Keshan Disease By: Tyler Marshall

Keshan Disease It is a selenium deficiency It is an essential mineral, required in small amounts It is strictly environmental Selenium is incorporated into proteins to make selenoproteins (antioxidant enzymes) Selenoproteins are important antioxidants that help prevent cellular damage from free radicals Also helps regulate thyroid function and plays a role in the immune system

Background It is common in places such as China and Russia It derived from China where it was found in children and young women Although it can also occur in men Highest prevalence is boys under age 15 and women of childbearing age Not a problem in the United States If the soil where plants are grown and animals are raised contain low levels of selenium then the disease can develop

Background United States has areas with high levels of selenium in their soil such as Nebraska and the Dakota Food distribution through the country helps prevent low selenium intake Keshan Disease does still rarely occur At times when someone is being fed through a vein (IV line) for a long period of time RDA for males and females is 55 micrograms per day

Signs and Symptoms Fatigue Heart muscle weakness Diarrhea Vomiting Fever Body Pains Lethargy Arrhythmia Cardiac Insufficiency Heart Enlargement- which can lead to heart failure Loss of heart tissue

Treatment Aside from change in diet a selenium supplement can be taken Won’t reverse heart muscle damage once it occurs So monitor and treat early before damage occurs In China they treat the condition with astragalus which is a herb that accumulates selenium from the soil If necessary and even possible surgery can be performed to correct the heart condition Foods rich in selenium are Brazil nuts, fish, eggs, chicken breasts, and grains

Diet Meal Plan Breakfast Day 1 Selenium Day 2 Day 3 Egg Sandwich Amount in egg 15 Quaker puffed wheat cereal 67 Oatmeal and Toast on with whole wheat bread 15, 11 With Cheddar cheese 4 Toast with whole wheat bread 11 Black walnuts 5 With turkey 27 Glass of milk Cocoa: cocoa mix, with aspartame 23 Glass of Milk Total: 46 78 54 Selenium measured in micrograms

Lunch Meal Day 1 Selenium Day 2 Day 3 Turkey sandwich Amount of Turkey: 27 Tuna sandwich Amount of light canned tuna: 68 With cheddar cheese 4 Side of shrimp 44.91 With spinach and whole wheat bread 2.70, 11 Side of asparagus 3.08 Glass of apple juice Total: 44.70 115.99 Selenium measured in micrograms

Dinner Meal Day 1 Selenium Day 2 Day 3 Brown Rice 10 Ground beef manwich 18 Macaroni and cheese with chicken Amount in macaroni : 19 Chicken breast 24 With mushrooms 36.85 Cheddar cheese and Cut chicken breast 4, 24 Glass of water Total: 34 54.85 47 Daily Totals 124.70 248.84 145.70 Selenium measured in micrograms

Questions Why is Keshan disease only common in certain areas of the world? The soil in these areas have low levels of selenium Besides changing your diet how can Keshan disease be treated? A selenium supplement can be taken or if it’s possible and necessary surgery can be performed. True or False: Selenium deficiency is a common problem in the United States? False

Resources http://flipper.diff.org/app/items/info/3393 Keshan diesease and selenium; Degidio; Health World December 1996 Absorption, distribution and excretion of selenium from beef and rice in healthy North American men1, 2; Hawkes, Chris, Alkan, Zeynep, Oehler, and Lynn; The Journal of Nutrition November 2003 Foods And Nutrition Encyclopedia 2nd Edition; Ensminger A., Ensminger M.E., Konlande, and Robson http://www.nlm.nih.gov/medlineplus/ency/article/002414.htm http://ods.od.nih.gov/factsheets/selenium?print=1