Cardiovascular Disease

Recall from Chapter 5 "Lipids" that low-density lipoproteins (LDLs) transport cholesterol and other lipids from the liver to the rest of the body. LDLs are often referred to as “bad cholesterol,” as an elevation in their levels in the blood is a risk factor for cardiovascular disease. Oxidation of the lipids and proteins in LDLs causes them to stick to the walls of arteries and this contributes to the development of fatty streaks and, eventually, plaque, which hardens the arteries. Hardening of the arteries, called atherosclerosisA progressive hardening of the arteries that can lead to a heart attack. can lead to a heart attack.

Vitamin E reduces the oxidation of LDLs, and it was therefore hypothesized that vitamin E supplements would protect against atherosclerosis. However, large clinical trials have not consistently found evidence to support this hypothesis. In fact, in the “Women’s Angiographic Vitamin and Estrogen Study,” postmenopausal women who took 400 international units (264 milligrams) of vitamin E and 500 milligrams of vitamin C twice per day had higher death rates from all causes.Waters, D.D. et al. “Effects of Hormone Replacement Therapy and Antioxidant Vitamin Supplements on Coronary Atherosclerosis in Postmenopausal Women: A Randomized Controlled Trial.” JAMA 288, no. 19 (2002): 2432–40. doi: 10.1001/jama.288.19.2432

Other studies have not confirmed the association between increased vitamin E intake from supplements and increased mortality. There is more consistent evidence from observational studies that a higher intake of vitamin E from foods is linked to a decreased risk of dying from a heart attack.

Cancer

The large clinical trials that evaluated whether there was a link between vitamin E and cardiovascular disease risk also looked at cancer risk. These trials, called the HOPE-TOO Trial and Women’s Health Study, did not find that vitamin E at doses of 400 international units (264 milligrams) per day or 600 international units (396 milligrams) every other day reduced the risk of developing any form of cancer.HOPE and HOPE-TOO Trial Investigators. “Effects of Long-Term Vitamin E Supplementation on Cardiovascular Events and Cancer.” JAMA 293 (2005):1338–47. http://jama.ama-assn.org/content/293/11/1338.long.^, Lee, I-M., et al. “Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer: The Women’s Health Study.” JAMA 294 (2005): 56–65. http://jama.ama-assn.org/content/294/1/56.long.

Eye Conditions

Oxidative stress plays a role in age-related loss of vision, called macular degeneration. Age-related macular degeneration (AMD)The progressive loss of central vision resulting from damage to the center of the retina, referred to as the macula. primarily occurs in people over age fifty and is the progressive loss of central vision resulting from damage to the center of the retina, referred to as the macula. There are two forms of AMD, dry and wet, with wet being the more severe form.

In the dry form, deposits form in the macula; the deposits may or may not directly impair vision, at least in the early stages of the disease. In the wet form, abnormal blood vessel growth in the macula causes vision loss. Clinical trials evaluating the effects of vitamin E supplements on AMD and cataracts (clouding of the lens of an eye) did not consistently observe a decreased risk for either. However, scientists do believe vitamin E in combination with other antioxidants such as zinc and copper may slow the progression of macular degeneration in people with early-stage disease.

Dementia

The brain’s high glucose consumption makes it more vulnerable than other organs to oxidative stress. Oxidative stress has been implicated as a major contributing factor to dementia and Alzheimer’s disease. Some studies suggest vitamin E supplements delay the progression of Alzheimer’s disease and cognitive decline, but again, not all of the studies confirm the relationship. A recent study with over five thousand participants published in the July 2010 issue of the Archives of Neurology demonstrated that people with the highest intakes of dietary vitamin E were 25 percent less likely to develop dementia than those with the lowest intakes of vitamin E.Devore, E. E. et al. “Dietary Antioxidants and Long-Term Risk of Dementia.” Arch Neurol 67, no.7 (2010): 819–25. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923546/?tool=pubmed. More studies are needed to better assess the dose and dietary requirements of vitamin E and, for that matter, whether other antioxidants lower the risk of dementia, a disease that not only devestates the mind, but also puts a substantial burden on loved ones, caretakers, and society in general.

