Chinese government programs to supplement people's diets with selenium in the 1970s greatly reduced cases of Keshan disease, according to the National Institutes of Health's Office of Dietary Supplements. Selenium deficiencies in the Keshan region in northeast China were severe enough to spur a form of heart disease called cardiomyopathy, now called Keshan's disease. Soil in some areas of China and Russia is naturally low in selenium. Soil in Nebraska, South Dakota and North Dakota is especially rich in selenium, and people living in these areas typically have the highest dietary intake of selenium in the United States, according to the 2014 Harvard Health publication "The Truth About Vitamins and Minerals." The higher the concentration of selenium in soil, the higher the concentration of selenium in crops. Soil around the world varies in its selenium concentration.
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