Abstract
BackgroundExposure to aflatoxin, a mycotoxin produced by fungi that commonly contaminates cereal crops across sub-Saharan Africa, has been associated with impaired child growth. We investigated the impact of aflatoxin exposure on the growth of Gambian infants from birth to two years of age, and the impact on insulin-like growth factor (IGF)-axis proteins.MethodsA subsample (N = 374) of infants from the Early Nutrition and Immune Development (ENID) trial (ISRCTN49285450) were included in this study. Aflatoxin-albumin adducts (AF-alb) were measured in blood collected from infants at 6, 12 and 18 months of age. IGF-1 and IGFBP-3 were measured in blood collected at 12 and 18 months. Anthropometric measurements taken at 6, 12, 18 and 24 months of age were converted to z-scores against the WHO reference. The relationship between aflatoxin exposure and growth was analysed using multi-level modelling.ResultsInverse relationships were observed between lnAF-alb and length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) z-scores from 6 to 18 months of age (β = − 0·04, P = 0·015; β = − 0·05, P = 0.003; β = − 0·06, P = 0·007; respectively). There was an inverse relationship between lnAF-alb at 6 months and change in WLZ between 6 and 12 months (β = − 0·01; P = 0·013). LnAF-alb at 12 months was associated with changes in LAZ and infant length between 12 and 18 months of age (β = − 0·01, P = 0·003; β = − 0·003, P = 0·02; respectively). LnAF-alb at 6 months was associated with IGFBP-3 at 12 months (r = − 0·12; P = 0·043).ConclusionsThis study found a small but significant effect of aflatoxin exposure on the growth of Gambian infants. This relationship is not apparently explained by aflatoxin induced changes in the IGF-axis.
Highlights
Exposure to aflatoxin, a mycotoxin produced by fungi that commonly contaminates cereal crops across sub-Saharan Africa, has been associated with impaired child growth
A mycotoxin produced by fungi that contaminate major cereal crops worldwide, with highest occurrence in hot and humid climates, is a major public health concern due to its carcinogenic [4], immunosuppressive [5] and growth suppressing effects [6]
This study aimed to examine the relationship between aflatoxin exposure and growth in Gambian infants from birth to two years of age, and to test the hypothesis that reductions in insulin-like growth factor (IGF)-axis proteins could be a mechanism for growth impairment
Summary
A mycotoxin produced by fungi that commonly contaminates cereal crops across sub-Saharan Africa, has been associated with impaired child growth. Reasonable progress has been made to reduce the global burden of undernutrition in children under five years of age (from 39·6% in 1990 to 23·8% in 2014) the rate of Exposure to aflatoxin, a mycotoxin produced by fungi that contaminate major cereal crops worldwide, with highest occurrence in hot and humid climates, is a major public health concern due to its carcinogenic [4], immunosuppressive [5] and growth suppressing effects [6]. Watson et al BMC Public Health (2018) 18:1247 and groundnuts are dietary staples and diet variety is poor In such settings, this high risk of exposure is further compounded by difficulties in the avoidance of contaminated food supplies, limited enforcement of regulatory food standards, and inadequate food storage conditions. A small number of longitudinal studies covering the first 24 months following birth, a critical time period for linear growth, have been conducted in settings where both undernutrition and aflatoxin exposure are prevalent, and the findings among these studies are inconsistent [7, 12, 15]
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