (2) No clear denition is currently given as to how much Se is required by
humans. The amount minimally needed likely depends on a number of anthropo-
metric characteristics: body weight, age, sex, health status. The recommendations
given cover a wide range of reference intakes spanning a daily uptake of 25–125 μg/
day (Hurst etal. 2013; Combs 2016); (3) The dietary intake level associated with Se
deciency for humans is reported to be <50 μg/day (Fairweather-Tait etal. 2011;
Combs 2016). However, as mentioned above, this recommendation depends on a
number of personal characteristics; (4) Research indicates that Se can reduce cancer
risk when the concentration of plasma Se ranges from 70 to 106 ng/ml (Combs
2016). Lower Se concentrations seem to increase the risk of several types of cancer,
while no positive chemopreventive effects have been observed above this level,
which likely corresponds to the amount of Se needed for full expression of the
human selenoproteins.
Concerning the importance of Se for human and animal health, many studies
have investigated this relationship, such as El-Ramady etal. (2015b), Niedzielski
etal. (2016), Han etal. (2016), Hauser-Davis etal. (2016), Krohn etal. (2016),
Hoffmann (2016), Bissardon etal. (2016), Schomburg (2011), Wang etal. (2016a,
b), Menezes etal. (2016) and Zanetti etal. (2016). On the other hand, the toxicity of
Se to higher plants also has been documented in many studies including Molnárová
and Fargasová (2009), Akbulut and Çakır (2010), Aggarwal etal. (2011), Madaan
and Mudgal (2011), Srivastava etal. (2012), Hladu etal. (2013), Talukdar (2013),
A.R. dos Reis et al.

211
Zhao etal. (2013), Chen etal. (2014), Sharma etal. (2014b), Mechora etal. (2015),
El-Ramady etal. (2015a, b), Lehotai etal. (2015), Nawaz etal. (2015), Handa etal.
(2016), Pilon etal. (2016), Pilon-Smits etal. (2016), and White (2016).
In general, the effects of Se deciency on humans include muscle weakness and
inammation, fragile red blood cells, abnormal skin coloration, heart muscle dys-
function, susceptibility to cancer, Keshan and Kashin-Beck diseases, whereas Se
toxicity includes liver and kidney damage, blood clotting, necrosis of heart and
liver, hair and nail loss and nausea and vomiting (Kabata-Pendias and Mukherjee
2007). Selenium in not essential for plants, but has benecial effects on plant growth
and stress tolerance. Many studies have indicated that already small Se doses are
sufcient for improving plant health (e.g. Kong etal. 2005; Eiche etal. 2015). High
Se levels tend to induce different toxic effects in plants, including reduced photo-
synthetic efciency and growth, chlorosis and nally plant death (Van Hoewyk
2013; Eiche etal. 2015). However, plant species differ considerably in their suscep-
tibility to high dosages of Se, and certain plant species even show stimulation of
growth on soils with high Se and are able to accumulate Se to astonishingly high
concentrations (Pilon-Smits etal. 2016).
Problems related to the deciency of Se are an emerging issue for human health
worldwide. A solution for this problem can be achieved through Se biofortication
of different crops, as reviewed by several authors using rice (Boldrin etal. 2013;
Wang etal. 2014; Reis etal. 2014; Sharma etal. 2014b, c;Pandey and Gupta 2015;
Li etal. 2016), maize (Chilimba etal. 2012; Longchamp and Castrec-Rouelle 2014;
Longchamp et al. 2013, 2015), wheat (Acuña et al. 2013; Galinha et al. 2013;
Fenech etal. 2013; Gong etal. 2014; Zhu etal. 2014; Li etal. 2014; Poblaciones
etal. 2014; Yasin etal. 2014; Galinha etal. 2015; Lazo-Vélez etal. 2015) and cru-
ciferous vegetables (Harris etal. 2014; Avila etal. 2014; Yasin etal. 2015b; Bañuelos
etal. 2015; Bachiega etal. 2016). Different forms of Se-biofortication have been
tested, including supplementation of fertilizers, foliar spraying directly on the plants
or using Se-accumulating plant leftovers for soil fortication, as recently reported
by Bañuelos etal. (2015), El-Ramady etal. (2015c), Malagoli etal. (2015), Galinha
etal. (2015), Yasin etal. (2015a, b), Bañuelos etal. (2016), Faria etal. (2016), Mao
etal. (2016), Ortiz-Monasterio etal. (2016), Reis etal. (2016), dos Reis (2016),
El-Ramady etal. (2016a), Li etal. (2016), Domingues et al. (2016), and Sharma
etal. (2016).
