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Peirovi-Minaee R, Taghavi M, Harimi M, Zarei A. Trace elements in commercially available infant formulas in Iran: Determination and estimation of health risks. Food Chem Toxicol 2024; 186:114588. [PMID: 38467297 DOI: 10.1016/j.fct.2024.114588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/17/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024]
Abstract
Infants are significantly more vulnerable to trace elements from their foods. The objective of the present study was to ascertain the concentrations of some trace elements namely; arsenic, cadmium, chromium, copper, nickel and lead in infant formulas sold in Iran and to estimate the potential health risks to the infants through consumption of these products. The mean concentrations of As, Cd, Cr, Cu, Ni and Pb in infant formula samples were 0.006, 0.040, 0.3980, 2.014, 0.166 and 0.285 mg/kg, respectively. The mean levels of the trace elements were in the following order: Cu > Cr > Pb > Ni > Cd > As. For arsenic, cadmium and copper, calculated EWIs (estimated weekly intakes) were within the PTWIs (provisional tolerated weekly intakes) recommended by FAO/WHO. For chromium, nickel and lead, the calculated EWIs were higher than the PTWIs in 88.8 %, 75 %, and 61.1 % of the formulas. HQs of Pb, Cu, Cd and As were above the safe limits, indicating health concerns from the consumption of some infant formulas. Based on the CR classification, CR values of some elements including Cd, Cr and Ni were above 1 × 10-4 in some brands, indicating that exposure to these elements from infant formulas may cause health risks. Therefore, regular monitoring of all the raw materials, stages of production and storage of infant formulas is essential to limit the exposure of this vulnerable age group to toxic trace elements.
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Affiliation(s)
- Roya Peirovi-Minaee
- Department of Environment Health Engineering, School of Health, Social Determinates of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran; Department of Environmental Health Engineering, School of Health, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahmoud Taghavi
- Department of Environment Health Engineering, School of Health, Social Determinates of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Marzieh Harimi
- Department of Environmental Health Engineering, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Ahmad Zarei
- Department of Environmental Health Engineering, School of Health, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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Liao KW, Lee WJ, Lin SC, Tsao YN, Lin HY, Liu C, Chin WS. Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan. J Food Sci 2024; 89:1804-1813. [PMID: 38258895 DOI: 10.1111/1750-3841.16929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn.
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Affiliation(s)
- Kai-Wei Liao
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ju Lee
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Shao-Chi Lin
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yi-Ning Tsao
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Ying Lin
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Chen Liu
- Master Program in Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
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Zhang C, Luo Y, Sun S, Tian T, Zhu M, Ahmad Z, Yang J, Jin J, Zhang H, Chen J, Geng N. Accumulation characteristics of metals in human breast milk and association with dietary intake in northeastern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:168515. [PMID: 37977390 DOI: 10.1016/j.scitotenv.2023.168515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/19/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
The trace elements present in breast milk play a vital role in the growth and development of infants. Nevertheless, numerous studies have reported the presence of toxic metal contamination in breast milk from various countries and regions, which poses potential risks to breastfed infants. This article aimed to investigate the characteristics of trace elements in breast milk and explore the relationship between breast milk and diet in Dalian, a coastal city in northeastern China. Breast milk samples and representative local food samples were collected from Dalian for research. The results revealed that 57 % of breast milk samples significantly exceeded the WHO safety limit (0.6 μg/L) for arsenic, with a measured mean value of 0.96 μg/L. Moreover, the levels of chromium (mean value: 2.63 μg/L) in 34 % of breast milk samples exceed the WHO recommended safety level (chromium: 1.5 μg/L). Aquatic foods accounted for 60 % to 90 % of the total intake of arsenic, cadmium, vanadium, mercury, and lead. The Spearman correlation analysis demonstrated strong positive correlations among breast milk metal elements, including copper-zinc (r = 0.68) and nickel‑chromium (r = 0.89). Furthermore, the food-to-milk accumulation factors (FMAF) of strontium, nickel, arsenic, vanadium, cadmium, and mercury were relatively low (median values <0.005). While the FMAF values for chromium and lead were higher, with median values of 0.038 and 0.07, respectively. The results indicated potential risks of the toxic metal arsenic in breast milk from Dalian, China for breastfed infants. Therefore, continuous monitoring of breast milk for toxic metals and foodborne contamination is necessary.
