Dietary Aflatoxin Exposure Research Articles

Dietary aflatoxin exposure of lactating mothers of children 0-6 months in Makueni County, Kenya.

The southeastern region of Kenya is prone to aflatoxin outbreaks, yet maternal and infant aflatoxin intake levels remain unclear. We determined dietary aflatoxin exposure of 170 lactating mothers breastfeeding children aged 6 months and below in a descriptive cross-sectional study involving aflatoxin analysis of maize-based cooked food samples (n = 48). Their socioeconomic characteristics, food consumption patternsand postharvest handling of maize were determined. Aflatoxins were determined using high-performance liquid chromatography and enzyme-linked immunosorbent assay. Statistical analysis was conducted using Statistical Package Software for Social Sciences (SPSS version 27) andPalisade's@Risk software. About 46% of the mothers were from low-income households, and 48.2% had not attained the basic level of education. A generally low dietary diversity was reported among 54.1% of lactating mothers. Food consumption pattern was skewed towards starchy staples. Approximately 50% never treated their maize, and at least 20% stored their maize in containers that promote aflatoxin contamination. Aflatoxin was detected in 85.4% of food samples. The mean of total aflatoxin was 97.8 μg/kg (standard deviation [SD], 57.7), while aflatoxin B1 was 9.0 μg/kg (SD,7.7). The mean dietary intake of total aflatoxin and aflatoxin B1 was 7.6 μg/kg/b.w.t/day (SD, 7.5) and 0.6 (SD,0.6), respectively. Dietary aflatoxin exposure of lactating mothers was high (margin of exposure < 10,000). Sociodemographic characteristics, food consumption patternsand postharvest handling of maize variably influenced dietary aflatoxin exposure of the mothers. The high prevalence and presence of aflatoxin in foods of lactating mothers are a public health concern and calls for the need to devise easy-to-use household food safety and monitoring measures in the study area.

Aflatoxin Occurrence, Food Regulations, Dietary Exposure, and Risk Assessment: A Mini Review from the Malaysian Perspective

Aflatoxins are ubiquitous and occur in food. Exposure to aflatoxins seriously impact the health of human and animal. It is concerning especially when aflatoxins are odourless, colourless, and tasteless that hardly be detected through naked eyes. Ingestion of aflatoxin-contaminated food contributes the major route of exposure. The present review is an update on the aflatoxin occurrence in food, aflatoxin regulations in food, and recent risk assessment of aflatoxin exposure in Malaysia. Peanuts and chili were more prone to aflatoxin contamination in Malaysia. The extreme weather experienced in Malaysia and global climatic change may worsen the aflatoxin contamination in food. The regulatory standards for aflatoxins imposed by Malaysia are less stringent than developed countries. The dietary exposure of aflatoxins among Malaysian was relatively high as compared with other Asia countries, ranging from 0.002 to 34.00 ng/kg body weight/day. Nonetheless, Malaysian population had low risk of aflatoxin-related liver cancer, with an estimated liver cancer risk of &lt;1 cancer case/100,000 population/year.

Chronic Aflatoxin Exposure and Cognitive and Language Development in Young Children of Bangladesh: A Longitudinal Study.

Aflatoxin can cross the blood-brain barrier, damage brain tissues, and have the potential to harm the development of the human brain. Although dietary aflatoxin exposure is common in children, there is a paucity of data on aflatoxin exposure and child developmental outcomes. The child's cognitive, motor, and language functions were assessed using the Bayley Scales of Infant and Toddler Development-III or BSID-III at the same time points. Association between exposure to aflatoxin and subtests of BSID-III were examined using mixed-effect linear regression. Aflatoxin assays were performed on 194, 167, and 163 children at 15, 24, and 36 months of age, and chronic aflatoxin exposure was detected in 20.6%, 16.8%, and 60.7% of children, respectively. Multi-variable analyses showed that aflatoxin exposure was independently related to the children's cognitive score (β: -0.69; 95% CI: -1.36, -0.02), receptive language score (β: -0.90; 95% CI: -1.62, -0.17), and expressive language score (β: -1.01; 95% CI: -1.96, -0.05). We did not observe any association between exposure to aflatoxin and the motor function of children. Chronic exposure to aflatoxin exposure was linked to reduced cognitive, expressive, and receptive language scores of the study children. Further research is needed in a different setting to confirm this novel finding.

