Design and preparation of market baskets of European Union commercial baby foods for the assessment of infant exposure to food chemicals and to their effects

Evaluation of Mycotoxins in Infant Breast Milk and Infant Food, Reviewing the Literature Data

In this review, an analysis focusing on mycotoxin determination in infant breast milk and infant food has been summarised for the last fifteen years of research focused on the intended population group of 1-9 months. The objective was to know the level of exposure of the child population to an estimated daily intake (EDI) of mycotoxins from the consumption of habitual foods. The EDI was compared with the tolerable daily intake (TDI) established by EFSA to estimate risk. In breast milk, the high prevalence and levels were for samples from Africa (Egypt and Tanzania) with aflatoxin M1 (1.9 μg/L and 10%), and Asia (Iran) with ochratoxin-A (7.3 μg/L and 100%). In infant formulas, high incidences and values were for samples with aflatoxin M1 from Burkina Faso (167 samples, 84%, 87 μg/kg). In cereal products, the highest incidence was for DON from the United States (96 samples), and the highest value was an Italian sample (0.83 μg/kg of enniatin B). In fruit products, patulin was the most detected in Italian (78) and Spanish (24) samples. The highest risk was observed in breast milk during the first month of age, the highest EDI for aflatoxin M1 was reported for Egypt (344-595 ng/kg bw/day) and ochratoxin-A for Iran (97-167ng/kg bw/day), representing a public health problem.

Infant Exposure to Metals through Consumption of Formula Feeding in Mekelle, Ethiopia

This study aimed at determination of heavy metals (cadmium, lead, and zinc) in milk-based infant formulas collected from Mekelle, Ethiopia, and their associated health risks to the infants through consumption of these products. The infant feeding samples were dry-ashed in a muffle furnace followed by digestion in nitric acid and the resulting solutions were analyzed by flame atomic absorption spectrophotometer. Cadmium was not detected in the samples while the levels of lead and zinc ranged from not detected value to 0.103 mg/kg and from 27.888 to 71.553 mg/kg, respectively. The estimated daily intake values and the health risk indices of both metals were below their respective safety limits and the threshold of 1, respectively. These findings show low infant health risk of these metals through consumption of these products. Nevertheless, regular monitoring of infant formula for toxic metals is required since infants are potentially more susceptible to metals.

Carcinogenic and non-carcinogenic risk of organochlorine pesticide residues in processed cereal-based complementary foods for infants and young children in Ghana

Fourteen organochlorine pesticides (OCPs) residues were analyzed in 10 brands of processed cereal-based complementary foods with the aim of assessing the health risk to infants and young children. The QuEChERS method was used for extraction and clean-up of pesticide residues. Subsequent detection and quantification were done using GC with ECD and PFPD. Levels of p,p'-DDE, dieldrin, β-endosulfan, β-HCH, and γ-HCH detected in the processed cereal-based complementary food were higher than their respective MRL. The mean estimated daily intakes of OCPs in infants were significantly higher than that of young children. Exposure levels of heptachlor and dieldrin were higher than their respective ADI's. Their HIs recorded were greater than 1 indicating the possibility of adverse health effect on consumers. Hazard ratio for carcinogenic risk posed by β-HCH, dieldrin, heptachlor, γ-HCH and γ-chlordane were greater than 1. This result raises concerns of possible carcinogenicity for infants and young children.

Occurrence and infant exposure assessment of nitrates in baby foods marketed in the region of Lisbon, Portugal

Commercial baby food labelled as from organic or conventional origin, including vegetable-based baby foods, fruit purees and fruit juices (n = 80), were analysed for nitrate content by an in-house validated HPLC method. Nitrate contents ranged from 5 to 230 mg kg(-1) with a mean concentration of 102 mg kg(-1) for vegetable-based baby foods, and a median of 5 mg kg(-1) for both fruit purees and juices. One sample of vegetable-based baby food was higher than the legislated value (200 mg kg(-1)). There were no significant differences between average nitrate levels in analysed samples regarding both farming systems. The estimated nitrate intake through baby foods for a mean nitrate concentration of 47 mg kg(-1) ranged between 0.5 (15% of ADI) and 1.3 mg kg(-1) bw day(-1) (35% of ADI). The ADI level was exceeded (107-146% of ADI) only for the 95th and 99th percentiles of nitrate concentration.