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Affiliation(s)
- Chengbin Zhang
- College of Materials Science and Engineering, Hebei University of Engineering, Handan 056038, China
| | - Yun Luo
- College of Medicine, Linyi University, Linyi 276005, China
| | - Shuai Sun
- Nanjing Institute of Environmental Science, Ministry of Ecology and Environment of the People's Republic of China, Nanjing 210042, China
| | - Tian Tian
- College of Materials Science and Engineering, Hebei University of Engineering, Handan 056038, China
| | - Meiwen Zhu
- Chongqing Academy of Metrology and Quality Inspection, Chongqing 401123, China
| | - Zia Ahmad
- Key Laboratory of Separation Sciences for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Jiajia Yang
- College of Materials Science and Engineering, Hebei University of Engineering, Handan 056038, China.
| | - Jing Jin
- Key Laboratory of Separation Sciences for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Haijun Zhang
- Key Laboratory of Separation Sciences for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Jiping Chen
- Key Laboratory of Separation Sciences for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
| | - Ningbo Geng
- Key Laboratory of Separation Sciences for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China.
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Zheng Q, Xiao J, Zhang D, Li X, Xu J, Ma J, Xiao Q, Fu J, Guo Z, Zhu Y, Ji J, Lu S. Bisphenol analogues in infant foods in south China and implications for infant exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 910:168509. [PMID: 37977386 DOI: 10.1016/j.scitotenv.2023.168509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Bisphenol analogues (BPs) are commonly used as modifiers, stabilizers and photo-initiators in polymer materials, including those used in food packaging. Compared to adults, infants are more sensitive to chemicals because their bodies are growing and not fully developed. Therefore, it is essential to determine the concentrations of BPs in common infant foods to assess infant exposure and prevent hazards. We collected 54 infant formula (IF) samples, 90 complementary food (CMF) samples and 62 breastmilk samples from breastfeeding women in south China. Tandem mass spectrometry coupled to liquid chromatography separation (HPLC-MS/MS) was used to detect the concentrations of 8 BPs in the three types of food samples. The estimated daily intake (EDI) of infants was also assessed. The results showed that the detection frequency of bisphenol F (BPF), bisphenol S (BPS), bisphenol AF (BPAF) and bisphenol AP (BPAP) were relatively high among the different infant foods. BPF, BPP and BPS were predominant among the detected BPs. The lowest 95th EDI for BPA was 0.67 ng kg-bw-1 day-1, exceeding the tolerable daily intake (TDI) limit for BPA set by the European Food Safety Authority in 2023. Thus, BP exposure is a significant risk to infants. More attention should be paid to the presence of BPs in daily use products and food, and intake limits should be set for BPs other than BPA.
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Affiliation(s)
- Quanzhi Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jinqiu Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Duo Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Xiangyu Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jiayi Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jiaojiao Ma
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Qinru Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jinfeng Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yue Zhu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Shaoyou Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
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Souza MCO, Souza JMO, da Costa BRB, Gonzalez N, Rocha BA, Cruz JC, Guida Y, Souza VCO, Nadal M, Domingo JL, Barbosa F. Levels of organic pollutants and metals/metalloids in infant formula marketed in Brazil: Risks to early-life health. Food Res Int 2023; 174:113594. [PMID: 37986457 DOI: 10.1016/j.foodres.2023.113594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023]
Abstract
Infant formula intake is recommended to ensure comprehensive nutritional and caloric fulfillment when exclusive breastfeeding is not possible. However, similarly to breast milk, infant formulas may also contain pollutants capable of inducing endocrine-disrupting and neurotoxic effects. Thus, considering the sensitivity of their developing physiological systems and that infants have heightened susceptibility to environmental influences, this study was aimed at assessing the contents of essential elements, and inorganic and organic pollutants in infant formulas marketed in Brazil. Additionally, health risk assessments for selected contaminants were also performed. Measured contents of essential elements (Ca, Fe, Mg, Mn, Cu, Se, and Zn) were congruent with label information. Nevertheless, some toxic elements (Pb, Cd, As, Ni, and Al) were also detected. Notably, in the upper-bound scenario, Pb and Cd surpassed established threshold values when comparing the estimated daily intake (EDI) and tolerable daily intake (TDI - 3.57 and 0.36 μg/kg bw, respectively). Bisphenol P (BPP) and benzyl butyl phthalate (BBP) were frequently detected (84 % detection rate both) with elevated contents (BPP median = 4.28 ng/g and BBP median = 0.24 ng/g). Furthermore, a positive correlation (0.41) was observed between BPP and BBP, implying a potential co-occurrence within packaging materials. Methyl-paraben also correlated positively with BBP (0.57), showing a detection rate of 53 %. The cumulative PBDE contents ranged from 0.33 to 1.62 ng/g, with BDE-154 and BDE-47 the dominant congeners. When comparing EDI values with TDIs, all organic pollutants remained below the thresholds across all exposure scenarios. Moreover, non-carcinogenic risks were below the threshold (HQ > 1) when dividing the EDIs by the respective reference doses for chronic exposure. While the current findings may suggest that infant formula intake poses no immediate risk in terms of the evaluated chemicals, it remains imperative to conduct further research to safeguard the health of infants considering other chemicals, as well as their potential cumulative effects.