13.2 Global Areas Related toSe Deciency andToxicity
Selenium can be found in all agroecosystem components including soil, plants,
rocks or water. In animal feed, the critical Se concentrations for Se adequacy and
toxicity are 0.05–0.10 mg/kg and 4–5 mg/kg, respectively (Zanetti etal. 2016).
Several global locations have been monitored where livestock may experience Se
toxicity, including areas in the western U.S.A. such as the San Joaquin Valley in
California (Frankenberger and Benson 1994), Colorado and Wyoming (El Mehdawi
13 Overview ofSelenium Deciency andToxicity Worldwide: Affected Areas,…

212
and Pilon-Smits 2012), Enshi, Hubei Province, China (Wang and Gao 2001), and
Australia (Thomson 2004) and Punjab Nawanshahr–Hoshiarpur region India
(Dhillon and Dhillon 2014). Due to the importance of Se (Table13.1), several stud-
ies have been conducted to quantify the Se levels in soil, water and crops from dif-
ferent areas, including those published by Bañuelos and Lin (2007), Dhillon etal.
(2008), Dhillon and Dhillon (2009a, b), (2014), (2016b), Sharma et al. (2009),
(2014a), Yuan etal. (2012), Wang etal. (2012), Eiche etal. (2015), Schilling etal.
(2015), Yasin etal. (2015c), (2016), Chawla etal. (2016), and Prakash (2016).
On the other hand, Se deciency predisposes to certain endemic diseases, as has
been well described for Se-poor areas in China, where Se deciency predisposes
people to Keshan disease, which is associated with childhood cardiomyopathy (Xia
etal. 2005). There are more than 40 countries described as having areas with very
low soil Se content, associated with human Se intakes of 10 μg/day or even less,
such as in areas of China (Moreno-Reyes etal. 1998; Tan etal. 2002; Li etal. 2007;
Han etal. 2016). In fact, in China Se decient areas are reported to represent 72%
of the country’s total area; these areas are often not intensively populated. Besides
these Se-decient areas, there are also Chinese areas with very high Se levels in soil
and in the agricultural products, thereby causing a high daily Se intake (Gao etal.
2011; Han etal. 2016).
Table 13.1 Soil, crop and water Se concentrations in different seleniferous areas worldwide
Country (region)
Total Se in
soil (mg/kg)
Total Se in cultivated
plants (mg/kg)
Total Se in
water (μg/L) References
China (Enshi,
Yutangba)
0.10–42.3
(4.75)
Maize (seeds): Stream water:
58.4
Zhu etal.
(2008)
0.17–4.82 (1.48)
India (Punjab) 2.7–6.55
(3.63)
Wheat, rice, maize and
mustard 13–670
Ground water:
479 (170)
Sharma etal.
(2009)
China (Enshi,
Yutangba)
3.76–79.08
(27.81)
Adenocaulon himalaicum
(leaf) 299–2278 (760)
Stream water:
15.13–192.7
(52.66)
Yuan etal.
(2012)
China (Enshi,
Jianshi)
2.89–87.3
(9.36)
Maize: Surface water: Qin etal.