Infant exposure to polybrominated diphenyl ethers (PBDEs) via consumption of homemade baby food in Korea

Limited data are available on the residue levels of polybrominated diphenyl ethers (PBDEs) in baby food. In this study, 24 PBDE congeners were determined in 147 homemade baby food samples collected from 97 households for 6-, 9-, 12-, 15-, and from 24 to 27-month-old infant groups during the period of 2012-2013. The concentrations of total PBDEs (ΣPBDE) ranged from 24.5 to 6000 (mean: 263) pg/g fresh weight, higher than those found in commercial formulae from the United States. The predominant congeners were BDEs 209 and 47, accounting for 92% of the ΣPBDE concentrations, reflected by high deca-BDE consumption in Korea. The residue levels and detection rates of BDE 47 in the baby food samples showed a gradual increasing trend with an increase in infant ages, due to changes in the food ingredients from hypoallergenic to greasy. The daily intakes of BDEs 47 and 209 via baby food consumption ranged from 0.04 to 0.58, 0.80 to 20.3, and 1.06 to 22.3 ng/kg body weight/day for 6-, 9-, 12-, 15-, and 24-27-month-old infant groups, respectively; these intakes were lower than the oral reference doses proposed by the US EPA. Together with three exposure sources, baby food, breast milk and dust ingestion for 6-month-old infants, the daily intake of ΣPBDE was 25.5 ng/kg body weight/day, which was similar to the intake via baby food consumption only for over 24-month-old infants in our study. This indicates that baby food is an important exposure pathway of PBDEs for over 24-month-old infants. This is the first study regarding the occurrence and exposure assessment of PBDEs via homemade baby food.

Assessment of infant exposure to food chemicals: the French Total Diet Study design

As part of the previous French Total Diet Studies (TDS) focusing on exposure to food chemicals in the population aged 3 years and older, the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) launched a specific TDS on infants to complete its overall chemical food safety programme for the general population. More than 500 chemical substances were analysed in food products consumed by children under 3 years old, including nutrients, several endocrine disruptors resulting from human activities (polychlorinated biphenyls, dioxins and furans, brominated flame retardants, perfluoroalkyl acids, pesticide residues, etc.) or migrating from food contact materials such as bisphenol A or phthalates, but also natural substances such as mycotoxins, phytoestrogens and steroids. To obtain a representative and general view of infant food consumption, food items were selected based on results of a national consumption survey conducted specifically on this population. Moreover, a specific study on food was conducted on 429 households to determine which home-cooking practices are employed to prepare food consumed by infants. Overall, the targeted chemical substances were analysed in more than 450 food samples, representing the purchase and home-cooking practices of over 5500 food products. Foods included common foods such as vegetables, fruit or cakes as well as specific infant foods such as infant formula or jarred baby food. The sampling plan covered over 80% of the total diet. Specificities in infant food consumption and habits were therefore considered to define this first infant TDS. This study, conducted on a large scale and focusing on a particularly sensitive population, will provide accurate information on the dietary exposure of children under 3 years to food chemicals, especially endocrine disruptors, and will be particularly useful for risk assessment analysis under the remit of ANSES' expert committees.

Executive summary: Evaluating the evidence base to support the inclusion of infants and children from birth to 24 mo of age in the Dietary Guidelines for Americans--"the B-24 Project"

The Dietary Guidelines for Americans (DGA) are the cornerstone of US government efforts to promote health and prevent disease through diet and nutrition. The DGA currently provides guidelines for ages ≥ 2 y. In an effort to determine the strength of the evidence to support the inclusion of infants and children from birth to age 24 mo, the partner agencies led by the Department of Health and Human Services Office of Disease Prevention and Health Promotion and the USDA Center for Nutrition Program and Policy initiated the project entitled "Evaluating the evidence base to support the inclusion of infants and children from birth to 24 months of age in the Dietary Guidelines for Americans--the B-24 Project." This project represents the first step in the process of applying systematic reviews to the process of deciding whether the evidence is sufficient to include this age group in future editions of the DGA. This supplement includes the B-24 Executive Summary, which describes the B-24 Project and the deliberations of the 4 working groups during the process of developing priority topics for the systematic review, and a research agenda to address the critical gaps. Also included in this supplement issue is an article on the Nutrition Evidence Library methodology for developing systematic review questions and articles from the invited content presenters at the B-24 Prime meeting.

Occurrence and exposure assessment of polychlorinated biphenyls and organochlorine pesticides from homemade baby food in Korea