Chronic aflatoxin exposure during pregnancy is associated with lower fetal growth trajectories: a prospective cohort from the Butajira Nutrition, Mental Health, and Pregnancy (BUNMAP) Study in rural Ethiopia

Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed. In the present study, we examined the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural setting in Ethiopia. In a prospective cohort study, we enrolled 492 pregnant females, with a singleton pregnancy and before 28 wk of gestation. Serum aflatoxin B1-lysine concentration was measured using LC-tandem MS. Three rounds of ultrasound measurements were conducted to estimate fetal weight at mean ± SD gestational age weeks of 19.1 ± 3.71, 28.5 ± 3.51, and 34.5 ± 2.44. Estimated fetal weight was expressed in centiles using the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B1-lysine concentration above or equal to the limit of detection) and unexposed mothers in the study. Mothers had a mean ± SD age of 26.0 ± 4.58 y. The median (25th, 75th percentile) serum aflatoxin B1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the females enrolled provided at least 2 ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational-age centile than the unexposed group (ß = -0.92; 95% CI: -1.77, -0.06 centiles/week; P=0.037). Chronic maternal aflatoxin exposure is associated with lower fetal growth over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure and adopting food safety measures in low-income settings, in particular during the fetal period of development.

Aflatoxin exposure among children of age 12–59 Months in Butajira District, South-Central Ethiopia: a community based cross-sectional study

BackgroundThe continued provision of safe food, free of aflatoxin remains a huge challenge in developing countries. Despite several favourable climatic conditions that facilitate aflatoxin contamination in Ethiopia, there is little information showing aflatoxin exposure in children. Therefore, this study assessed aflatoxin exposure among young children in Butajira district, South-Central Ethiopia.MethodsCommunity based cross-sectional study stratified by agro-ecology was employed in Health and Demographic Surveillance Site (HDSS) of Butajira. The study included 332 children aged 12–59 months and were selected by simple random sampling technique using the HDSS registration number as a sampling frame. We collected data on dietary practice and aflatoxin exposure. Aflatoxin M1 concentration in urine was measured by Enzyme-Linked Immunosorbent assay (ELISA). The data analysis was carried out using STATA.ResultsDetectable urinary Aflatoxin M1 was found in 62.4% (95% CI: 56.9 – 67.5%) of the children at a level ranging from 0.15 to 0.4 ng/ml. Children living in lowland agro-ecological zone had [AOR = 2.11 (95% CI; 1.15, 3.88] odds of being exposed to aflatoxin as compared to children living in highland agro-ecological zone. Children at lower socio-economic status [AOR = 0.27 (95% CI; 0.14, 0.50] and medium socio-economic status [AOR = 0.47 (95% CI; 0.25, 0.87] had 73% and 53% lower odds of being exposed to aflatoxin as compared to children in the higher socio-economic status, respectively.ConclusionsAflatoxin exposure among young children was very high in South-Central Ethiopia. This high aflatoxin exposure might emphasize the need for aflatoxin exposure mitigation strategies in Ethiopia. Especially, raising awareness of the community towards aflatoxin exposure is very crucial. In addition, further research is required to assess long-term aflatoxin exposure and its association with child growth and development.

Occurrence, dietary exposure, and risk assessment of aflatoxins in wheat flour from Iran

ABSTRACT This study was performed to determine the concentration and assess the risk of aflatoxins (AFs) i.e. aflatoxin B1 (AFB1), B2 (AFB2), G1 (AFG1), and G2 (AFG2) in wheat whole and refined flour samples for Iranian adults. Sixty-five (60.19%) out of 108 analysed samples were positive for AFB1 and total AFs (AFB1+ AFB2+ AFG1+ AFG2). The range of AFB1 and the total AFs in samples were 0.14–7.34 and 0.34–7.61 µg kg−1, respectively. While, their means were 1.70 ± 0.22 and 2.15 ± 0.23, respectively. AFB1 level in 7 (6.48%) samples exceeded maximum limits allowed according to Iran standard (5 µg kg−1) while all samples had total AFs at an acceptable level (15 µg kg−1). The incidence and concentration of AFs in wheat whole flour samples were higher than that of refined flour one. The estimated daily intake (EDI), the margin of exposure (MOE), hepatocellular cancer risk of AFB1 through flour samples were 0.004 µg kg−1 bw day−1, 108.74 and 4.12 cases per 100,000 individuals/75 years, respectively. As EDI was more than the suggested value of 0.017 ng kg−1 bw day−1 and hepatocellular cancer risk was higher than the recommended level of 0.1 cases/75 years/100,000 individuals and MOE >10,000, it could be concluded AFs level in flour samples had a health potential risk to human health.