(2013)
0.39–37.2 (3.76) 2.0–519 (46)
USA (Pine
Ridge Fort
Collins, CO)
8.2 Brassica juncea (leaf):
711
Yasin etal.
(2015c)
India (Punjab) 0.024–3.06
(0.449)
Cultivated and naturally
growing weed plants:
Ground water: Dhillon and
Dhillon (2016a)
0.01–6.60 (0.2795) 0.01–35.6
(0.972)
A.R. dos Reis et al.

213
13.3 Selenium Deciency andToxicity inSoils andPlants
inMiddle East andEurope
It has been documented that Se occurs in different mammalian tissues ranging from
0.7in heart tissue to 2.5 mg/kg in muscles, with an estimated average Se content in
human soft tissues of 0.11 mg/kg (Kabata-Pendias and Mukherjee 2007). Concerning
the Se intake and its status in Middle East and Europe, a suboptimal Se status was
found throughout these regions with only few exceptions (Table13.2). In general, it
can be noticed that the intake status of Se across Europe is low. This means that the
Se level in European soils is inadequate, particularly in Eastern Europe. There is no
complete systematic review of the soil Se quality and Se status in subjects living in
the Middle East (Stoffaneller and Morse 2015; Sharma etal. 2009).
13.4 Selenium Status inBrazilian Soils andCrops
Selenium is one of various compounds and chemical elements important to ensure
the quality of food, together with proteins, carbohydrates, fats, vitamins, iron (Fe),
iodine (I), and zinc (Zn) (Rayman etal. 2012). Genetic breeding programs can con-
tribute positively to the development of improved crop varieties. So far, crop breed-
ing has focused almost exclusively on higher productivity, i.e. crop quantity rather
than quality. However, problems of nutritional deciencies are experienced by
almost half the world’s population, especially Fe, I, Se, vitamin A and Zn in devel-
oping countries (Rayman etal. 2012). These deciencies happen basically due to
two reasons: 1) low concentration of micronutrients in the soils, which are affected
by texture class, mineral composition and soil pH; 2) a dilution effect of the essen-
tial micronutrients and vitamins for human health in the most productive varieties
or cultivars. While Se concentrations in agricultural products (food) depend primar-
ily on their concentrations in the soil, genotypic variation can also inuence the
absorption capacity of Se by plants.
The two major inorganic forms of Se in soils are selenate and selenite. In com-
parison to selenate, selenite forms usually are more strongly retained in the soil
colloids, a process which depends on environment characteristics such as pH, ionic
strength, ion concentration and other effects. Considering that the range between
essential and toxic levels of Se in plants and animals is very narrow (Lyons etal.
2003), the study of Se levels in agricultural soils and their sorption behavior under
different conditions of pH, ionic strength and concentration of competing ions
becomes highly relevant for a better understanding of the dynamics of Se in soils.
In many areas of Brazil, agricultural products have low levels of Se, and thus it
is important to understand the behavior of Se in soils and to assess the mechanisms
of its transfer to edible parts of plants, which are primary sources of food for the
population and animals. Table13.3 summarizes what is known so far regarding the
Se and sulfur concentrations in soils collected from different regions of Brazil.
13 Overview ofSelenium Deciency andToxicity Worldwide: Affected Areas,…

214
Table 13.2 Survey for investigating human Se status in some Arabian and European countries (as
a reference: a desirable plasma Se level is 70–106 μg/L)
Country
Subject details and
number
Mean Se status in human
(μg L−1) References
Arabian countries
Egypt 67 patient children and
60 healthy children
Serum: 40.1in patient
children and 83.3in control
Saad etal. (2014)
Egypt 80 obese children and
80 healthy children
Serum: 63.6in the obese
compared to 78.3in
controls
Azab etal. (2014)
Egypt 108 patients children
and 60 healthy children
Serum: 31.5in patients and
65.9in control
Sherief etal. (2014)
Jordan Subjects: 73 total; 56
smokers; 17
non-smokers
Blood: 332in smokers and
187in case of non-smokers
Massadeh etal.
