Vitamin D insufficiency in Greenlanders on a westernized fare: ethnic differences in calcitropic hormones between Greenlanders and Danes.

We studied the influence of age, gender, latitude, season, diet and ethnicity on plasma 25-hydroxyvitamin D 25 OHD, PTH, 1,25-dihydroxyvitamin D, vitamin D-binding protein, bone-specific alkaline phosphatase, and osteocalcin levels in 46 Greenlanders living in Nuuk (64 degrees N) on a traditional fare (group A), 45 Greenlanders living in Nuuk on a westernized fare (group B), 54 Greenlanders (group C), and 43 Danes (Group D) living in Denmark (55 degrees N) on a westernized fare. Blood specimens were drawn both summer and winter. Vitamin D insufficiency (plasma 25 OHD <40 nmol/l) was common in all four study groups during summer (23-74%) and winter (42-81%). Compared to groups A and D, vitamin D insufficiency was significantly more frequent in groups B and C. In all groups, summer levels of 25 OHD were above winter levels. Multiple regression analysis revealed a significant effect of ethnicity. Compared to Danes, Greenlanders had higher 1,25-dihydroxyvitamin D levels, but lower 25 OHD and PTH levels despite relatively low plasma calcium concentrations. In addition to ethnicity, 25(OH)D levels were influenced by age, season (summer > winter), and diet (a traditional Inuit diet>westernized diet). Ethnic differences exist between Greenlanders and Danes. Our results suggest that Greenlanders may have an inherent lower "set-point" for calcium-regulated PTH release or an enhanced renal 1,25(OH)(2)D production. In addition to ethnicity, age, season, and diet were important determinants of vitamin D status. Changes from a traditional to a westernized fare are associated with a reduced vitamin D status in Greenlanders. Vitamin D supplementation should be considered.

Modulation of atherosclerotic risk factors by seal oil: a preliminary assessment.

We examined whether dietary supplementation with seal oil influenced the risk factors of atherosclerosis in healthy volunteers. Two intervention studies were carried out as preliminary steps in a larger project which aim at elucidating the disease preventive potential of seal oil. In study I ten healthy volunteers added 10 capsules of seal oil to their normal Western diet for six weeks. Blood tests were analysed for total-, HDL-, and LDL-cholesterol and plasma triglyceride, and the ratio of n-6/n-3 fatty acid was determined in plasma and erythrocyte membranes. In study II we examined the effect in five healthy volunteers who had only 5 capsules of seal oil daily for six weeks. As an additional test in study II, the effect on the proinflammatory TNF-alpha cytokine in lymphocytes was determined. A slightly decreased, however, not significant effect was observed for each of the cholesterol's after seal oil supplementation. In both studies plasma triglyceride, and the n-6/n-3 fatty acid ratio of plasma and erythrocytes were significantly reduced upon seal oil intake. During the intervention period of study II a distinct reduced level of TNF-alpha was observed in isolated lymphocytes. The examinations suggest that supplementation of seal oil, 10 capsules or 5 capsules/day, may have beneficial effects on factors thought to be associated with cardiovascular and thrombotic diseases.

High serum coenzyme Q10, positively correlated with age, selenium and cholesterol, in Inuit of Greenland. A pilot study.

Greenlanders (Eskimos) have low prevalence of ischaemic heart disease, partly explained by a lower extent of atherosclerosis and a low n-6/n-3 ratio of polyunsaturated fatty acids. As atherosclerosis is also a result of oxidative stress, the total antioxidative readiness could have a substantial impact. From a health survey we chose the subpopulation from the most remote area, where the traditional Greenlandic diet with high intake of sea mammals and fish predominates. The mean (SD) of S-CoQ10 in males was 1.495 (0.529) nmol/ml and 1.421 (0.629) nmol/ml in females, significantly higher (p < 0.001) compared to a Danish population. In a linear multiple regression model the S-CoQ10 level is significantly positively associated with age and S-selenium in males, and S-total cholesterol in females. The high level of CoQ10 in Greenlanders probably reflects diet, since no bioaccumulation takes place, and it could probably be a substantial part of the antioxidative defense.

Selenium and fertility in animals and man--a review.