Abstract 754: Serum iron markers in relation to hepatocellular carcinoma risk among patients with non-alcoholic fatty liver disease

Abstract Background: Hepatocellular carcinoma (HCC) is the 6th most commonly diagnosed cancer and the 3rd leading cause of cancer death in the US. Around 85-90% of primary liver cancer is HCC. Besides identified risk factors for HCC including chronic infection with hepatitis B and C virus (HBV and HCV), alcohol abuse, dietary aflatoxin exposure and hereditary hemochromatosis, nonalcoholic fatty liver disease (NAFLD) is as another important risk factor for HCC. NAFLD is a spectrum of liver disease that ranges from hepatic steatosis through non-alcoholic steatohepatitis (NASH) with or without fibrosis and may progress to cirrhosis or HCC. Iron is an essential metal and hepatocytes are its main storage site. Increased body iron from the intestine due to high dietary iron or hereditary or acquired hemochromatosis may result in hepatic iron overload. NAFLD is frequently associated with elevated serum iron indices when hepatic iron in the absence of hemochromatosis. Epidemiologic data on the association between serum iron markers and risk of HCC are sparse. The aim of the study was to examine the association of iron related serum markers with risk of HCC in NAFLD patients. We hypothesized that elevated serum iron levels, which reflects hepatic iron, are associated with increased risk of HCC among NAFLD patients. Methods: 48,328 patients with NAFLD were identified in the electronic health records (EHR) of the University of Pittsburgh Medical Center (UPMC) between 1/1/2004 to 12/31/2018. Among them, 19,908 had at least one measurement of serum iron, transferrin saturation, total iron binding capacity (TIBC) and serum ferritin. After an average 4.47 years of follow-up, 363 patients with NAFLD were diagnosed with HCC at least 30 days after measurement of iron markers. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and the 95% confidence intervals (CIs) for HCC incidence associated with elevated levels of the four iron markers adjusted for age, sex, race, body mass index, history of diabetes and tobacco smoking. Results: Serum iron and transferrin saturation were significantly elevated in NAFLD patients who developed HCC compared to others who remained free of HCC during the study. The HR of HCC for elevated serum iron &amp;gt;175 mcg/dl was 3.41 (95% CI 1.48 - 7.85) compared to its normal range at 75-175 mcg/dl. Similarly, the HR for HCC associated with elevated transferrin saturation &amp;gt;35% was 2.56 (95% CI 1.49-4.39) relative to the normal range at 25-35%. The associations were not statistically significant for TIBC and serum ferritin with HCC risk. Conclusions: Elevated serum iron and transferrin saturation levels, but not TIBC or serum ferritin, were significantly associated with increased risk of developing HCC in NAFLD patients. These findings support future studies evaluating serum iron level in risk stratification of NAFLD patients at risk of HCC and potential links to pathogenesis of HCC. Citation Format: Yi-Chuan Yu, Renwei Wang, Jaideep Behari, Ada Youk, Nancy W. Glynn, Jian-Min Yuan. Serum iron markers in relation to hepatocellular carcinoma risk among patients with non-alcoholic fatty liver disease [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 754.

Risks of aflatoxin exposure among adolescents in boarding schools in Kilimanjaro region, Tanzania