(2010)
KSA 42 Saudi in 45–60 years
and 34 Saudi in 20–30
years
Serum: 91.24 and 86.63,
resp.
Stoffaneller and
Morse (2015)
KSA 170 diabetics with an
equal number of control
Urinary: 31.1 for diabetics
and 39.1 for control
El-Yazigi and
Legayada (1996)
KSA 513 children Serum: < 56 from 53.4%
of total
Al-Saleh etal.
(2006)
Kuwait 66 obese female
patients and 44 female
control
Serum: 86.08in obese
group and 101.14in the
control group
Alasfar etal. (2011)
Lebanon 159 healthy men and
284 women; age 18–65
years
Plasma: 151.2 for men and
135.0 for women
Obeid etal. (2008)
Yemen 75 patient children and
74 healthy control
Serum: 78.96in cases and
94.75in controls
Elemraid etal.
(2011)
European countries
Austria Patients with
autoimmune thyroiditis
and control
Serum: 98.0in the patients
and 103.2in control
Wimmer etal.
(2014)
Denmark 97 patients and 830
control
Serum: 89.9 for patients
and 98.8in controls
Bülow Pedersen
etal. (2013)
Denmark 3333 males (53–74
years)
Low serum: 31.58–78.96
and high serum
102.65–236.88
Suadicani etal.
(2012)
Estonia 404 subjects (19.5–52
years)
Serum: 26–116 (mean: 75) Rauhamaa etal.
(2008)
Germany 60 patients (aged 65
year)
From 89.05 to 70.84 Stoppe etal. (2011)
Germany 104 cardiac surgical
patients
Blood: 89.05 and 70.84
pre- and post-surgery,
respectively
Stoppe etal. (2013)
Germany 44 trauma patients Plasma: 62.38 Blass etal. (2013)
(continued)
A.R. dos Reis et al.

215
There still is a lack of comprehensive information about the distribution of Se in
Brazilian soils; this is an aim of current research. Better knowledge of the of the
levels and dynamics of Se in soils throughout Brazil are expected to greatly contrib-
ute to future research aiming to provide optimal levels of Se to crops, applied
through fertilizer (agronomic bio-fortication) to increase the natural intake of Se
by the Brazilian population.
Ferreira etal. (2002) observed that food consumed in Brazil has signicantly low
concentrations of Se. This observation likely is due to low Se concentrations in
Brazilian soils. Similar results were reported by Faria (2009), showing very low Se
Table 13.2 (continued)
Country
Subject details and
number
Mean Se status in human
(μg L−1) References
Greece 47 singleton pregnant
women in age 30 + 5
years
Urine: 91, 82 and 69 for the
1st trimester, 2nd and 3rd
trimester, res.
Koukkou etal.
(2014)
Finland 60 adults Plasma: 70.27in the 1970s
to 110.54 after
Se-fertilizers in 1984
Alfthan etal. (2015)
France 1389 subjects aged
59–71 years followed
for 9 years
Plasma: 16.58in men and
15.79in women
Akbaraly etal.
(2010)
Hungary 197 consecutive
patients
Blood: in non-survivors
102.2 compared with
survivors 111.1
Koszta etal. (2012)
Italy 54 melanoma patients
and 56 control
Plasma: 99in the cases and
89in the control
Vinceti etal. (2012)
Poland 95 lung cancer cases,
113 laryngeal cancer
cases
Serum: 63.2 compared to
74.6 control
Jaworska etal.
(2013)
Poland 80 children (age 6–17;
40 boys, 40 girls)
Serum: 102.3 and 111.1in
control girls and boys,
respectively
Błażewicz etal.