Dietary Reference Intakes for Vitamin E

The Recommended Dietary Allowances (RDAs) and Tolerable Upper Intake Levels (ULs) for different age groups for vitamin E are given in Table 8.2 "Dietary Reference Intakes for Vitamin E". The RDAs are based on scientific evidence that these levels of vitamin E in the diet prevent conditions associated with vitamin E deficiency, which are rare (signs and symptoms of such conditions are not always evident) but are primarily the result of nerve degeneration. People with malabsorption disorders, such as Crohn’s disease or cystic fibrosis, and babies born prematurely, are at higher risk for vitamin E deficiency.

Fat in the diet is required for vitamin E absorption as it is packaged into lipid-rich chylomicrons in intestinal cells and transported to the liver. The liver stores some of the vitamin E or packages it into lipoproteins, which deliver it to cells.

Vitamin E supplements often contain more than 400 international units, which is almost twenty times the RDA. The UL for vitamin E is set at 1,500 international units for adults. There is some evidence that taking vitamin E supplements at high doses has negative effects on health. As mentioned, vitamin E inhibits blood clotting and a few clinical trials have found that people taking vitamin E supplements have an increased risk of stroke. In contrast to vitamin E from supplements, there is no evidence that consuming foods containing vitamin E compromises health.

Dietary Sources of Vitamin E

Add some nuts to your salad and make your own dressing to get a healthy dietary dose of vitamin E.

© Thinkstock

Vitamin E is found in many foods, especially those higher in fat, such as nuts and oils. Some spices, such as paprika and red chili pepper, and herbs, such as oregano, basil, cumin, and thyme, also contain vitamin E. (Keep in mind spices and herbs are commonly used in small amounts in cooking and therefore are a lesser source of dietary vitamin E.) See Table 8.3 "Vitamin E Content of Various Foods" for a list of foods and their vitamin E contents.

Cardiovascular Disease

Vitamin C’s ability to prevent disease has been debated for many years. Overall, higher dietary intakes of vitamin C (via food intake, not supplements), are linked to decreased disease risk. A review of multiple studies published in the April 2009 issue of the Archives of Internal Medicine concludes there is moderate scientific evidence supporting the idea that higher dietary vitamin C intakes are correlated with reduced cardiovascular disease risk, but there is insufficient evidence to conclude that taking vitamin C supplements influences cardiovascular disease risk.Mente, A., et al. “A Systematic Review of the Evidence Supporting a Causal Link between Dietary Factors and Coronary Heart Disease.” Arch Intern Med 169, no.7 (2009): 659–69. http://archinte.ama-assn.org/cgi/content/full/169/7/659.

Vitamin C levels in the body have been shown to correlate well with fruit and vegetable intake, and higher plasma vitamin C levels are linked to reduced risk of some chronic diseases. In a study involving over twenty thousand participants, people with the highest levels of circulating vitamin C had a 42 percent decreased risk for having a stroke.Myint, P.K. et al. “Plasma Vitamin C Concentrations Predict Risk of Incident Stroke Over 10 Y[ears] in 20,649 Participants of the European Prospective Investigation into Cancer, Norfolk Prospective Population Study.” Am J Clin Nutr 87, no.1 (2008): 64–69. http://www.ajcn.org/content/87/1/64.long.

Cancer

There is some evidence that a higher vitamin C intake is linked to a reduced risk of cancers of the mouth, throat, esophagus, stomach, colon, and lung, but not all studies confirm this is true. As with the studies on cardiovascular disease, the reduced risk of cancer is the result of eating foods rich in vitamin C, such as fruits and vegetables, not from taking vitamin C supplements. In these studies, the specific protective effects of vitamin C cannot be separated from the many other beneficial chemicals in fruits and vegetables.

Immunity

Vitamin C does have several roles in the immune system, and many people increase vitamin C intake either from diet or supplements when they have a cold. Many others take vitamin C supplements routinely to prevent colds. Contrary to this popular practice, however, there is no good evidence that vitamin C prevents a cold. A review of more than fifty years of studies published in 2004 in the Cochrane Database of Systematic Reviews concludes that taking vitamin C routinely does not prevent colds in most people, but it does slightly reduce cold severity and duration. Moreover, taking megadoses (up to 4 grams per day) at the onset of a cold provides no benefits.Douglas, R.M. et al. “Vitamin C for Preventing and Treating the Common Cold.” Cochrane Database of Systematic Reviews 4 (2004): CD000980. http://www.ncbi.nlm.nih.gov/pubmed/15495002?dopt=Abstract.