School feeding in low-income countries is dominated by cereals and legumes, which are susceptible to aflatoxin contamination but are usually not assessed for aflatoxins. A cross sectional study was conducted to assess aflatoxin exposure among adolescents through consumption of school meals in Kilimanjaro region. Food frequency questionnaires and 24 h dietary recalls were used to collect information on food consumption. At least four samples of common food used in school meals were collected. A deterministic approach was used to estimate the dietary aflatoxin exposure. High Performance Liquid chromatography (HPLC) was used to analyse presence of aflatoxin contamination. Results showed that, maize based food and beans were consumed on daily basis. The intake of maize flour and dehulled maize ranged from 17.5 to 738.2 g and 28.2 to 272 g per person per day respectively. Furthermore, consumption of beans and rice were in the range of 121.1 to 595.2 g and 15.7 to 42.2 g per person per day respectively. Total aflatoxins ranged 0.20-438.53 μg/kg (median 2.30 μg/kg). The highest contamination range (0.59-438.53 μg/kg) was in maize while the lowest (0.20-3.41 μg/kg) was found in rice. Similarly, the highest aflatoxin B1 (AFB1) concentration (35.88 μg/kg) was in dehulled maize while the lowest (0.44 μg/kg) was in rice. The highest dietary exposure to total aflatoxins and AFB1 due to consumption of maize ranged from 0.70 to 973.45 ng/kg/bodyweight (bw)/day, and from 0.05-81.06 ng/kg/bw/day, respectively. This pronounced risk of exposure to aflatoxins might have been contributed by a monotonous maize based diet in boarding schools. These findings call for institutions immediate interventions, such as the use of appropriate storage technologies, sorting, cleaning and winnowing in order to remove damaged grains, thereby reducing the risk of dietary exposure to aflatoxins. Likewise, the relevant ministries should consider food diversification and routine risk assessments of the susceptible crops throughout the value chain as a long-term intervention plan at policy level.

Review on the Aflatoxins’ Contamination of Foods and Public Health Effects among Nigerian Population

Aflatoxin in foods and feeds need adequate monitoring on account of their severe toxicity and carcinogenicity to both humans and animals. This review was aimed at examining the public health risks attributed to chronic exposure of aflatoxins in foods within Nigeria. Both the reported cases of aflatoxins in foods and biomarkers in Nigeria signified increase in dietary exposure. Aflatoxins contamination levels ranges from 1.3 ng/g to 51,192ng/g in foods with an estimated dietary exposure of 0.00017 ng/kgbw/day to 9, 880.56 ng/kgbw/day. The percentage incidence of primary liver cancer cases (PLCC) attributable to the dietary aflatoxin exposure for every 100,000 Nigerians per year ranges from 0.0024 to 708.13% between 1998 to 2008 which increases to 0.0046 to 45,602% between 2009 to 2018. The percentage incidence of PLCC signified by urine aflatoxin M1 (AFM1) levels in adults was around 0.23 – 1.29% per 100,000 population per year. In children, the estimated PLCC and stunting due to aflatoxin exposure via breast milk were 0.0019 to 237.71 cancers per 100,000 populations per year and mild to severe stunting with height-for-age z-score (HAZ) value above -3 HAZ reductions. Hence, there is need for additional monitoring of the marketed foods and implementing more stringent control and prevention strategies that reduce dietary exposure levels in Nigeria.

Spatial analysis of dietary exposure of aflatoxins in peanuts and peanut oil in different areas of China

Peanuts in China are heavily contaminated with aflatoxin, which pose a threaten to human health. To compare the dietary exposure risk of aflatoxins (AFT) in peanuts and peanut oil in different areas of China, the spatial distribution of AFT contamination levels in peanuts and peanut oil from different areas was analyzed. The dietary exposure was calculated by simple distributed risk assessment method before characterizing the health risk using both the margin of exposure (MOE) approach proposed by the European Food Safety Authority (EFSA) and the quantitative liver cancer risk approach proposed by the Joint Food and Agricultural Organization/World Health Organization (FAO/WHO) Expert Committee on Food Additives (JECFA). The results showed that the AFT content in peanuts and peanut oil was high with agglomeration in several provinces of East and South China under a subtropical temperate monsoon climate, and the AFT contamination in peanut oil was more substantial than peanuts. On average, the estimated dietary exposure to AFT from the total of peanuts and peanut oil for Chinese general population ranged from 1.776 to 1.940 ng/kg bw/day (LB-UB), from which the MOE values of 88–96 (UB-LB) and liver cancer risk of 0.055–0.060 cases/100,000 persons/year (LB-UB) were calculated. As for different areas in China, the mean AFT exposure ranged between 0.000 and 17.270 ng/kg bw/day. Moreover, the corresponding health risk was estimated at 10–868759 MOE values and 0.000–0.851 liver cancer cases/100,000 persons/year. Guangdong, Fujian and Jiangxi provinces were at a higher risk rank. The liver cancer risk of AFT exposure from peanuts and peanut oil was far below all-cause liver cancer incidence (18.0 cases/100,000 persons/year) in China, but several areas with relatively high risk should be of concern. Compared with other age groups, children aged 2–6 years should be paid more attention because they have the highest AFT exposure level.

