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

Abstract

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.

Urinary Aflatoxin M1 Concentration and Its Determinants in School-Age Children in Southern Ethiopia

“…Various studies have reported that high exposure to AF is directly related to the frequent consumption of certain food products such as nuts, nut products, cereals, and spices and herbs [32]. In the present study, children who consumed haricot bean and cow's milk frequently had higher mean urinary AFM1 than those who consumed these foods less frequently.…”

“…In Malaysia, a high amount of AFB1 was detected in nuts and nut products, and among the major contributing factors were the warm and humid weather conditions [43]. Moreover, the improper storage of foods and agricultural products promotes the growth of the fungi, and subsequently the contamination of these products by AF [32,44]. In Indonesia, the tropical climate and inappropriate food safety practices contributed to the AFB1 contamination of maize and nuts [45].…”

Aflatoxins: Occurrence, Exposure, and Binding to Lactobacillus Species from the Gut Microbiota of Rural Ugandan Children

“…The children's exposure to aflatoxin B 1 was confirmed by analysis of their urine samples for the presence of aflatoxin M 1 . As reported previously, approximately 1.2% to 2.2% of the dietary aflatoxin B 1 intake can be excreted in urine as aflatoxin M 1 [46]. If two minimal intake levels below 10 ng per kg body weight are considered outliers, the average percentage of aflatoxins excreted in the urine as aflatoxin M 1 equals 3.3% ± 2.8%.…”

Aflatoxin exposure in a population of HIV patients at risk of hepatocellular carcinoma North-Central, Nigeria

“…Some studies have demonstrated a relationship between urinary aflatoxin levels and dietary exposure. 6 , 17 Although we only quantified acute exposure from urine samples in this study and not diet, it is plausible that the source of exposure may be dietary. Compared to other studies in other regions of Africa with a similar aflatoxin burden, our study showed a similar high burden of exposure.…”

“…Measurement of the metabolite AFM1 in urine, is an index of dietary AFB1 exposure. [6][7][8] It has been demonstrated that HCC patients with exposure to this potent carcinogen tend to have 4.5 times more aflatoxins than controls. 3 The interplay of AFB1 with other risk factors for HCC in the setting of HIV in Nigerians is yet to be determined.…”