A new study suggests that taking selenium in supplement form is associated with an increased risk of developing type 2 diabetes. The important element of this study is that people were actually randomly assigned to selenium supplementation or placebo condition. Participants were given 200 ug per day of selenium (in addition to the selenium they got from foods and "other sources"). This means that there is a possibility that this study is showing us "cause and effect" rather than correlational studies (seen often with nutrition and human health) that merely show an association. Although the primary outcome of this study was prevention of skin cancer, the rate of occurrence for type 2 diabetes was sufficiently strong enough to merit a stand-alone publication. Both the original article and accompanying editorial are available for free online (The editorial gets into some hairy nutritional biochem, but is pretty clear on possible mechanisms). The same group has shown previously that selenium supplements are ineffectual in the prevention of cardiovascular disease.
What you need to know
First, selenium deficiency is very rare in this country, we get plenty from our food supply. Selenium has what is known as a very narrow therapeutic index--meaning the difference between the amount we need and the amount that is known to cause harm is very small. An upper limit of 400 micrograms a day has been set by the Institute of Medicine to reduce the risk of selenium toxicity. (Read more about Selenium.)
There have been many, many studies looking at different forms of vitamin supplementation, including B vitamins, vitamin E, selenium, and beta-carotine, and disease prevention. Most of these studies, however, show absolutely no effect on health at best, and a few show increased risk for health problems.
Meanwhile food and supplement companies are tripping over themselves to bring you, the eager consumer, functional foods.
This should concern you. It really should. When you factor in fortification of breakfast cereals that give you 100% of everything in the world, taking a daily multivitamin (you know, for "insurance"), and then throw in a meal replacement bar (fortified) and a few "Smart" or "Energy" beverages and you are positively over the limit for some micronutrients. Some, like selenium, may be bad for you even if you have "high-normal" levels. The trend of fortifying foods is only going to increase--because consumers demand it, and because it lets food companies incur massive profits.
I'm not saying you can't take a Centrum and eat Total cereal with a glucosamine-B vitamin-orange juice chaser (no, I didn't make that up)--but you may want to think about what you're really getting. It may be too much.
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