Establishment of a prognostic model for predicting short-term disease-free survival in cases of hepatitis B-related hepatocellular carcinoma with the TP53 249Ser mutation in southern China.

BackgroundHepatitis B virus (HBV) infection and dietary aflatoxin exposure are two major and synergistic carcinogenic factors of hepatocellular carcinoma (HCC) in southern China. Mutation of the TP53 gene at codon 249 (TP53 249Ser) is recognized as a fingerprint of aflatoxin B1 (AFB1) exposure.MethodsA total of 485 HCC patients positive for serum hepatitis B surface antigen were enrolled. The clinicopathological information and survival time were collected. TP53 249Ser mutations in HCC were detected by Sanger DNA sequencing after PCR amplification. Immunohistochemical staining was used to evaluate TP53 expression. Propensity score matching (PSM) and Cox proportional hazards regression (CPHR) were conducted to identify independent risk factors for prognosis that were incorporated into the nomogram. Univariate logistic regression analysis was used to compare differences in clinical factors between the TP53 249Ser mutation group and the non-mutation group. A Kaplan-Meier plot, univariate and multivariate Cox proportional hazards models were used to assess the association between clinicopathological characteristics and survival outcomes.ResultsAfter PSM, a total of 322 cases were included in the analysis of clinical prognosis. Results of CPHR showed that the mutation group had a relatively higher risk of tumor recurrence within 2 years after undergoing hepatectomy (P=0.039, HR =1.47, 95% CI: 1.02–2.18). The prognostic model performed better in terms of 2-year DFS prediction than BCLC stage. Patients who had a nomogram score of more than 160 were considered to have a higher risk of recurrence within 2 years.ConclusionsOur study found that the TP53 249Ser mutation may be a high risk factor of HBV-related HCC recurrence in the short term. And we initially established a nomogram scoring system for predicting 2-year recurrence in HBV-related HCC patients in southern China.

Risk assessment of mycotoxins in stored maize: case study of Shandong, China

Risk characterisation of dietary exposure of aflatoxins (AFs), fumonisins (FBs), deoxynivalenol (DON), zearalenone (ZEA) in maize from Shandong Province was conducted in this study. A total of 520 maize samples were collected after harvesting in 2014 and 2015 from 26 selected villages in Shandong Province, China. A deterministic approach was used in the current study. The dietary intake data of maize was obtained from ‘Shandong Statistical Yearbook 2018’. The risk characterisation of FBs, DON, and ZEA was evaluated in 4 population groups (2 to 6-year-old children, standard adults, city adults and village adults) based on probable intake. 2 to 6-year-old children and adults were exposed to FBs (0.42 and 0.20 μg/kg body weight (bw)/day), DON (0.04 and 0.019 μg/kg bw/day), and ZEA (0.0024 and 0.0011 μg/kg bw/day) through mean maize consumption in diets, which was lower than the provisional maximum tolerable daily intake of each mycotoxin established by JECFA. Risk assessments showed a low risk for liver cancer due to consumption of aflatoxin B1 (0.027-0.21 cases per 100,000 persons per year) contaminated maize compared with China’s current liver cancer incidence of 24.6 cases per 100,000 persons per year.

Childhood dietary exposure of aflatoxins and fumonisins in Tanzania: A review

Aflatoxins (AFs) and Fumonisins (FBs) are common contaminants of maize, from secondary metabolites of fungi. Presence of AFs and FBs in maize-based complimentary food is evident in various studies ...

Epidemiology of Liver Cancer in Africa: Current and Future Trends.