Gout is a disease caused by elevated circulating levels of uric acid and is characterized by recurrent attacks of tender, hot, and painful joints. There is some evidence that a higher intake of vitamin C reduces the risk of gout.

Dietary Reference Intakes for Vitamin C

The classic condition associated with vitamin C deficiency is scurvy. The signs and symptoms of scurvy include skin disorders, bleeding gums, painful joints, weakness, depression, and increased susceptibility to infections. Scurvy is prevented by having an Adequate Intake of fruits and vegetables rich in vitamin C.

The RDAs and ULs for different age groups for vitamin C are listed in Table 8.4 "Dietary Reference Intakes for Vitamin C". They are considered adequate to prevent scurvy. Vitamin C’s effectiveness as a free radical scavenger motivated the Institute of Medicine (IOM) to increase the RDA for smokers by 35 milligrams, as tobacco smoke is an environmental and behavioral contributor to free radicals in the body.

High doses of vitamin C have been reported to cause numerous problems, but the only consistently shown side effects are gastrointestinal upset and diarrhea. To prevent these discomforts the IOM has set a UL for adults at 2,000 milligrams per day (greater than twenty times the RDA).

At very high doses in combination with iron, vitamin C has sometimes been found to increase oxidative stress, reaffirming that getting your antioxidants from foods is better than getting them from supplements, as that helps regulate your intake levels. There is some evidence that taking vitamin C supplements at high doses increases the likelihood of developing kidney stones, however, this effect is most often observed in people that already have multiple risk factors for kidney stones.

Dietary Sources of Vitamin C

Citrus fruits are great sources of vitamin C and so are many vegetables. In fact, British sailors in the past were often referred to as “limeys” as they carried sacks of limes onto ships to prevent scurvy. Vitamin C is not found in significant amounts in animal-based foods.

Because vitamin C is water soluble, it leaches away from foods considerably during cooking, freezing, thawing, and canning. Up to 50 percent of vitamin C can be boiled away. Therefore, to maximize vitamin C intake from foods, you should eat fruits and vegetables raw or lightly steamed. For the vitamin C content of various foods, see Table 8.5 "Vitamin C Content of Various Foods".

Vision

Retinol that is circulating in the blood is taken up by cells in the retina, where it is converted to retinal and is used as part of the pigment rhodopsin, which is involved in the eye’s ability to see under low light conditions. A deficiency in vitamin A thus results in less rhodopsin and a decrease in the detection of low-level light, a condition referred to as nightblindness.

Insufficient intake of dietary vitamin A over time can also cause complete vision loss. In fact, vitamin A deficiency is the number one cause of preventable blindness worldwide. Vitamin A not only supports the vision function of eyes but also maintains the coverings and linings of the eyes. Vitamin A deficiency can lead to the dysfunction of the linings and coverings of the eye, causing dryness of the eyes, a condition called xerophthalmia. This condition can progress, causing ulceration of the cornea and eventually blindness.

Immunity

The common occurrence of advanced xerophthalmia in children who died from infectious diseases led scientists to hypothesize that supplementing vitamin A in the diet for children with xerophthalmia might reduce disease-related mortality. In Asia in the late 1980s, targeted populations of children were administered vitamin A supplements, and the death rates from measles and diarrhea declined by up to 50 percent. Vitamin A supplementation in these deficient populations did not reduce the number of children who contracted these diseases, but it did decrease the severity of the diseases so that they were no longer fatal. Soon after the results of these studies were communicated to the rest of the world, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) commenced worldwide campaigns against vitamin A deficiency. UNICEF estimates that the distribution of over half a billion vitamin A capsules prevents 350,000 childhood deaths annually.Sommer, A. “Vitamin A Deficiency and Clinical Disease: An Historical Overview.” J Nutr 138 (2008):1835–39. http://jn.nutrition.org/content/138/10/1835.long.

