Ny statusartikel: Europæere mangler selen

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En ny oversigtsartikel af en af verdens betydeligste eksperter i selen gennemgår den nyeste selenforskning. Konklusionen er, at langt de fleste europæere har så lave selenniveauer, at de vil have gavn af et tilskud. I meget selenrige områder af verden vil tilskud dog muligvis ikke gavne.

Oversigtsartiklen er skrevet af Professor Margaret Rayman, University of Surrey, Guildford, UK. Hun gennemgår de seneste års selenforskning som konkluderer, at selen har vist gavnlige virkninger på områder som virusbeskyttelse, human fertilitet, skjoldbruskkirtelsygdom og kræft.

Disse positive effekter er observeret i befolkningsgrupper med et utilstrækkeligt selenindtag. I befolkningsgrupper der i forvejen har et meget høj selenindtag er hypotensen, at yderligere tilskud ikke kan anbefales, fordi tilskud muligvis kan øge disse personers risiko for forhøjet blodsukker.

 

USA og Europa
Der er en række stater i midvesten i USA, hvor landbrugsjorden naturligt indeholder meget selen og hvor lokalbefolkningen derfor har meget høje selenværdier i blodet. I Europa derimod er det daglige selenindtag fra kosten omkring 40 µg og i Østeuropa noget lavere.

Tre store befolkningsundersøgelser har vist en U-formet sammenhæng for selenindholdet i blod.  Det betyder en stadig bedre virkning af selen op til et vist punkt, hvorefter nytten af højere tilskud begynder at falde. Når det gælder indholdet af selen i blodet (serum-selens) indflydelse på forskellige, helbredsparametre viser forskningsresultater følgende:

 

Dødelighed

  • Serum-selen under 105 µg/L = Forøget dødelighed
  • Serum-selen mellem 105-170 µg/L = Dødelighed under normalen
  • Serum-selen mellem 130-150 µg/L = Laveste dødelighed
  • Serum-selen over 170 µg/L = Tilsyneladende forøget dødelighed

I Europa ligger befolkningernes serum-selen-niveau typisk mellem 80-100 µg/L. Der er således plads til forbedring.

 

Immunsystemet
Et højt indhold i blodet samt selentilskud har forbedret ældres immunforsvar og herundet øget den celledræbende virkning på tumorer i undersøgelser. Selen har ligeledes påvirket indlæggelsestiden positivt hos HIV-patienter samt overlevelse af børn født af HIV-inficerede mødre.

 

Hjernen
Der er en sammenhæng mellem lavt selen og flere tilfælde af epilepsi / Parkinsons syge og kognitiv forringelse.

 

Fertilitet
Selentilskud har forbedret sædkvaliteten og et lavt selenniveau øger risikoen for svangerskabsforgiftning og for tidlig fødsel.

 

Skjoldbruskkirtlen
Der er et forhold mellem et højt selenindhold i blodet og/eller tilskud og lavere risiko for at få en autoimmun skjoldbruskkirtelsygdom og kræft i skjoldbruskkirtlen

 

Inflammation
Der er et sammenhæng mellem lavt selenindhold og septisk chok, et livstruende tilstand, hvor blodtrykket falder på grund af infektion og inflammation. Selen givet intravenøst synes at mindske dødeligheden hos patienter med systemisk inflammation, dvs. udbredt betændelse i hele kroppen.

 

Hjerte
Høj selenstatus beskytter mod hjertesygdom i store befolkningsundersøgelser, og tilskud sænker risikoen ved at forbedre andelen af fedt i blodet. Dette blev vist i den engelske forundersøgelse til Precise, hvor personer med normal (lavt) selenindtag deltog.

 

Kræft
Der er vist positive virkninger af tilskud på personer med et selenindhold i blodet på under 122 µg / L. En reanalyse foretaget fem år efter denne undersøgelses afslutning peger på at der måske kunne være en forøget risiko for at udvikle hudkræft hos personer med et selenindhold i blodet højere end 122 µg/L, men det er spekulativt.

