Dietary Exposure and Risk Assessment of Aflatoxin M1 for Children Aged 1 to 9 Years Old in Serbia

Milićević, Dragan; Milešević, Jelena; Gurinović, Mirjana; Janković, Saša; Đinović-Stojanović, Jasna; Zeković, Milica; Glibetić, Maria

doi:10.3390/nu13124450

Cited by 21 publications

(14 citation statements)

References 39 publications

(50 reference statements)

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“…Very few studies reported MOE to AFM1 among their population. Nevertheless, our findings were higher than the values reported in Serbia of which the MOE to AFM1 was far lower from 10,000 among children [ 53 ].…”

Section: Discussioncontrasting

confidence: 95%

Aflatoxin B1 Occurrence in Children under the Age of Five’s Food Products and Aflatoxin M1 Exposure Assessment and Risk Characterization of Arab Infants through Consumption of Infant Powdered Formula: A Lebanese Experience

Daou

Hoteit

Bookari

et al. 2022

Toxins

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Aflatoxin M1 (AFM1) is a salient metabolite that can be used to assess Aflatoxin B1 (AFB1) exposure in humans and animals. The carcinogenic potency of AFB1 and AFM1 was severely reported. The aims of this study were (1) to survey the contamination level of AFM1 in the most traded infant powdered formula brands (IPF) (n = 42) along with the AFB1 level in under 5’s children food brands (biscuits, cornflakes, and cereals) (n = 42) and (2) to assess the estimated daily intake (EDI), the hazard quotient (HQ) and the margin of exposure (MOE) of AFM1 among infants (0–12 months) in Lebanon. All of the samples were analyzed using ELISA technique. AFB1 was below detection limit in all of the children’s food brands samples. Out of 42 IPF samples 9.5% were AFM1-positive in the range of 29.54–140.16 ng/L and exceeded the maximum tolerable limit (MTL) set by the European commission (25 ng/kg). The overall average contamination level was 5.72 ± 0.014 ng/L. The EDI of AMF1 for male was in the range of 0.37–0.78 ng/kg/b.w./day and 0.40–0.87 ng/kg/b.w./day for females. Similarly, the HQ calculation resulted in an average of 3.05 for males and 3.28 for females. MOE calculations were far lower from 10,000 in both genders which indicates a high risk of genotoxicity and carcinogenicity. Despite that, AFM1′s EDI and HQ scored low among Lebanese infants but unambiguously the risk characterization still substantial. As infants consume more IPF relative to their body weight, the persistence of IPF with high AFM1 levels threatens their health. Thus, infant’s exposure risk to AFM1 in IPF should be a continuous focus of attention.

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Section: Discussioncontrasting

confidence: 95%

Aflatoxin B1 Occurrence in Children under the Age of Five’s Food Products and Aflatoxin M1 Exposure Assessment and Risk Characterization of Arab Infants through Consumption of Infant Powdered Formula: A Lebanese Experience

Daou

Hoteit

Bookari

et al. 2022

Toxins

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“…The risk of the youngest age groups was also the conclusion of the study of Roila et al (2021) from the Central Italian region and the studies of Kerekes et al (2016) and Serraino et al (2019) also related to the Italian population. AFM1 risk of consumers of broader age groups is presented in other European studies (from Greece, Albania, and Serbia) as well (Udovicki et al, 2019;Djekic et al, 2020;Milićević et al, 2021;Topi et al, 2022) which underlines the emergence and the importance of the topic.…”

Section: Exposure and Risk Characterization Results And Approachesmentioning

confidence: 64%

“…The same results have been published in the studies of Kerekes et al (2016) and Serraino et al (2019), where AFM1 exposure of Italian consumers has been estimated. Health risk regarding AFM1 is also confirmed in other European studies, e.g., from Serbia by Djekic et al (2020) and Milićević et al (2021). Roila et al (2021) also declare a public health concern related to the youngest consumers of the population of Central Italy regarding AFM1 exposure.…”

Section: Introductionmentioning

confidence: 61%

Probabilistic modeling and risk characterization of the chronic aflatoxin M1 exposure of Hungarian consumers

