Assessment of multiple mycotoxin exposure and its association with food consumption: a human biomonitoring study in a pregnant cohort in rural Bangladesh

Kyei, Nicholas N. A.; Cramer, Benedikt; Humpf, Hans‐Ulrich; Degen, Gisela H.; Ali, Nurshad; Gabrysch, Sabine

doi:10.1007/s00204-022-03288-0

Cited by 10 publications

(11 citation statements)

References 72 publications

(103 reference statements)

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“…The mean dietary exposure to OTA of pregnant women from Bangladesh who had pulses in their diet was between 400 and 8070 ng/kg bw/day and a positive correlation was found between pulses and OTA exposure. However, the high exposure might be due to other contaminated food items such as nuts, seeds, and vegetables (Kyei et al 2022). Vietnamese consumers' dietary exposure to OTA based on tofu, beans, and products consumption is between 0.2 and 0.7 ng/kg bw/day with MOEs > 10,000 (Huong et al 2016), depicting a lower exposure than the one reported herein in all our scenarios.…”

Section: Exposure Assessment and Risk Characterization For The Baseli...contrasting

confidence: 56%

Assessing the Mycotoxin-related Health Impact of Shifting from Meat-based Diets to Soy-based Meat Analogues in a Model Scenario Based on Italian Consumption Data

2022

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The aim of this study was to assess the risk of replacing meat with plant-based analogues with respect to mycotoxin exposure, as a proof of concept to demonstrate the need for a proper regulatory framework for mycotoxins in meat imitates. Hence, we considered a full replacement of meat consumption with soy-based meat analogues and we evaluated the exposure to AFB1 and OTA, based on the Italian National Food Consumption Survey INRAN-SCAI 2005–2006 and the European Food Safety Authority occurrence data. The overall health impact from soy-based food consumption and a meat-free diet was quantified in terms of Disability-Adjusted Life Years (DALYs) in three different contamination and consumption scenarios. The substitution of meat products with soy-based imitates would prevent up to 406.2 colorectal cancer cases/year/country associated with 532 healthy years of life. However, we also determined an increased risk of liver cancer and loss of healthy life-years due to AFB1 exposure and a potential risk of renal cancer as due to an increased intake of OTA, leading up to 1208 extra cancer cases associated with the loss of 12,080 healthy life-years/country. Shifting to a plant-based diet actually eliminates a cancer risk factor such as processed meat, however, higher and unexpected risks could arise if mycotoxins are not properly regulated in plant-based meat alternatives. Taking into account the ubiquitous occurrence of mycotoxins, also in the light of climate change, and the growing trend toward plant-based meat analogues, greater importance should be given to actual food consumption trends and correlated with updated natural toxins regulations and risk assessments. Graphical abstract

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Section: Exposure Assessment and Risk Characterization For The Baseli...contrasting

confidence: 56%

Assessing the Mycotoxin-related Health Impact of Shifting from Meat-based Diets to Soy-based Meat Analogues in a Model Scenario Based on Italian Consumption Data

2022

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“…Such urine biomarker data can be also used for calculating the mycotoxin’s probable daily intake (PDI) since information on kinetics and urinary excretion rates in humans are now available, which then allows to assess risks by comparing the estimated PDIs for CIT to the ’level of no concern for nephrotoxicity’ as provisional tolerable daily intake (pTDI) value [ 21 ]. This is of considerable interest, also in the light of co-occurrence with the nephrotoxic mycotoxin OTA in foods and in human fluids [ 4 , 11 , 22 , 23 , 24 ]. However, biomonitoring data on CIT are limited, and only a few studies so far include children cohorts [ 20 , 23 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Citrinin Exposure in Germany: Urine Biomarker Analysis in Children and Adults