In the twenty-first century, science has demonstrated that vitamin A greatly affects the immune system. What we are still lacking are clinical trials investigating the proper doses of vitamin A required to help ward off infectious disease and how large of an effect vitamin A supplementation has on populations that are not deficient in this vitamin. This brings up one of our common themes in this text—micronutrient deficiencies may contribute to the development, progression, and severity of a disease, but this does not mean that an increased intake of these micronutrients will solely prevent or cure disease. The effect, as usual, is cumulative and depends on the diet as a whole, among other things.

Growth and Development

Vitamin A acts similarly to some hormones in that it is able to change the amount of proteins in cells by interacting with DNA. This is the primary way that vitamin A affects growth and development. Vitamin A deficiency in children is linked to growth retardation; however, vitamin A deficiency is often accompanied by protein malnutrition and iron deficiency, thereby confounding the investigation of vitamin A’s specific effects on growth and development.

In the fetal stages of life, vitamin A is important for limb, heart, eye, and ear development and in both deficiency and excess, vitamin A causes birth defects. Furthermore, both males and females require vitamin A in the diet to effectively reproduce.

Cancer

Vitamin A’s role in regulating cell growth and death, especially in tissues that line and cover organs, suggests it may be effective in treating certain cancers of the lung, neck, and liver. It has been shown in some observational studies that vitamin A-deficient populations have a higher risk for some cancers. However, vitamin A supplements have actually been found to increase the risk of lung cancer in people who are at high risk for the disease (i.e., smokers, exsmokers, workers exposed to asbestos). The Beta-Carotene and Retinol Efficacy Trial (CARET) involving over eighteen thousand participants who were at high risk for lung cancer found that people who took supplements containing very high doses of vitamin A (25,000 international units) and beta-carotene had a 28 percent higher incidence of lung cancer midway through the study, which was consequently stopped.Goodman, G.E. et al. “The Beta-Carotene and Retinol Efficacy Trial: Incidence of Lung Cancer and Cardiovascular Disease Mortality During 6-year Follow-up after Stopping Beta-Carotene and Retinol Supplements.” J Natl Cancer Inst 96, no. 23 (2004): 1743–50. http://jnci.oxfordjournals.org/content/96/23/1743.long.

Vitamin A supplementation is a relatively common practice in treating some types of cancer patients and is thought to improve the effectiveness of some anticancer drugs, but many oncologists (physicians who treat cancer patients) do not recommend this practice as vitamin A may actually inhibit the actions of some anticancer drugs.

Vitamin A Toxicity

Vitamin A toxicity, or hypervitaminosis A, is rare. Typically it requires you to ingest ten times the RDA of preformed vitamin A in the form of supplements (it would be hard to consume such high levels from a regular diet) for a substantial amount of time, although some people may be more susceptible to vitamin A toxicity at lower doses. The signs and symptoms of vitamin A toxicity include dry, itchy skin, loss of appetite, swelling of the brain, and joint pain. In severe cases, vitamin A toxicity may cause liver damage and coma.

Vitamin A is essential during pregnancy, but doses above 3,000 micrograms per day (10,000 international units) have been linked to an increased incidence of birth defects. Pregnant women should check the amount of vitamin A contained in any prenatal or pregnancy multivitamin she is taking to assure the amount is below the UL.

Dietary Reference Intakes for Vitamin A

There is more than one source of vitamin A in the diet. There is preformed vitamin A, which is abundant in many animal-derived foods, and there are carotenoids, which are found in high concentrations in vibrantly colored fruits and vegetables and some oils.

Some carotenoids are converted to retinol in the body by intestinal cells and liver cells. However, only miniscule amounts of certain carotenoids are converted to retinol, meaning fruits and vegetables are not necessarily good sources of vitamin A. Beta-carotene dissolved in oil is more readily converted to retinol; one-half of a microgram of beta-carotene is converted to retinol. Overall, the carotenoids do not have the same biological potency of preformed vitamin A, but as you will soon find out, they have other attributes that influence health, most notably their antioxidant activity.

The RDA for vitamin A includes all sources of vitamin A. The amount of vitamin A obtained from carotenoids—the retinol activity equivalent (RAE)—can be calculated. For example, 12 micrograms of fruit- or vegetable-based beta-carotene will yield 1 microgram of retinol, as mentioned.

The RDA for vitamin A is considered sufficient to support growth and development, reproduction, vision, and immune system function while maintaining adequate stores (good for four months) in the liver.