(2015)
Portugal 136 women (20–44
years)
Serum: 81 Lopes etal. (2004)
Slovenia 15 recruits Plasma: 71.75–82 (mean
76.87)
Pograjc etal. (2012)
Spain 84 healthy adults (31
males and 53 females
Plasma: 87.3in males and
67.3in females
Millán Adame etal.
(2012)
Spain 340 subjects 86.5% had plasma Se
below 125
Sánchez etal.
(2010)
The
Netherlands
1197 pregnant women
from 12 weeks
gestation
Serum: at 12 weeks and
after 75.80 and 80.54,
respectively
Rayman etal.
(2011)
UK 501 elderly volunteers Plasma: 90.71 at baseline Rayman etal.
(2012)
UK 1042 subjects (19–64
years)
Plasma: 86.86 Stranges etal.
(2010)
13 Overview ofSelenium Deciency andToxicity Worldwide: Affected Areas,…

216
Table 13.3 Concentrations of Selenium and Sulfur in Brazilian soils
City State
Se (μg/
kg)
S (g/
kg)
Geographic
coordinates References
Sena
Madureira- Acre
Acre 184 5 9° 25′ 54″ S
68° 35′ 42″ W
Silva Junior
(2016)
Itacoatiara-
Amazonas
Amazonas 530 17 3° 6′ 31″ S
58° 26′ 33″ W
Silva Junior
(2016)
Silvânia Goiás 49 −16° 39′ 32″ S
48° 36′ 29″ W
Carvalho (2011)
Itaúba Mato Grosso 174 7 11° 06′ 00″ S
55° 02′ 06″ W
Silva Junior
(2016)
Pirapora Minas Gerais 44 −17° 20′ 42″ S
44° 56′ 06″ W
Carvalho (2011)
Capinópolis Minas Gerais 50 −18° 40′ 55″ S
49° 34′ 11″ W
Carvalho (2011)
Caracaraí-
Roraima
Roraima 182 10 1° 28′ 10″ S
60° 44′ 16″ W
Silva Junior
(2016)
Alvinlândia São Paulo 10 −22° 26′ 00″ S
49° 45′ 00″ W
Nogueira etal.
(2013)
Analândia São Paulo 70 −22° 07′ 00″ S
47° 39′ 00″ W
Nogueira etal.
(2013)
Araras São Paulo 60 −22° 19′ 00″ S
47° 10′ 00″ W
Nogueira etal.
(2013)
Bonm Paulista São Paulo 200 −21° 05′ 00″ S
47° 08′ 00″ W
Nogueira etal.
(2013)
Capivari São Paulo 50 −22° 59′ 01″ S
47° 30′ 00″ W
Nogueira etal.
(2013)
Capivari São Paulo 110 −22° 59′ 10″ S
47° 30′ 10″ W
Nogueira etal.
(2013)
Conchal São Paulo 50 – 22° 19′ 00″ S
47° 00′ 10″ W
Nogueira etal.
(2013)
Cosmópolis São Paulo 110 – 22° 38′ 00″ S
47° 11′ 00″ W
Nogueira etal.
(2013)
Gália São Paulo 10 – 22° 17′ 00″ S
49° 33′ 00″ W
Nogueira etal.
(2013)
Garça São Paulo 10 – 22° 12′ 00″ S
49° 56′ 00″ W
Nogueira etal.
(2013)
Garça São Paulo 10 – 22° 12′ 00″ S
49° 39′ 10″ W
Nogueira etal.
(2013)
Ibaté São Paulo 70 – 21° 57′ 00″ S
47° 59′ 00″ W
Nogueira etal.
(2013)
Ibituruna São Paulo 300 – 21° 8′ 36″ S
44° 44′ 24″ W
Nogueira etal.
(2013)
Itirapina São Paulo 70 – 22° 15′ 10″ S
47° 00′ 49″ W
Nogueira etal.
(2013)
Itirapina São Paulo 70 – 22° 15′ 00″ S
47° 49′ 00″ W
Nogueira etal.