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et al. 2022

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Citrinin (CIT), a mycotoxin known to exert nephrotoxicity, is a contaminant in food and feed. Since CIT contamination is not regularly analyzed, data on its occurrence and especially levels in food commodities are insufficient for conducting a conventional exposure assessment. Yet, human biomonitoring, i.e., an analysis of CIT and its metabolite dihydrocitrinone (DH-CIT) in urine samples allows to estimate exposure. This study investigated CIT exposure in young (2–14 years) and adult (24–61 years) residents of three federal states in Germany. A total of 179 urine samples from children and 142 from adults were collected and analyzed by a targeted LC-MS/MS based method for presence of CIT and DH-CIT. At least one of the biomarkers was detected and quantified in all urines, which indicated a widespread dietary exposure to the mycotoxin in Germany. Interestingly, the biomarker concentrations of CITtotal (sum of CIT and DH-CIT) were higher in children’s urine (range 0.05–7.62 ng/mL; median of 0.54 ng/mL) than in urines from adults (range 0.04–3.5 ng/mL; median 0.3 ng/mL). The biomarker levels (CITtotal) of individual urines served to calculate the probable daily CIT intake, for comparison to a value of 0.2 µg/kg bw/day defined as ‘level of no concern for nephrotoxicity’ by the European Food Safety Authority. The median exposure of German adults was 0.013 µg/kg b.w., with only one urine donor exceeding this provisional tolerable daily intake (pTDI) for CIT. The median exposure of children was 0.05 µg/kg bw per day (i.e., 25% of the pTDI); however, CIT exposure in 12 individuals (6.3% of our study group) exceeded the limit value, with a maximum intake of 0.46 µg/kg b.w. per day. In conclusion, these results show evidence for non-negligible exposure to CIT in some individuals in Germany, mainly in children. Therefore, further biomonitoring studies and investigations aimed to identify the major sources of CIT exposure in food commodities are required.

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“…where C is the mycotoxin concentration, adjusted for urine density or creatinine, W is the individual's body weight (kg), E is the excretion rate (%) of the mycotoxin, and V is the daily urine excretion volume (ml) (Kyei et al 2022). PDI estimates for the middle-bound exposure scenario were used to investigate the relationship between dietary mycotoxin intake and birth outcomes.…”

Section: Maternal Dietary Mycotoxin Exposure Assessment During Pregnancymentioning

confidence: 99%

“…(CIT + Dihydrocitrinone (HO-CIT)) by converting metabolites using their molar mass. Details of health risk characterization of the estimated maternal daily intake of individual mycotoxins based on their toxicity profiles are presented elsewhere (Kyei et al 2022). Briefly, considering OTA's carcinogenicity, no exposure level is considered safe.…”

Section: Maternal Dietary Mycotoxin Exposure Assessment During Pregnancymentioning

confidence: 99%

Maternal exposure to multiple mycotoxins and adverse pregnancy outcomes: a prospective cohort study in rural Bangladesh

et al. 2023

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There is limited and inconsistent evidence, primarily from cross-sectional studies, linking mycotoxins to adverse birth outcomes. This study investigates the potential role of maternal dietary exposure to multiple mycotoxins in the development of several adverse pregnancy and birth outcomes. We analyzed data from 436 singleton pregnancies enrolled in a prospective cohort study in the rural Habiganj district, Bangladesh, between July 2018 and November 2019. Thirty-five urinary mycotoxin biomarkers were quantified using liquid chromatography coupled with tandem mass spectrometry and used to estimate dietary mycotoxin exposure. Multivariable regression models, adjusted for potential confounding and clustering, were fitted to assess the associations between maternal exposure to frequently occurring mycotoxins (ochratoxin A-OTA, citrinin- CIT, and Deoxynivalenol- DON) and pregnancy loss, preterm birth (PTB), low birth weight (LBW), born small-for-gestational-age (SGA) and small-vulnerable newborn. The results indicate that only in 16 of 436 pregnancies (4%) were urine samples free from all investigated mycotoxins. Biomarkers for six major mycotoxins were detected in the urine samples. OTA (95%), CIT (61%), and DON (6%) were most frequently detected, with at least two mycotoxins co-occurring in the majority of women (63%). There was evidence that maternal dietary intake of OTA was associated with higher odds of having an LBW baby, with the odds increasing in a dose-dependent manner. We found no evidence of associations between pregnancy loss, PTB, SGA, small-vulnerable newborns, and maternal dietary exposure to OTA, CIT, and DON, albeit with large confidence intervals, so findings are consistent with protective as well as large harmful effects. Exposure to multiple mycotoxins during pregnancy is widespread in this rural community and represents a health risk for mothers and babies. Tailored public health policies and interventions must be implemented to reduce mycotoxin exposure to the lowest possible level.

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Assessment of multiple mycotoxin exposure and its association with food consumption: a human biomonitoring study in a pregnant cohort in rural Bangladesh

Cited by 10 publications

References 72 publications

Assessing the Mycotoxin-related Health Impact of Shifting from Meat-based Diets to Soy-based Meat Analogues in a Model Scenario Based on Italian Consumption Data

Assessing the Mycotoxin-related Health Impact of Shifting from Meat-based Diets to Soy-based Meat Analogues in a Model Scenario Based on Italian Consumption Data

Citrinin Exposure in Germany: Urine Biomarker Analysis in Children and Adults

Maternal exposure to multiple mycotoxins and adverse pregnancy outcomes: a prospective cohort study in rural Bangladesh

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