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Affiliation(s)
- Marília Cristina Oliveira Souza
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Analytical and System Toxicology Laboratory, Avenida do Café s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil.
| | - Juliana Maria Oliveira Souza
- Department of Biochemistry, Biological Sciences Institute, University of Juiz de Fora, Campus Universitário, Rua José Lourenço Kelmer, s/n - São Pedro, Juiz de Fora, MG 36036-900, Brazil
| | - Bruno Ruiz Brandão da Costa
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Forensic Toxicology Analysis Laboratory, Avenida dos Bandeirantes, 3900 - Monte Alegre, 14015-130, Ribeirao Preto, Sao Paulo, Brazil; University of Sao Paulo, Institute of Biosciences, Department of Botany, Laboratory of Phytochemistry, Rua do Matão, 277, 05508-090 Sao Paulo, Brazil
| | - Neus Gonzalez
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - Bruno Alves Rocha
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Analytical and System Toxicology Laboratory, Avenida do Café s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Jonas Carneiro Cruz
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Analytical and System Toxicology Laboratory, Avenida do Café s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Yago Guida
- Institute of Biophysics Carlos Chagas Filho, Health Sciences Center, Federal University of Rio de Janeiro, 21941-902 Rio de Janeiro, RJ, Brazil
| | - Vanessa Cristina Oliveira Souza
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Analytical and System Toxicology Laboratory, Avenida do Café s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Martí Nadal
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - José L Domingo
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - Fernando Barbosa
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology, and Food Sciences, Analytical and System Toxicology Laboratory, Avenida do Café s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
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Akyıldız D, Bay B. The effect of breastfeeding support provided by video call on postpartum anxiety, breastfeeding self-efficacy, and newborn outcomes: A randomized controlled study. Jpn J Nurs Sci 2023; 20:e12509. [PMID: 36071624 DOI: 10.1111/jjns.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/23/2022] [Accepted: 08/12/2022] [Indexed: 01/05/2023]
Abstract
AIM To examine the effects of breastfeeding support given by video call on anxiety, breastfeeding self-efficacy, and newborn outcomes. METHODS We conducted a randomized controlled experimental trial with 72 women and their babies. Participants were randomly assigned to the intervention (video call) group (VCG: standard care + video call) and control group (CG: standard care). The primary outcomes of this study were the mean postpartum maternal anxiety level and the mean breastfeeding self-efficacy level. The secondary outcome was neonatal outcomes. This study followed the CONSORT (Consolidated Standards of Reporting Trials) checklist. RESULTS Women in VCG had lower anxiety levels than the CG at postpartum 2 weeks (mean difference [MD] 25.42, p = .000) and 1 month (MD 47.72, p = .000). The breastfeeding self-efficacy level of women in the VCG was higher than the CG at postpartum 2 weeks (MD 13.18, p = .007) and 1 month (MD 10.1, p = .001). The newborns in VCG had higher weight gain and daily breastfeeding frequency than the CG at the postpartum second week (MD 9.64, p = .001, MD 2.88, p = .000; respectively) and 1 month (MD 47.16, p = .000, MD 2.98, p = .000; respectively). There were lower rates of challenges of breastfeeding, hyperbilirubinemia, and feeding with formula in VCG than CG at the postpartum second week (p = .043, p = .043, p = .039; respectively). CONCLUSIONS Breastfeeding support via video calling has positive effects on maternal anxiety, breastfeeding self-efficacy, and newborn health. Postpartum caregivers may benefit from video calling for breastfeeding support.
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Affiliation(s)
- Deniz Akyıldız
- Division of Midwifery, Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Onikişubat, Turkey
| | - Betül Bay
- School of Nursing and Midwifery/College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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