(2013)
Itirapina São Paulo 80 6 22° 15′ 54″ S
47° 52′ 44″ W
Faria (2009)
(continued)
A.R. dos Reis et al.

217
Table 13.3 (continued)
City State
Se (μg/
kg)
S (g/
kg)
Geographic
coordinates References
Marília São Paulo 10 – 22° 13′ 15″ S
49° 56′ 55″ W
Nogueira etal.
(2013)
Matão São Paulo 98 5 21° 35′ 27″ S
48° 26′ 54″ W
Faria (2009)
Miguelópolis São Paulo 30 – 20° 10′ 00″ S
48° 02′ 00″ W
Nogueira etal.
(2013)
Mogi Mirim São Paulo 70 – 22° 22′ 00″ S
46° 56′ 00″ W
Nogueira etal.
(2013)
Mogi-Guaçu São Paulo 100 – 22° 22′ 00″ S
46° 56′ 00″ W
Nogueira etal.
(2013)
Pariquera Açu São Paulo 670 – 24° 43′ 00″ S
47° 52′ 00″W
Nogueira etal.
(2013)
Pariquera Açu São Paulo 650 – 24° 43′ 10″ S
47° 52′ 10″ W
Nogueira etal.
(2013)
Piracicaba São Paulo 60 – 22° 43′ 10″ S
47° 38′ 10″ W
Nogueira etal.
(2013)
Piracicaba São Paulo 560 – 22° 43′ 15″ S
47° 38′ 16″ W
Nogueira etal.
(2013)
Piracicaba São Paulo 30 – 22° 43′ 10″ S
47° 38′ 20″ W
Nogueira etal.
(2013)
Piracicaba São Paulo 320 – 22° 43′ 18″ S
47° 38′ 23″ W
Nogueira etal.
(2013)
Piracicaba São Paulo 68 6 22° 38′ 36″ S
47° 49′ 52″ W
Faria (2009)
Piracicaba São Paulo 220 12 22° 42′ 40″ S
47° 37′ 43″ W
Faria (2009)
Piracicaba São Paulo 108 17 22° 38′ 40″ S
47° 49′ 24″ W
Faria (2009)
Pirassununga São Paulo 160 8 22° 04′ 60″ S
47° 34′ 36″ W
Faria (2009)
Pirassununga São Paulo 78 8 21° 56′ 30″ S
47° 28′ 50″ W
Faria (2009)
Pirassununga São Paulo 197 9 21° 57′ 60″ S
47° 26′ 60″ W
Faria (2009)
Ribeirão Preto São Paulo 40 – 21° 10′ 00″ S
47° 48′ 00″ W
Nogueira etal.
(2013)
Ribeirão Preto São Paulo 110 – 21° 10′ 00″ S
47° 48′ 00″ W
Nogueira etal.
(2013)
São Carlos São Paulo 60 – 22° 01′ 00″ S
47° 53′ 00″ W
Nogueira etal.
(2013)
São Pedro São Paulo 10 – 22° 32′ 15″ S
47° 54′ 00″ W
Nogueira etal.
(2013)
São Pedro São Paulo 10 – 22° 32′ 23″ S
47° 54′ 16″ W
Nogueira etal.
(2013)
Deciency Se
range
100–600 −Lyons etal.
(2003)
13 Overview ofSelenium Deciency andToxicity Worldwide: Affected Areas,…

218
concentrations in pasture grass (Brachiaria sp. and Stylosanthes sp.) ranging from
40 to 66 μg/kg. On the other hand, Brazilian nuts growing in the North-West of
Brazil are considered the richest food source for Se, but its concentrations range
dramatically from 0.03 to 512 mg/kg, likely reecting soil Se. There is evidence of
Se deciency in the Brazilian human population; however, no extensive research
data on the subject are available.