Dietary Sources of Vitamin A

Preformed vitamin A is found only in foods from animals, with the liver being the richest source because that’s where vitamin A is stored (see Table 8.7 "Vitamin A Content of Various Foods"). The dietary sources of carotenoids will be given in the following text.

Eye Conditions

Lutein, found in green leafy vegetables, and zeaxanthin, found in peppers, corn, and saffron, act as antioxidants in the retina of the eye and protect it from ultraviolet light damage. Diets high in these carotenoids are associated with a decreased risk of AMD, and there is good evidence that supplements containing these carotenoids also provide vision benefits. A review published in the August 2010 issue of Current Medical Research and Opinion concludes that supplementation with lutein and zeaxanthin reduces the incidence of AMD and cataracts.Barker II, F. M. “Dietary Supplementation: Effects on Visual Performance and Occurrence of AMD and Cataracts.” Curr Med Res Opin 26, no. 8 (2010): 2011–23. http://informahealthcare.com/doi/abs/10.1185/03007995.2010.494549.

The data that supports that beta-carotene supplementation may delay the progression of AMD is more convincing when beta-carotene is taken in combination with other micronutrients. The Age-Related Eye Disease Study found that a supplement containing 500 milligrams of vitamin C, 400 international units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc oxide, and 2 milligrams of copper as cupric oxide reduced the risk of progressing to advanced stages of AMD by 25 percent.Age-Related Eye Disease Study Research Group. “A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation with Vitamins C and E, Beta-Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss.” Arch Ophthalmol 119, no. 10 (2001): 1417–36. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1462955/. This study did not find that the formulated supplement significantly prevented the onset of disease, only that it delayed its progression specifically in people with intermediate or advanced stage AMD. Studies are ongoing to determine if other antioxidant combinations actually protect against developing AMD at all.

Cardiovascular Disease

While some studies do associate a decreased risk for atherosclerosis with higher dietary intake of carotenoids, others do not. There is a large number of studies that show total carotenoid intake is associated with improvement in blood vessel function. A smaller number of studies show that intake of specific carotenoids, such as lycopene and alpha-carotene, are also associated with improved blood vessel function. The main problems associated with linking carotenoids to a decrease in cardiovascular disease risk, or any other disease for that matter, are that they are present in foods containing many other beneficial plant chemicals, and trials evaluating the effects of specific carotenoids in the form of supplements provide inconsistent and sometimes contradictory results.

Cancer

A higher intake of some carotenoids, but not others, is linked to decreased risks for some cancers. A review of two large studies (> 120,000 men and women) published in the October 2000 issue of The American Journal of Clinical Nutrition reports that there is no significant association between beta-carotene intake and lung cancer risk, but men and women with the highest intakes of total carotenoids had a more than 30 percent risk reduction for developing lung cancer.Michaud, D.S. et al. “Intake of Specific Carotenoids and Risk of Lung Cancer in 2 Prospective US Cohorts.” Am J Clin Nutr 72, no. 4 (2000): 990–97. http://www.ajcn.org/content/72/4/990.long. Other large studies conducted in Europe have confirmed the inverse relationship of total dietary carotenoid intake with lung cancer risk. There is some evidence that diets rich in lycopene, which is present in high concentrations in tomatoes, is linked to decreased prostate cancer risk, but it is not known if it is lycopene specifically or some other component in tomatoes that protects against prostate cancer.

Flavonoids

Flavonoids are a large class of chemicals including anthocyanidins (found in red, blue, and purple berries), flavanols (found in teas, chocolate, berries, apples, yellow onions, kale, and broccoli), and isoflavones (found in soy products). Flavonoids are very effective free radical scavengers, and there is some evidence that higher intakes of flavonoid-rich foods and/or beverages reduce the risk of cardiovascular disease, but this has not been consistently observed. Although flavonoids have been shown to reduce the incidence of some tumors in animals, similar studies in humans have been inconclusive.

Organosulfur Compounds

These compounds are predominantly found in garlic, but can also be found in onions and leeks. It’s suspected that the higher intake of garlic is the aspect of the Mediterranean diet that contributes to a decreased risk of cardiovascular disease. Animal and laboratory studies suggest the organosulfur compounds in garlic reduce cholesterol, are anti-inflammatory, stimulate the synthesis of glutathione, and cause death of cancer cells. There is some evidence in humans that garlic reduces cholesterol, but more recent studies did not confirm that the effect was signficant or sustained. A higher intake of garlic likely inhibits blood clot formation in humans.

