Mycotoxin exposure biomonitoring in breastfed and non-exclusively breastfed Nigerian children

Abstract

BACKGROUND: Infants are a vulnerable population whose nutrition changes as complementary foods are introduced; a process which may modify patterns of exposure to dietary mycotoxins. However, exposure monitoring of dietary mycotoxin mixtures in several biological samples obtained from breastfed and non-exclusively breastfed children is scarce. OBJECTIVES: To examine mycotoxin co-exposure patterns in infants using a multi-specimen, multi-mycotoxin approach. METHODS: Breast milk, complementary food and urine obtained from 65 infants, aged 1-18 months, in Ogun state, Nigeria, were analyzed for mycotoxins using ultra-sensitive LC-MS/MS approaches. RESULTS: Complementary food was contaminated with seven distinct classes of mycotoxins including aflatoxins (9/42 samples; range: 1.0-16.2ug/kg) and fumonisins (14/42; range: 8-167ug/kg). Aflatoxin M1 was detected in breast milk (4/22), while six other classes of mycotoxins were quantified; including dihydrocitrinone (6/22; range: 14.0-59.7ng/L) and sterigmatocystin (1/22; 1.2ng/L) detected for the first time. Mycotoxins were detected in 64/65 of the urine samples, with seven distinct classes of mycotoxins observed demonstrating ubiquitous exposure. Two aflatoxin metabolites (AFM1 and AFQ1) and FB1 were detected in 6/65, 44/65 and 17/65 samples, respectively. Mixtures of mycotoxin classes were common, including 14/42, 22/22 and 56/65 samples having 2-4, 2-6 or 2-6 mycotoxins present, for complementary food, breast milk and urine, respectively. Aflatoxin and/or fumonisin was detected in 12/14, 4/22 and 46/56 for complimentary foods, breast milk and urine, respectively. Furthermore, the detection frequency, mean concentrations and occurrence of mixtures were typically greater in urine of non-exclusively breastfed compared to breastfed children. CONCLUSIONS: The study provides novel insights into mycotoxin co-exposures in children in a mycotoxin high-risk country without proper food safety measures. Albeit a small sample set, it highlights significant transition to higher levels of infant mycotoxin exposure as complementary foods are introduced, providing impetus to mitigate during this critical early-life period and encourage breastfeeding.

Mycotoxin Occurrence, Exposure and Health Implications in Infants and Young Children in Sub-Saharan Africa: A Review

“…Ochratoxin A, ENN B, and AFM1 were detected in 15%, 9%, and 1% of the samples, respectively, with the concentration being below the limit of quantification (LOQ), except for one sample with ENN B at a concentration of 9 ng/L [90]. This is in line with a recent study by Ezekial et al [75], which detected nine mycotoxins, including AFM1, alternariol methyl ether (AME), BEA, dihydrocitrinone (DCIT), ENN B, ENN B1, OTA, ochratoxin B (OTB), and sterigmatocystin (STG) in breast milk samples from Nigeria. Another study also reported a 40% co-occurrence rate of AFs and OTA in breast milk samples obtained from 113 mothers from Sierra Leone, with the individual toxin concentrations ranging from 3-372,000 ng/L for AFs (AFB1, AFM1, AFM2, AFG1, AFG2, and aflatoxicol) and 200-337,000 ng/L for OTA [98].…”

“…In addition, the authors recorded the occurrence of other EU-regulated mycotoxins in the cereal-based foods, including FBs, ZEN, ochratoxin A (OTA), and DON. These mycotoxins were also reported in a more recent study from the same country [75]. Similarly, Ware et al [73] investigated the occurrence of AFs, OTA, and FBs in 199 infant formulas and 49 cereal-and oilseed-based infant products marketed and consumed in the capital city of Burkina Faso using high-performance liquid chromatography/fluorescence detector (HPLC/FD).…”

“…The consumption of unsorted maize led to a significantly higher FB exposure level (8,87 µg/kg bw/day) in IYC when compared to an FB value of 0.28 µg/kg bw/day estimated for IYC fed with sorted maize. While studies have highlighted the high mycotoxin exposure of fully weaned (complementary foods) infants compared to breastfed infants [34,75], evidence of exposure of breastfed infants to mycotoxins has also been reported. Magoha et al [93,100] reported mycotoxin exposure data of infants consuming breast milk in Tanzania.…”

Determination of aflatoxin M1 and deoxynivalenol biomarkers in infants and children urines from Bangladesh

“…Urine AFM 1 levels in young Bangladeshi children are far lower than levels found in children of some African countries (Table 5 ), i.e. in Cameroon (Ediage et al 2013 ), Guinea (Polychronaki et al 2008 ), Nigeria (Ezekiel et al 2020 , 2018 ; Sarkanj et al 2018 ), Sierra Leone (Jonsyn-Ellis 2001 ) and Tanzania (Chen et al 2018 ). However, the AFM 1 mean level in our cohort is higher than that reported in children urines in Egypt (Polychronaki et al 2008 ), and it approaches levels found in Ethiopia (Ayelign et al 2017 ).…”

“…In Africa, children in Cameroon have apparently lower DON exposure (Ediage et al 2013 ) than those in Tanzania geometric mean 2.5 ng/mL, with 21–54% above TDI in one (Srey et al 2014 ) or more in another study (Gong et al 2015 ). DON has been detected now in urines of breastfed and non-exclusively breastfed infants from Nigeria (Ezekiel et al 2020 ). DON was also found in urines from children and adults in Haiti (Gerding et al 2015 ), at levels similar to those found in Swedish children (Mitropoulou et al 2018 ).…”