13.5 Selenium Status inSoils inRelation toPlant
andHuman Health
The relationship between Se content in soils and plants as well as human health can
be followed through many recent studies (Hateld etal. 2012; Yuan et al. 2012;
Fordyce 2013; Hurst etal. 2013; El-Ramady etal. 2015b,c; Alfthan etal. 2015;
Mora etal. 2015; Winkel etal. 2015; El-Ramady etal. 2016b; Wang etal. 2016a;
White 2016). It should be noted that human Se intake and Se status in the population
depends rstly on Se concentration in soils, and hence the Se concentrations in the
harvested edible plants in these soils. In other words, human Se intake and Se status
start from the Se concentration in soils. Many factors can affect the content of Se in
different foods, including different uptake rate by plants, which is related to plant
type, soil pH, microbial activity, rainfall and a number of other biogeochemical
parameters (Stoffaneller and Morse 2015). Therefore, human Se intake and Se sta-
tus can be largely controlled by manipulating Se concentrations in plants, which are
a function of soil Se concentration, speciation and bioavailability, as well as the
activity of soil microorganisms (Winkel etal. 2015).
The interrelation of soil, crop and human Se status has been impressively shown
in a recent Chinese study analyzing the importance of Se for the risk of thyroid dis-
eases. Wu and colleagues studied the neighboring Se-rich and Se-poor regions of
Ziyang and Ningshan counties, where average soil Se concentrations were 4–33 mg/
kg and 0.17 mg/kg, respectively. This difference directly translated into the average
blood Se concentrations of the farmers living in these areas, with the subjects from
Ziyang displaying 103.6 μg/L (IQR 79.7, 135.9) versus the farmers from the Se-poor
area of Ningshan, who had an average of only 57.4 μg/L (IQR: 39.4, 82.1). A lower
Se status is known to increase thyroid disease risks (Schomburg 2011), and conse-
quently, the farmers in Ningshan showed an almost twice as high prevalence of hypo-
thyroidism and autoimmune thyroid diseases than those from Ziyang (Wu etal.
2015). Extrapolating this concept, it would be highly fascinating and interesting try-
ing to calculate the number of Se-dependent diseases worldwide that could be pre-
vented by a better Se supply. Of course, due to the different life styles, differences in
genotype, environment, nutrition and activity patterns and the complex and multi-
factorial reasons for human diseases, this is very complicated to do.
One way to test the importance of Se for human health is via a retrospective
observational study. This is a longitudinal human study where serum or plasma
A.R. dos Reis et al.

219
samples are collected, analyzed and stored over long periods of time. Then, e.g. 20
years later, when some of the participants have developed a certain disease, their
blood samples are analyzed together with samples from comparable control sub-
jects from within the same study. One instructive example has just been published
analyzing the importance of the Se status for preventing colorectal cancer (Hughes
etal. 2015), which clearly provided evidence that within the same population, the
subjects with relatively low Se status had a signicantly increased risk for this dev-
astating disease.
A second very powerful way of testing the importance of Se for human health is
by conducting randomized controlled supplementation studies. Here, subjects are
recruited and asked to take a daily supplement containing Se, while a control group
takes a placebo. The participants do not know into which group they have been
recruited, an assay design called “blind”. In the high quality trials also the medical
doctors are unaware of the verum or placebo status of a given patient, in which case
the study is denoted as a “double blind” study. These studies run over several years
and are relatively expensive.
With respect to cancer, two most important double-blind randomized con-
trolled trials (RCT) have been conducted in the US.The nutritional prevention of
cancer trials (NPC trial) yielded an impressive reduction of cancer cases by Se
supplementation over a study period of around 5 years (Clark etal. 1996). The
more recent SELECT (Selenium and Vitamin E Cancer Prevention Trial) failed to
replicate these impressive chemopreventive effects of Se (Klein etal. 2011). The
most likely reason for this discrepancy lies in the baseline Se status of the partici-
pants, which were already very high at the start of SELECT.The comparison of
these two RCT is supporting the notion that health benets of Se supplements are
restricted to those human subjects who have an insufcient intake and a sub-
maximal expression of the biologically active selenoproteins. Similar results have
been obtained in a number of respective animal experiments. Together, these stud-
ies highlight the essentiality of Se for humans and other mammals, and the need
for a sufcient daily Se intake.