To evaluate the information on selenium with relation to fertility in animals and man the available literature was reviewed. Selenium is incorporated in the sperm mitochondria capsule and may thus affect the behavior and function of the spermazoon. Se seems to be essential for normal spermatozoa development in both experimental animals and in livestock and probably also in humans. Regarding selenium and female fertility only sparse information exists. In experimental animals a low selenium level affects fertility in males, but little attention has been devoted to female reproductive performance, and the data are insufficient for conclusion. In livestock numerous investigations have been performed and the effects of selenium supplementation often in combination with other antioxidants have been evaluated, but no valid conclusion can be drawn. In general adequate nutritional supply will secure optimal reproduction in both males and females, while additional supplementation seems to have a negative effect. In humans contradictive information is found. Both low and high sperm selenium concentrations are reported to have a negative influence on the number of spermatozoa and on the motility. The optimal sperm selenium concentration waits to be defined. Some evidence indicates that a metabolic defect in a selenium incorporation into sperm cells may be associated with human infertility. No human data relating selenium to female infertility were found.

The Inuit diet. Fatty acids and antioxidants, their role in ischemic heart disease, and exposure to organochlorines and heavy metals. An international study.

Traditional food is culturally, economically and nutritionally important for the Greenlandic Inuit people. In the 1970s the preventive effect of marine fat on cardiovascular disease, thrombosis and atherosclerosis was described. The low incidence of ischemic heart disease among Greenlanders has been related to the high intake of marine food. Since 1990 routine autopsies have taken place in two towns in Greenland, Nuuk and Ilulissat. The autopsies represent 26% of the total number of deaths in these two towns. Samples have been collected from 104 autopsies. International cooperative studies have analysed specimens in relation to ischemic heart disease as a benefit related to diet, as well as the level of heavy metals and organochlorine in organs as a risk related to diet. High amounts of mono-unsaturated and Omega-3 poly-unsaturated fatty acid were found in adipose tissue. Liver analyses of selenium have confirmed the expected high intake among Greenlanders. Reduced atherosclerotic lesions were found in the coronary arteries. Blood pressure levels calculated from renovascholopathia of hypertension indicate prevailing levels similar to those in industrialized countries. Some factors in Greenland may be protecting the coronary arteries, thereby of setting the expected effect of hypertension. The level of methyl mercury in organs is generally high. PCB concentrations found in organs of Greenlanders are higher than among other populations. Health and risk effects of the traditional foods need further investigation.

Fatty acids and antioxidants in the Inuit diet. Their role in ischemic heart disease (IHD) and possible interactions with other dietary factors. A review.

The recent literature on the role of fatty acids and antioxidants as protective factors in ischemic heart disease (IHD) has been reviewed. Serum cholesterol, especially LDL-cholesterol, is regarded as an index of risk for IHD. Epidemiological studies have connected a high dietary intake of n-3 fatty acids with a low occurrence of IHD. It is believed that this effect is brought about by a modification of the eicosanoid synthesis and a lowering of the cholesterol level. Intervention studies have not demonstrated that n-3 acids can lower the level whereas monounsaturated fatty acids (MUFAs) have been shown to have such an effect although they were previously believed to be neutral. The epidemiological observations probably reflect the combined effect of both n-3 polyunsaturated fatty acids (PUFAs) and MUFAs. Recently, oxidized LDL has been suggested to be involved in the earliest lesion of atherogenesis. This hypothesis suggest that the antioxidant balance is an important factor for IHD. As the traditional Greenlandic diet is rich in n-3 PUFAs, MUFAs and antioxidants (selenium), epidemiological studies in Greenland could shed important light on the role of individual dietary components and their interactions.

Glutathione redox cycle enzymes and selenium in severe rheumatoid arthritis: lack of antioxidative response to selenium supplementation in polymorphonuclear leucocytes.

