Aflatoxin M1 in milk does not contribute substantially to global liver cancer incidence

Turna, Nikita Saha; Havelaar, Arie H.; Adesogan, A.T.; Wu, Felicia

doi:10.1093/ajcn/nqac033

Cited by 13 publications

(17 citation statements)

References 43 publications

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“…Increased aflatoxin exposure is linked to increased liver cancer risk in humans [16], and field corn produced in the US is in part used for human food both in the US and worldwide. Additionally, increased aflatoxin in dairy animal feed is linked to higher levels of a metabolite aflatoxin M1 in milk [45], which-although not associated with significant human cancer risk [46]may nonetheless cause toxicological effects not yet elucidated.…”

Section: Discussionmentioning

confidence: 99%

Climate change will increase aflatoxin presence in US Corn

Hennessy

Tack

et al. 2022

Environ. Res. Lett.

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The impacts of climate change on agricultural production are a global concern and have already begun to occur (1, 2), with major drivers including warmer temperatures and the occurrence of extreme weather events (3-8). An important dimension of the climate change-crop yield relationship that has often been overlooked in the empirical literature is the influence that warming temperatures can have on plant damage arriving through biotic channels, such as pest infestation or fungal infection (5). Aflatoxins are carcinogenic chemicals produced by the fungi Aspergillus flavus and A. parasiticus, which commonly infect food crops. Currently, in the United States, aflatoxin is a perennial contaminant in corn grown in the South, but rare in the Corn Belt and northern states. Climate change may expand aflatoxin’s geographical prevalence, however; because hot, dry summers promote aflatoxin accumulation. Here we model aflatoxin risk as a function of corn plant growth stages and weather to predict US regions with high aflatoxin risk in 2031-2040, based on sixteen climate change models. Our results suggest that over 89.5% of corn-growing counties in fifteen states, including the Corn Belt, will experience increased aflatoxin contamination in 2031-2040 compared to 2011-2020. Interestingly, the results are spatially heterogeneous and include several Southern counties expected to have lower aflatoxin risk, because the causative fungi become inactivated at very high temperatures.

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Section: Discussionmentioning

confidence: 99%

Climate change will increase aflatoxin presence in US Corn

Hennessy

Tack

et al. 2022

Environ. Res. Lett.

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“…The results of this study will inform researchers and policymakers on the impact of AFM 1 in milk on children’s nutrition outcomes and will have implications for the transforming dairy value chains in Ethiopia. Ethiopia has recently adopted strict AFM 1 standards in milk and other dairy products, which has led to dairy farmers dumping their milk instead of selling it in the market 12. An earlier study showed that cancer risk from AFM 1 consumption was expected to be extremely low 12.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, milk can harbour multiple contaminants such as AFM 1 . AFB 1 , the parent compound of AFM 1 , may impair child growth9 through several pathways such as disruption of insulin-like growth factors,10 intestinal damage11 and immunosuppressive effects that increase infection susceptibility 12 13. Whether AFM 1 could cause similar effects is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…The action level for AFM 1 in milk in the USA is the same, at 0.5 µg/L15; while the European Union standard is 0.05 µg/L 16. The recent lack of evidence linking AFM 1 to cancer has led to the question of whether the standards set are reasonable 12. Moreover, dairy markets are important in Ethiopian livelihoods, particularly in rural areas where dairy is an important source of supplemental income 17.…”

Section: Introductionmentioning

confidence: 99%

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Study protocol to assess aflatoxin M1 health risks versus benefits of dairy consumption in Ethiopian children: an epidemiological trial and risk-benefit analysis

Wu,

Headey,

Hirvonen

et al. 2024

BMJ Open

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IntroductionIn Sidama, Ethiopia, animal-source foods can be difficult to access. Milk has important nutrients for child growth, but carries the risk of aflatoxin M1(AFM1) contamination. AFM1is a metabolite of the mycotoxin aflatoxin B1(AFB1) in dairy feed; cows secrete AFM1in milk when their feed contains AFB1produced byAspergillusfungi in maize, nuts and oilseeds. It is unknown whether AFM1compromises child growth and health.Methods and analysisThis protocol paper describes our study in Sidama to determine the impact of milk consumption and AFM1on child growth in the first 18 months of life. We will collect baseline and end-line data on dairy production, socioeconomic and nutritional factors of 1000 dairy-owning households with children ages 6–18 months at baseline; and gather samples of milk and dairy feed and child anthropometrics. We will conduct phone interviews every 6 months to ascertain changes in practices or child health. Dairy feed will be tested for AFB1; milk for AFM1, pathogens and nutrients. Controlling for herd size, socioeconomic, nutritional and behavioural factors, we will determine the association between child anthropometrics and milk consumption, as well as AFM1exposure. We will examine whether AFM1exposure affects child growth in the first 18 months of life, and weigh the benefits and risks of milk consumption.Ethics and disseminationThe protocol is approved by the Institutional Review Boards of the Ethiopian Public Health Institute (EPHI-IRB-481–2022), Michigan State University (STUDY00007996) and International Food Policy Research Institute (DSGD-23–0102). Written informed consent will be obtained from all participants, who may withdraw from the study at any time. Confidentiality of collected data will be given high priority during each stage of data handling. The study’s findings will be disseminated through stakeholder workshops, local and international conferences, journal articles and technical reports.

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“…AFs have been reported to play a causative role in 4.6-28.2% of the global HCC cases via consumption of contaminated food (Liu & Wu, 2010). Moreover, AF metabolites such as AFM1 has recently been quantified to cause ~13-32 HCC cases/year/100,000 population/ng AFM1 consumed, globally (Saha Turna et al, 2022). Growth impairment is another adverse effect that has been linked with chronic dietary exposure to AFs through breastmilk, infant formula and weaning foods during the early stages of life (Ahlberg et al, 2018;Saha Turna & Wu, 2019) and is a major concern for developing or low/middle income countries where high AF prevalence rates are observed.…”

Section: Introductionmentioning

confidence: 99%