Intersection between Obesity, Dietary Selenium, and Statin Therapy in Brazil

Abstract

Obesity is among the most alarming health concerns, impacting public health and causing a socioeconomic challenge, especially in developing countries like Brazil, where approximately one quart of the population presents obesity. As an established risk factor for numerous comorbidities with a multifactorial etiology, obesity is a consequence of energy-dense overfeeding, however with significant undernourishment, leading to excessive adipose tissue accumulation and dysfunction, dyslipidemia, and micronutrient deficiencies. About 60% of patients with obesity take statins, a cholesterol-lowering medication, to curb dyslipidemia, with ~10% of these patients presenting various myopathies as side effects. Statins act upon the rate-limiting enzyme of cholesterol biosynthesis in the liver, which is a pathway providing intermediates to the synthesis of selenoproteins, i.e., enzymes containing the micronutrient selenium. Statins have been postulated to negatively impact selenoprotein synthesis, particularly in conditions of selenium deficiency, and potentially implicated in the myopathies occurring as side effects of statins. The Brazilian population is prone to selenium deficiency, hence could be considered more susceptible to statin side effects. This review examines the specific consequences to the Brazilian population of the harmful intersection between obesity development and concomitant micronutrient deficiencies, particularly selenium, combined with statin treatment in the context of nutrition in Brazil.

Effects of Regular Brazil Nut (Bertholletia excelsa H.B.K.) Consumption on Health: A Systematic Review of Clinical Trials

“…Statins inhibit cholesterol synthesis via the mevalonate pathway, an important pathway for selenoprotein synthesis. Therefore, subjects who use statins are at an increased risk of developing Se deficiency and oxidative stress [ 56 , 57 ]. BN is a source of Se and may help maintain the nutritional status and oxidative balance of Se in patients using statins.…”

Challenging Aspects to Precise Health Strategies in Native Hawaiian and Other Pacific Islanders Using Statins

“…Dyslipidemia is a powerful and prevalent risk factor for the development and progression of atherosclerosis and CVD ( 2 , 20 ). Typical dyslipidemia consists of increased triglycerides (TG) and free fatty acids, decreased high-density lipoprotein cholesterol (HDL), and normal or slightly increased low-density lipoprotein cholesterol (LDL) ( 6 ). Recently, Sun et al ( 11 ), studying traits for which the Native Hawaiians exhibit excess risk, observed that 2,239 individuals (56.8%) presented hyperlipidemia (or dyslipidemia), in which 657 individuals were undiagnosed.…”

“…Thus, studies and current guidelines have focused on aggressive LDL-C lowering with a statin in both primary and secondary intervention settings ( 2 , 4 , 5 ). Nevertheless, significant side effects, such as muscle disorders, have been associated with statin use ( 6 ). The occurrence of statin side effects varies among different ethnic groups and is associated with individual intrinsic factors or external aspects ( 7 ).…”

Selenium Supplementation during Puberty and Young Adulthood Mitigates Obesity-Induced Metabolic, Cellular and Epigenetic Alterations in Male Rat Physiology

“…Obesity is among the most alarming global public health problems [1]. It is associated with premature mortality and increases the burden of non-communicable diseases [2]. Importantly, in men, obesity is also linked to deregulation of reproductive physiology [3].…”