The antioxidant capacity of the glutathione redox cycle and the concentrations of selenium in serum, red blood cells or whole blood, and polymorphonuclear leucocytes was evaluated in nine patients with severe rheumatoid arthritis (RA) and eight healthy controls receiving daily supplementation with 250 micrograms selenomethionine for six months. Serum and whole blood concentrations of selenium and the activity of the selenium dependent enzyme glutathione peroxidase (GSH-Px) were low in the serum, red blood cells, and polymorphonuclear leucocytes of patients with RA before selenium supplementation. During supplementation serum and whole blood concentrations of selenium and the activity of GSH-Px in serum and red blood cells of patients with RA and serum GSH-Px in controls increased. Selenium and GSH-Px in polymorphonuclear leucocytes were unaffected in patients with RA in contrast with the controls where both were augmented. Glutathione reductase activity in the red blood cells and polymorphonuclear leucocytes of patients with RA was low but increased during selenium supplementation. Whole blood concentrations of glutathione were slightly lower in patients with RA than controls and no difference in the content in polymorphonuclear leucocytes was found between the groups. The activity in red blood cells of glucose-6-phosphate dehydrogenase was high in patients with RA, indicating sufficient function of the hexose monophosphate pathway. The reduced antioxidant activity of the glutathione redox cycle in patients with severe RA was mainly due to the low availability of selenium. This was further supported by the response to selenium supplementation in serum and red blood cells. In the polymorphonuclear leucocytes, however, no biochemical effects of selenium supplementation were seen. This lack of antioxidative response could play a pathogenetic part in inflammation in patients with RA.

High dose antioxidant supplementation to MS patients. Effects on glutathione peroxidase, clinical safety, and absorption of selenium.

High-dose antioxidant supplementation has recently been recommended for multiple sclerosis (MS) patients. This study tests the clinical safety, the glutathione peroxidase (GSH-px) activity, and the absorption of selenium during such supplementation. Eighteen MS patients were given 6 tablets especially made for this study, equivalent to 6 mg sodium selenite, 2 g vitamin C, and 480 mg vitamin E a day for five wk. GSH-px, which was lower than in non-MS controls before the start of treatment, increased fivefold during 5 wk of treatment. Side effects were scarce. Ten MS patients were subjected to a 24-h selenium absorption study after ingestion of 2 active tablets, equivalent to 2 mg sodium selenite. Selenium, which was low initially, increased 24% during the first 3 h and then stabilized. It is concluded that the tested antioxidant treatment seems to be safe and that MS patients have low GSH-px, which may be increased by the tested antioxidant treatment.

Selenium in rheumatoid arthritis. A historical prospective approach.

Time-dependent changes in serum selenium concentrations were studied in 28 patients with rheumatoid arthritis and the concentrations were related to disease activity. The mean length of the observation period was 7.3 years and a mean of 6 analyses was performed for each patient. Serum selenium fluctuated with disease activity in most patients and a relatively low concentration was recorded in periods of high disease activity. Gold treatment had no influence on the selenium concentrations and selenium levels measured within the first year of the disease were not demonstrated to have any prognostic significance.

Has selenium a beneficial role in human exposure to inorganic mercury?

Laboratory experiments have indicated that selenium acts as a powerful antagonist to mercury intoxication. The literature is reviewed and from this it is concluded that mercury and selenium react in various ways. 1) The mercuric ion binds to selenium to form a biologically inert complex leading to increased body burden of both elements. This reaction seems to take place only when a threshold of mercury exposure is exceeded. 2) Selenium influences the oxidation rate of elemental mercury and as such the distribution pattern. This reaction is influenced by the nature of the antioxidative system. In species with low glutathione peroxidase activity, mercury oxidation seems decreased which can lead to an increased brain uptake. In this process there is no threshold. 3) Selenium can, as part of the antioxidative defence system, counteract mercury induced lipid peroxidation. Other antioxidants e.g. vitamin E might be just as effective. Based upon the literature it is hypothesised that to man selenium is of no benefit in cases of exposure to mercury either as mercuric mercury or as vapours. The only protection against mercury will still be a low exposure level.

Glutathione peroxidase activity in patients with rheumatoid arthritis and in normal subjects: effects of long-term selenium supplementation.

The effects of dietary supplementation with selenium were studied in 6 patients with severe, active rheumatoid arthritis (RA) and in 6 healthy control subjects. Initial concentrations of Se in red blood cells and in serum, and the activity of the Se-dependent enzyme glutathione peroxidase (GSH-Px) in red blood cells, serum, and granulocytes were significantly lower in RA patients compared with controls. During Se supplementation, however, the differences in Se levels and in GSH-Px activity between the 2 groups disappeared, except that, in RA patients, GSH-Px activity in granulocytes increased but remained significantly lower than in controls.