et al. 2022

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Aflatoxin contamination can appear in various points of the food chain. If animals are fed with contaminated feed, AFB1 is transformed—among others—to aflatoxin M1 (AFM1) metabolite. AFM1 is less toxic than AFB1, but it is still genotoxic and carcinogenic and it is present in raw and processed milk and all kinds of milk products. In this article, the chronic exposure estimation and risk characterization of Hungarian consumers are presented, based on the AFM1 contamination of milk and dairy products, and calculated with a probabilistic method, the two-dimensional Monte-Carlo model. The calculations were performed using the R plugin (mc2d package) integrated into the KNIME (Konstanz Information Miner) software. The simulations were performed using data from the 2018–2020 food consumption survey. The AFM1 analytical data were derived from the Hungarian monitoring survey and 1,985 milk samples were analyzed within the framework of the joint project of the University of Debrecen and the National Food Chain Safety Office of Hungary (NÉBIH). Limited AFM1 concentrations were available for processed dairy products; therefore, a database of AFM1 processing factors for sour milk products and various cheeses was produced based on the latest literature data, and consumer exposure was calculated with the milk equivalent of the consumed quantities of these products. For risk characterization, the calculation of hazard index (HI), Margin of Exposure, and the hepatocellular carcinoma incidence were used. The results indicate that the group of toddlers that consume a large amount of milk and milk products are exposed to a certain level of health risk. The mean estimated daily intake of toddlers is in the range of 0.008–0.221 ng kg−1 bw day−1; the 97.5th percentile exposure of toddlers is between 0.013 ng kg−1 bw day−1 and 0.379 ng kg−1 bw day−1, resulting in a HI above 1. According to our study, the exposure of older age groups does not pose an emergent health risk. Nevertheless, the presence of carcinogenic compounds should be kept to a minimum in the whole population.

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“…The study, the implemented methodology, and harmonized data present a basis for further food and nutrition research, policy and strategy initiatives, exposure and environmental impact of food consumption assessment, development of dietary recommendations, and are a high-quality foundation for the establishment of food system research. For instance, the dataset has already been employed for exposure risk assessments to aflatoxin M1 in milk products and nitrites and phosphorus intake from meat products in the child population ( 38 , 39 ). All four countries successfully submitted food consumption data to EFSA (two national study reports are already available online at the moment) ( 40 , 41 ), which can now become part of the pan-European pool of harmonized data resources within the EU Menu umbrella ( 42 ).…”

Section: Resultsmentioning

confidence: 99%

Implementation of Harmonized Food Consumption Data Collection in the Balkan Region According to the EFSA EU Menu Methodology Standards

et al. 2022

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Initiatives in the Capacity Development in Nutrition Research in the Balkan region in the last decade have been toward the creation of contemporary, harmonized Research Infrastructure (RI) compliant with European standards. This study describes the process of creation and implementation of the European Food Safety Authority (EFSA) EU Menu methodology in the Balkan region during the EFSA support projects for food consumption data collection in four countries (Serbia, Montenegro, Bosnia and Herzegovina, and North Macedonia). This process entailed the application and improvement of an innovative tool, the DIET ASSESS and PLAN (DAP), a platform for standardized food consumption data collection and dietary intake assessment. DAP comprises computerized food consumption, anthropometric measurements, and physical activity questionnaires, validated food picture book, and FoodEx2 exposure hierarchy with sets of facet descriptors of the interest. It hosts the Balkan food platform with a Serbian food composition database (FCDB) and Regional FCDB, compliant with European Food Information Resource (EuroFIR™) standards. The implementation of the DAP platform in national dietary surveys conducted with the support of the EFSA EU Menu project in Balkan countries enabled harmonized food consumption data compilation and reporting. Application of the methodology entailed the development of study protocol and extensive education and training of study personnel. The entire data collection process was managed by internal and external survey coordinators. A pilot study was conducted to test the entire data collection and control process and was afterward used to make necessary improvements and adjustments to meet EU Menu requirements. Data collected are internationally comparable with food consumption data in other European countries within the framework of the EU Menu program. The existence of such data in the Balkan region will catalyze research activities in emerging topics, such as identification of dietary patterns, the establishment of national nutrient reference values and food-based dietary guidelines (not only in Serbia, but in the whole Balkan region), dietary exposure assessments, the endorsement and evaluation of new food legislations, the environmental and other effects of diet on the food system. The developed and implemented methodology underpins evidence-based policy-making processes lacking in the field of public health nutrition in the region.

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Dietary Exposure and Risk Assessment of Aflatoxin M1 for Children Aged 1 to 9 Years Old in Serbia

Cited by 21 publications

References 39 publications

Aflatoxin B1 Occurrence in Children under the Age of Five’s Food Products and Aflatoxin M1 Exposure Assessment and Risk Characterization of Arab Infants through Consumption of Infant Powdered Formula: A Lebanese Experience

Aflatoxin B1 Occurrence in Children under the Age of Five’s Food Products and Aflatoxin M1 Exposure Assessment and Risk Characterization of Arab Infants through Consumption of Infant Powdered Formula: A Lebanese Experience

Probabilistic modeling and risk characterization of the chronic aflatoxin M1 exposure of Hungarian consumers

Implementation of Harmonized Food Consumption Data Collection in the Balkan Region According to the EFSA EU Menu Methodology Standards

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