Data on the residue levels of persistent organic pollutants (POPs) in baby food samples are scarce. This is the first study to explore current contamination status and exposure assessment of organochlorines (OCs), including polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs), in baby food from Korea. In this study, the concentrations of OCs were determined in homemade baby food samples (n=100) collected from 6-, 9-, 12- and 15-month-old infant groups. The average concentrations of PCBs, dichloro-diphenyl-trichloroethanes (DDTs), hexachlorocyclohexanes (HCHs) and chlordanes (CHLs) in baby food samples were 37.5, 96.6, 26.0, and 13.2 pg/g fresh weight, respectively. The major compounds were CBs 28, 153, 52, and 33 for PCBs and p,p'-DDE, p,p'-DDT and β-HCH for OCPs. The contribution of DDTs to the total OC concentrations increased from 30% (6-month-old infants) to 67% (15-month-old infants) with increasing infant age, while the concentrations of PCBs, HCHs and CHLs gradually decreased with increasing infant age, suggesting that highest priority for risk reduction of DDTs. The estimated daily intakes (EDIs) of OCs in Korean infants from baby food consumption were lower than the thresholds proposed by the United States Environmental Protection Agency and Health Canada, implying limited potential health risks. However, considering simultaneous exposure from baby food and breast milk consumption, chlordanes and heptachlor epoxide posed potential health risks. Considering the importance of early development and the vulnerability of infants, it is essential to perform systematic monitoring and management programs of OCs in baby food for risk reduction in Korean infants.

Infant dietary exposure to dioxins and dioxin-like compounds in Greece

The dietary exposure of infants to polychlorinated dibenzo dioxins and furans (PCDD/Fs) and dioxin like polychlorinated biphenyls (dl-PCBs) is an issue of great social impact. We investigated for the first time the dietary intake of these compounds in infants living in Greece. We included in our study two age groups: 0-6 months, when infants are fed exclusively by human milk and/or formula milk, and 6 to 12 months, when solid food is introduced to nutrition. We took into consideration analytical results for PCDD/Fs and dl-PCBs concentrations in the most popular infant formulae in the Greek market, previous data for mother milk concentrations of PCDD/Fs and dl-PCBs from Greece, and finally analytical data for fat-containing food products from the Greek market. In the first study group, it was found than in infants exclusively fed by breast milk, the calculated sum of PCDD/Fs and dioxin-like PCBs (60.3-80.4 TEQ pg/kg body weight) was significantly higher than that of infants that consume a combination of human milk and formula (31.2-41.6 TEQ pg/kg body weight). In the second study group, separate daily intake estimations were performed for babies receiving human milk (estimated total daily intake 19.76-24.95 TEQ pg/kg body weight) and formula milk (estimated total daily intake 1.60-2.24 TEQ pg/kg body weight). The risks of this exposure should not be overestimated because nursing is restricted to a limited period of human life and besides, the potential consumption of higher levels of dioxin-like compounds is fully compensated by the significant benefits of breast-feeding.

Genistein and dicarboximide fungicides in infant formulae from the EU market

A method based on ultrasonic extraction and purification by solid phase extraction followed by LC-MS/MS and GC-MS analysis was developed for the determination of genistein, genistin, iprodione, vinclozolin and procymidone in infant powdered formulas. The method was tested for different formulations: milk, soy and hypoallergenic, and was applied to European pooled samples. Spike recoveries ranged from 53.1% to 91.5% and the relative standard deviation values for repeatability ranged from 9.6% to 17.7%, except for iprodione in milk formula (22.3%). None of the fungicides were found in the European pooled formulae, while genistein was found at 9.7μg/g in soy formula and the concentration of genistin, its β-glycosylated form, was respectively 31.4ng/g and 476ng/g in milk and soy formula.

Assessment of dietary exposure to PCDD/F and dioxin-like PCB in infant formulae available on the EU market

In infant period, human milk and infant formulae are the major sources of exposure to dioxins (polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (PCB). Since in many parts of Europe the mothers are increasingly reluctant to breastfeed their babies, the main objective of the present study is to assess the level of exposure of non-breast-fed infants during their early development. Consequently, the concentration levels of PCDD/F and dioxin-like PCB were determined in industrial infant formulae including "starting" (aged 0-4months) and "follow-on" (after 4months) products of milk formula, soy formula and hypoallergenic infant formula, available on the EU market. Furthermore, dietary exposure to dioxin of exclusively formula-fed infants was assessed at each month from 0 to 9months. The results suggest that dietary exposure to dioxins via formulae is higher when consuming "starting" than "follow-on" infant formulae on a body-weight basis. Estimated dietary exposure after 4months of age was always below the lowest range of the Tolerable Daily Intake (TDI) of 1pg WHO-TEQkg(-1)bwd(-1) and Provisional Tolerable Monthly Intake (PTMI) of 70pg WHO-TEQkg(-1)bwmonth(-1). The highest estimated cumulative dietary exposure to PCDD/F and dioxin-like PCB was obtained considering infants of 0-1months fed with the "starting" hypoallergenic infant formula (2.8pg WHO-TEQkg(-1)bwd(-1) and 84pg WHO-TQkg(-1)bwmonth(-1)). However, these elevated levels are much lower than those observed in some studies in breast-fed infants. The study can be used for further risk assessments in regard to infant exposure.