In conclusion, a dramatic number of humans worldwide likely fall into the Se
decient category. Lyons etal. (2003) estimated that around a billion people are
Se decient, and it might even be more. The fraction of sub-optimally Se supplied
humans currently may include a large part of the European population (with the
exception of Finland, where a nation-wide Se supplementation effort is in place),
large parts of Africa and Asia (including China), and also Australia, New Zealand
and large parts of South America. This “hidden hunger” may translate to higher
incidence of infections (e.g. in Africa), osteopathy problems (in China), and can-
cer and thyroid problems (in Europe). Selenium toxicity is a problem of smaller
magnitude, but has its own set of devastating effects in different areas across the
world. A solution to both of these problems is to focus on development of
Se-enriched dietary plant material.
13 Overview ofSelenium Deciency andToxicity Worldwide: Affected Areas,…

220
13.6 Roles ofPlants inAlleviating Se Deciency andToxicity
It is well documented that Se has a vital role in alleviating toxic effects in plants of
heavy metals and other oxidative stresses, and can promote plant growth when sup-
plied at low concentration. However, a phytotoxic effect and inhibition of plant
growth has also been reported for many plant species when grown under high Se
concentration (Feng etal. 2013). All plants readily take up Se, a property that may
be used for cleanup of excess environmental Se (phytoremediation) or for bioforti-
cation of crops with Se. Phytoremediation of Se-enriched soil or water can be
considered an emerging eld. Some studies have been published concerning the
role of plants in alleviating environmental Se toxicity, such as Gupta and Gupta
(2015) and Hawrylak-Nowak etal. (2015). Concerning the use of plants to solve the
problem of Se deciency, several plant species have been successfully biofortied
with Se to alleviate this deciency, including rice (Pandey and Gupta 2015), maize
(Longchamp etal. 2013, 2015), wheat (Galinha etal. 2015; Lazo-Vélez etal. 2015),
cucumber (Hawrylak-Nowak etal. 2015), lentil (Ekanayake etal. 2015), lettuce
(Hawrylak-Nowak 2013) and cruciferous vegetables (Bañuelos etal. 2015; Bachiega
etal. 2016). Selenium may be applied to soil as fertilizer or as foliar spray, in the
forms of selenate or selenite.
Collectively, it is becoming more and more obvious that Se plays an important
role in human health, and dietary Se intake worldwide largely depends on crop Se
content. Plant Se accumulation depends on a given soil, as well as on plant species,
as some plants are able to accumulate and tolerate high Se concentrations while
other plant species do not take up much Se and are sensitive to it. Furthermore, Se
bioavailability in soil has a direct impact on the Se concentrations of the plants that
are locally produced and consumed, and thereby on the daily Se intake of humans.
The results from an increasing number of clinical studies highlight the health risks
associated with too low a daily Se intake, a problem that may affect a billion or more
people. In order to improve this situation in the future, research needs to be intensi-
ed on the improvement of soil Se bioavailability, ways for controlling and optimiz-
ing Se uptake and accumulation in plants, and the many health effects that are
related to Se status in humans. It is hoped that an increased awareness for this topic
will in the long run improve human health in general and especially in the low-
income countries where infectious and childhood diseases are a constant and deadly
health threat to large parts of the population, and also to the general human com-
munity. Biofortication of crops with Se can be a relatively cost-effective and safe
way to bring about important signicant health benets to the world population.
This trace element can be analytically monitored fairly easily, and its levels con-
trolled on its path from atmosphere to soil, to plant and nally to animal and human
organisms.
A.R. dos Reis et al.

221
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