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Effects of Dietary Factors on Selenium Levels of Children to Prevent Kashin–Beck Disease During a High-Prevalence Period in an Endemic Area: a Cohort Study

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Abstract

Selenium (Se) supplements have been used to control Kashin–Beck disease (KBD) for decades, but the effect of diet without Se supplements is unclear because the prevalence of KBD has decreased. This matched cohort study was undertaken to determine dietary factors affecting selenium nutrition status of children living in KBD areas and the effects of Se supplements in preventing KBD. A total of 593 children aged 5–12 years were randomly selected during the high prevalence period of KBD from 1992 to 1995. Children in one village received Se supplemented (Se+) salt and were matched with three children in 16 other villages who did not receive Se supplemented (Se−) salt. A questionnaire and determinations of occipital hair Se to reflect body Se status were obtained at baseline (April 1992), at 6 months (October 1992), and yearly each April through 1995. Hair Se content in the Se+ group was significantly higher than in the Se− group (P < 0.001) at all time-points and was significantly related to the incidence of suspected KBD symptoms (P = 0.018). Four dietary factors significantly affected hair Se contents. Se levels were increased by consumption of Se+ salt (P < 0.001) and eating meat/egg often (P = 0.019) or occasionally (P = 0.001). Se levels were decreased by consumption of grain mildewed at harvest or in storage (P < 0.001 for each) and drinking ditch, river, or cellar water (P < 0.001; P = 0.002; P < 0.001, respectively). These results show that Se+ salt had a significant effect in maintaining the Se nutrition status of children in this cohort study but that dietary factors in those without Se supplements contributed as well.

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Acknowledgments

We appreciate the Bin and Yongshou CDC for their outstanding support in the collection of hair samples. We are also grateful to Dexiu Ding, Shiyan Zhang, Zhilun Wang, Xiwang Tan, Jianjun Zhang, Huayin Bi, Xiaoyan Mo, Sichun Li, Xue Li, and Dong Geng for their best work of questionnaire enquiry; Zhidao Yu and Fengshi Chen for the determinations of hair Se content; and Jiuxing Wang for collecting X-ray images of the children’s right hands. This work was supported in part by the National Natural Scientific Foundation of China (30972556), the“13115” major program of the Technology Science Innovation Project of Shann’xi Province (2009ZDKG-79), and a grant from the Medical Program of the Eighth-Five National Plan for Science and Technology in China (85-917-01-02).

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Authors and Affiliations

  1. Key Laboratory of Environment and Genes Related to Diseases, Medical College of Xi’an Jiaotong University, No. 76 Yan Ta West Road, Xi’an, Shaanxi, 710061, China

    Y. J. Ning, X. Wang & X. Guo

  2. Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University College of Medicine, Xi’an, Shaanxi, China

    L. Ren

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  1. Y. J. Ning
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Correspondence to X. Guo.

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Ning, Y.J., Wang, X., Ren, L. et al. Effects of Dietary Factors on Selenium Levels of Children to Prevent Kashin–Beck Disease During a High-Prevalence Period in an Endemic Area: a Cohort Study. Biol Trace Elem Res 153, 58–68 (2013). https://doi.org/10.1007/s12011-013-9651-6

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