Hepatocellular carcinoma (HCC) is a disease of global public health significance with mortality on the rise, despite the preventable nature of its risk factors especially in Africa. It is now the sixth most common cancer worldwide, fifth in males, and ninth in females. HCC incidence and mortality are predicted to increase in African countries constrained by limited resources to combat endemic levels of viral infection and synergistic environmental risk factors. The changing nature of HCC etiology is particularly illustrated here with the traditional risk factors like viral hepatitis coexisting alongside high human immunodeficiency virus (HIV) prevalence and rapidly increasing urbanization that have promoted a sharp increase in additional risk factors like coinfection, type 2 diabetes mellitus, and obesity. Although there are some differences in etiology between North Africa and sub-Saharan Africa, risk factors like chronic viral hepatitis B and C, aflatoxin exposure, and iron overload predominate. Aggressive hepatitis B genotypes, combined with hepatitis B virus/hepatitis C virus/HIV coinfections and aflatoxin exposure, promote a more aggressive molecular phenotype. In parallel to a better understanding of the molecular etiology of HCC, policy and planning initiatives to address the burden of HCC must be anchored within the reality of the limited resources available. Establishment and coordination of cancer registries across Africa is needed to improve the quality of data necessary to galvanize action. Preventive measures including hepatitis B vaccination programs, measures to prevent maternal-to-child and child-to-child transmission, delivery of universally accessible antiretroviral and antiviral treatments, and reduction of dietary aflatoxin exposure can contribute markedly to reduce HCC incidence. Finally, the development of biomarkers and new therapeutic interventions will need a better understanding of the unique genetic and epigenetic characteristics of HCC on the continent. We present a narrative review of HCC in Africa, discussing present and future trends.

Willingness to pay of Nigerian poultry producers and feed millers for aflatoxin‐safe maize

Dietary aflatoxin exposure is a widespread problem in the developing world and causes severe negative health consequences to humans and livestock animals. A new biological control product, called Aflasafe, has been introduced in Nigeria to mitigate aflatoxin contamination of maize in the field and in storage. No known prior work has estimated how much African agribusinesses using maize for animal feed will pay for aflatoxin‐safe maize. This study measured the levels of Aflasafe awareness, surveyed current aflatoxin management practices, and estimated, using choice experiments, willingness to pay (WTP) for aflatoxin‐safe maize by Nigerian poultry producers and feed millers. Data was gathered from 272 orally administered surveys, which included discrete choice experiments examining maize purchasing decisions. Results suggest that the proportion of enterprises that were aware of aflatoxin was found to vary across states. Two latent classes of Nigerian poultry producers and feed millers were identified that were willing to pay average premiums of 4.9% and 30.9%, respectively for maize with 10 parts per billion (ppb) aflatoxin concentration relative to maize with 20 ppb aflatoxin concentration. Both latent classes were, on average, willing to pay larger premiums for maize with 4 ppb aflatoxin concentration. There was evidence that latent class membership, and hence WTP, varied based on awareness of aflatoxin and across geographies.JEL CLASSIFICATIOND29; I15; O13

Inadequate management of complementary foods contributes to the risk of aflatoxin exposure and low nutrition status among children

Early exposure to aflatoxins through complementary food is linked to impaired growth in childhood. The current study assessed the household’s practices on management of complementary foods in relation to the risk of aflatoxin exposure and poor nutritional status among infant and young children in Tanzania. A cross-sectional study of complementary feeding practices, aflatoxin exposure and nutritional status was conducted to 101 infants and young children aged between 6-23 months in Dodoma region of Tanzania. The intake of complementary food was estimated by using repeated 24 h dietary recall. Flour used as complementary food was sampled from each of the 101 families and aflatoxins were analysed using high-performance liquid chromatography. A deterministic approach was used to estimate dietary exposure of aflatoxins in the complementary foods. Anthropometric measurements were taken and rates of stunting, underweight and wasting estimated according to the WHO standard procedures. Multivariate logistic regression analysis was used to assess the association between feeding practices and aflatoxin exposure or the growth performance among subjects. The average consumption of complementary flour was 118 g per child per day and 52% of the flours contained groundnuts. AFB1 was detected in 42.5% of the flour and levels ranged from 0.3 to 2,128.0 μg/kg (mean 228.11±49.84 μg/kg). Dietary exposures of aflatoxin B1 ranged from 0.1 to 23,172.81 ng/kg body weight per day (mean 1,337±392.5 ng/kg). Of the subjects, 40.4% (95% CI; 29.8; 50.9) were stunted and significant association was found between stunted growth and dietary exposure of AFB1 (adjusted odd ratio (AOR)=5.9; 95% CI: 0.019-0.028). Early introduction of cereal-and groundnut-based complementary foods in Tanzania is associated with high risk of aflatoxin exposure and impaired growth in children. There is need to integrate aflatoxin management measures in the guidelines for Infant and Young Children Feeding of Tanzania.