Observational studies suggest diets high in organosulfur compounds decrease the risk of gastric and colorectal cancer. For other cancers, the data is less consistent.

Lignans

Lignans are a group of chemical compounds obtained from many food sources, including grains, nuts, seeds, fruits, and vegetables, and especially flax seed. Some lignans are also called phytoestrogens as they can mimic or inhibit some of the actions of the hormone estrogen in the body.

The antiestrogenic effect of some lignans suggests they may be helpful in treating hormone-dependent cancers, such as breast and ovarian cancers. However, studies are few and conflicting on whether eating foods high in lignans reduces breast or ovarian cancer.

In regard to cardiovascular disease risk, diets rich in whole grains are protective, but it remains unclear whether it is the lignans in whole grains that are responsible for the reduced risk. Whole grains contain many other beneficial phytochemicals, micronutrients, and fiber.

Herbs and Spices

These are the aromatic parts of plants, such as the leaves, seeds, pods, and berries. They are an additional dietary source of phytochemicals, and many have exceptional antioxidant capacity.

Throughout the ages, people have used spices and herbs not only for adding flavor to foods, but also as medicines. Curcumin, the principal component of tumeric, has been used for over two thousand years in India to treat a variety of ailments. As of 2011, over seventy clinical trials are investigating the health benefits of curcumin, which may include reducing cancer risk and delaying the progression of Alzheimer’s disease.

You learned in the beginning of this chapter that nutmeg comes from the dried seed kernel of Myristica fragrans and has been used as an antimicrobial, antifungal, and anti-inflammatory agent, and as a pain reliever. In high doses nutmeg acts similar to a psychoactive drug in that it causes euphoria, delusions, and hallucinations. According to a study conducted on over 3,100 foods, beverages, spices, herbs, and supplements, the spices and herbs were the dietary sources most rich in antioxidants (see Note 8.20 "Interactive 8.3").

Tea

Drinking tea can enhance physiological, mental, and social aspects of health.

© Shutterstock

Tea is an aromatic beverage made from the dried parts of plants steeped in hot water. Its health benefits have been known for years, and as with coffee the benefits are not just physiological, but also mental and social. In folklore, teas are considered curatives of stomachache, diarrhea, and even the plague. In The Book of Tea, Okakura Kakuzo asserts that consuming a cup of tea provides “the adoration of the beautiful among the sordid facts of everyday existence.”Okakura Kakuzo. The Book of Tea. (Berlin, Germany: Dover Publications, 1964).

Teas can contain more than seven hundred different phytochemicals. Some of them may be beneficial and others may not be, as some reduce the dietary absorption of some micronutrients. The health claims of drinking tea—black, green, or red—number at least in the hundreds but remain mostly scientifically unsupported. There are a great number of studies showing that drinking tea is at least linked to a decreased risk of heart disease, cancer, and diabetes, but the exact phyotchemicals illiciting these health benefits are under intense scrutiny. Moreover, people who consume more tea are likely to drink fewer soft drinks and therefore, based on a “replacement theory,” have a reduced likelihood of having a chronic disease.

Dietary Reference Intakes for Selenium

The IOM has set the RDAs for selenium based on the amount required to maximize the activity of glutathione peroxidases found in blood plasma. The RDAs for different age groups are listed in Table 8.9 "Dietary Reference Intakes for Selenium".

Selenium at doses several thousand times the RDA can cause acute toxicity, and when ingested in gram quantities can be fatal. Chronic exposure to foods grown in soils containing high levels of selenium (significantly above the UL) can cause brittle hair and nails, gastrointestinal discomfort, skin rashes, halitosis, fatigue, and irritability. The IOM has set the UL for selenium for adults at 400 micrograms per day.

Dietary Sources of Selenium

Organ meats, muscle meats, and seafood have the highest selenium content. Plants do not require selenium, so the selenium content in fruits and vegetables is usually low. Animals fed grains from selenium-rich soils do contain some selenium. Grains and some nuts contain selenium when grown in selenium-containing soils. See Table 8.10 "Selenium Contents of Various Foods" for the selenium content of various foods.