 

Forslag til hvorfor selen ikke viste gavnlig effekt i SELECT-forsøget på prostatakræft

  • Deltagerne havde i forvejen høje selenværdier i blodet (USA)
  • Meget få rygere deltog: Nogle af de bedste effekter af selen er set på rygere og hos dem med de laveste selenværdier (Clark 1996)
  • Der blev ikke fundet ret mange med prostatakræft i hverken selen- eller placebogruppen, hvilket gør det svært at påvirke prostatakræft i første omgang
  • Der blev ikke brugt selengær, men selenmethionin. (Clark brugte selengær med dets indhold af forskellige organiske selenforbindelser)

 

Blodsukker / Diabetes
Resultaterne har være blandet i store befolkningsundersøgelser. Dyreforsøg har vist, at både meget lave og meget høje selenværdier øger blodsukkeret.

Professor Raymans samlede gennemgang af selenforskningen peger på en tærskelværdi for blodets selenindhold på 122 µg/L som markerer henholdsvis positive eller muligt negative virkninger af at tage selentilskud.

Personer med selen-værdier på under 122 µg/L i blodet vil have gavn af at øge værdien til 130-150 µg/L. Derimod vil personer med værdier over 122 µg/L i blodet næppe have gavn af selentilskud. At det skulle have negative virkninger for helbredet er imidlertid en hypotese, som kun yderligere forskning vil kunne be- eller afkræfte.

 

Selentabletten stadig gavnlig
Hvis for eksempel en typisk person fra Europa (England) supplerer med en tablet 100 mikrogram SelenoPrecise vil blodets selenniveau stige fra omkring 90 op til 140 µg / L, hvilket netop er det attraktive område at ligge i.

 

Sammenfatning
Raymans nye review viser at der ved lavt selenniveau (gælder stort set alle i Europa) er positive effekter ved tilskud med selen og at der ved meget højt selenniveau via kosten (fortrinsvis i USA) ikke kan forventes gavnlige effekter – førstnævnte er påvist videnskabeligt, mens sidstnævnte afventer endelig afklaring.

 

Ref
Rayman MP. Selenium and human health. The Lancet 2012; Feb.29. E-pub ahead of print.

 

Danske forhold
Danmarks Tekniske Universitet DTU revurderede i december 2011 hvor meget selen der maksimalt må være i kosttilskud. I øjeblikket må der være 125 µg, men det foreslås fremover hævet til 139 µg for voksne. De 139 µg er fremkommet med udgangspunkt i EFSAs øvre sikre grænser for selenindtag som er 200 µg for de 11-14 årige, 250 µg for de 15-17 årige og 300 µg for voksne. Herfra er så trukket kostens selenindhold som er 59 µg for kvinder, hvorfor deres maksimale tilskud burde være 241 µg, men da man vælger den laveste fællesnævner som er de 200 µg til de 11-14 årige fratrukket 61 µg fra kosten, ender resultatet på de 139 µg.

 

Fisk og selen
Det Europæiske Fødevaresikkerhedsagentur EFSA har for nylig gennemgået al dokumentation vedrørende selen i kosten – især i fisk – de skriver:

“Selen indtaget fra fisk havde ingen tilsyneladende virkning på mængden af den selen der indbygges i funktionelle selenoproteiner og effekten på blodets selenindhold var lavt.”
(Meltzer et al, 1993, Åkesson og Srikumar, 1994; Svensson et al, 1992; Huang et al. 1995)

 

 

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  • Hello, i think that i saw you visited my weblog thus i came to “return the favor”.I’m attempting to find things to improve my web site!I suppose its ok to use a few of your ideas!!

  • Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point. You clearly know what youre talking about, why waste your intelligence on just posting videos to your blog when you could be giving us something informative to read?

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