Risk assessment of aflatoxin-related liver cancer in Bangladesh

ABSTRACTAflatoxins are mycotoxins (fungal toxins) produced by Aspergillus species in variety of food commodities. Consumption of aflatoxin-contaminated food can cause adverse health effects, including liver cancer. Aflatoxin exposure is usually higher in hot and humid countries. Previous biomarker-based studies have indicated significant exposure to aflatoxins among the Bangladeshi population. Recently, high aflatoxin levels were reported in dates, which are consumed in large quantities during the month of Ramadan in Bangladesh and other Muslim countries. Bangladesh has recently enacted aflatoxin regulation in foods. In this study, we determined the risk of aflatoxin-related liver cancer among the Bangladeshi population based on the average dietary intakes of different aflatoxin contaminated foods, accounting for the synergistic impacts of aflatoxin with chronic hepatitis B viral infection in inducing cancer. We also determined whether the new aflatoxin regulations in Bangladesh could significantly reduce the risk of liver cancer. The mean number of cancer cases per year caused by dietary aflatoxin exposure in Bangladesh was estimated at about 1311, or 43.9% of the total annual liver cancer cases in Bangladesh. The new aflatoxin regulations do not appear likely to significantly reduce the risk of liver cancer in the country.

The impact of reducing dietary aflatoxin exposure on child linear growth: a cluster randomised controlled trial in Kenya

IntroductionObservational studies have documented an association between aflatoxin (AF) exposure and reduced linear growth in infants and young children. Our objective was to assess the effectiveness of reducing AF exposure...

Occurrence, dietary exposure and risk assessment of aflatoxins in arepa, bread and rice

The purpose of this study was to assess the risk of aflatoxins due to arepa, bread and rice consumption among the adult population of the Department of Caldas, Colombia. A high-performance liquid chromatography method with fluorescence detection (HPLC-FD) was validated and used to determine aflatoxins in 246 samples. Dietary exposure was calculated by estimated daily intake (EDI), whereas risk characterization was assessed using the risk of cancer and margin of exposure (MOE) approaches. The method showed good selectivity, linearity (R2 > 0.9993), limit of detection (LOD = 0.004–0.014 ng mL−1), limit of quantification (LOQ = 0.014–0.046 ng mL−1), accuracy (2.40%–14.1%), and recovery (58%–110%). Aflatoxins were detected in 38.6% of the samples at levels between 0.08 and 41.75 μg kg−1, and 11.4% of the samples contaminated with AFB1 exceeded the limit (2 μg kg−1) established by the European Commission (EC). The EDI of aflatoxins due to the consumption of arepa (0.732) and rice (3.093) were above the recommended level of 0.017 ng kg−1 bw day−1. Also, the estimated number of liver cancer cases associated with AFB1 exposure due to arepa (0.726) and rice (3.314) consumption was above the suggested limit of 0.1 cases/75 years/100,000 individuals. Finally, the MOEs obtained by arepa and rice consumption were 277.5 and 60.79, respectively, far from the safe margin of 10,000, thereby indicating a potential risk to public health.

Association between Urinary Aflatoxin (AFM₁) and Dietary Intake among Adults in Hulu Langat District, Selangor, Malaysia.

Aflatoxin is a food contaminant and its exposure through the diet is frequent and ubiquitous. A long-term dietary aflatoxin exposure has been linked to the development of liver cancer in populations with high prevalence of aflatoxin contamination in foods. Therefore, this study was conducted to identify the association between urinary aflatoxin M1 (AFM1), a biomarker of aflatoxin exposure, with the dietary intake among adults in Hulu Langat district, Selangor, Malaysia. Certain food products have higher potential for aflatoxin contamination and these were listed in a Food Frequency Questionnaire, which was given to all study participants. This allowed us to record consumption rates for each food product listed. Concomitantly, urine samples were collected, from adults in selected areas in Hulu Langat district, for the measurement of AFM1 levels using an ELISA kit. Of the 444 urine samples collected and tested, 199 were positive for AFM1, with 37 of them exceeding the limit of detection (LOD) of 0.64 ng/mL. Cereal products showed the highest consumption level among all food groups, with an average intake of 512.54 g per day. Chi-square analysis showed that consumption of eggs (X2 = 4.77, p = 0.03) and dairy products (X2 = 19.36, p < 0.01) had significant associations with urinary AFM1 but both food groups were having a phi and Cramer’s V value that less than 0.3, which indicated that the association between these food groups’ consumption and AFM1 level in urine was weak.