Contamination level and exposure assessment to Aflatoxin M1 in Jordanian infant milk formulas

Research on commercial milk formulas for young children: A scoping review

A scoping review of publications about commercial milk formulas intended for or consumed by children 12-36 months (CMF 12-36) was conducted. This review aimed to comprehensively map the existing literature, identify key concepts in the field and understand its evolution through time. A total of 3329 articles were screened and 220 were included, published between 1986 and 2024. Most works were published after 2016 (70.0%) and in high-income countries (71.8%). Original studies were the vast majority (81.8%) of publications. Most publications dealt with feeding practices or analysed the composition and/or contamination of specific products (44.1% and 35.9%), but since the late 2000s, publications about marketing, policy, legislation, and consumer perception started to appear. Most published works (65.5%) did not focus exclusively on CMF 12-36 and included formulas for other demographics or other foods. About half of the works (55.5%) did not consider CMF 12-36 to be a breast milk substitute. We found 81 distinct product denominations used to refer to CMF 12-36, Growing Up Milk was the most common (25.9%). CMF industry was involved in 41.8% of all analysed works, and industry participation and funding were not always clearly informed (22.5% lacked a conflict of interest statement, and 25.5% did not present any information about funding). In the last decade, publications about CMF 12-36 have increased in volume and diversified in scope and subject matter. CMF-industry participation has always been and still is present in the field, so possible vested interests should be taken into account when appreciating the literature.

Assessment of Aflatoxin M1 in human breast and powdered milk in Tehran, Iran

AIM AND BACKGROUND

Aflatoxins, produced by Aspergillus flavus and Aspergillus parasiticus, are among the most toxic mycotoxins. Aflatoxin M1 (AFM1) is a hydroxylated metabolite of aflatoxin B1 (AFB1), found in milk and dairy products from animals fed AFB1-contaminated feed. Consumption of AFM1 has related adverse effects on human health. Breast milk can be a source of contamination for infants due to the presence of AFM. AFM1 can also contaminate powdered milk, a significant product of the milk industry. Consequently, monitoring dairy products for these toxins is imperative.

STUDY METHOD

A total of 50 samples (25 samples of breast milk and 25 samples of powdered infant milk formula) were collected in Tehran from December 2021 to February 2022. HPLC method was used for the determination of AFM1 in samples.

RESULTS

and Discussion: AFM1 was detected in 72% of breast milk samples and 96% of powdered milk samples. AFM1 levels varied significantly between the two sample types (p < 0.05). The average amount of AFM1 in breast milk samples was 25.82 ± 4.72 ng/kg, while the average amount in powdered milk samples was 40.59 ± 7.76 ng/kg. Moreover, 44% of the breast and 68% of powdered milk samples exceeded the AFM1 content limit of the European Union and the Iranian national standard. This study concludes that given the importance of breast milk and formula to maternal and infant health, monitoring and regulating the toxin levels in these products in Tehran is crucial.

Review, meta-analysis and carcinogenic risk assessment of aflatoxin M1 in different types of milks in Iran

REVIEWS

Despite in recent decades, several studies on the concentration of aflatoxins M1(AFM1) in various milks have been studied, as we know, no systematic review, meta-analysis and carcinogenic risk assessment study was conducted in Iran till now.

OBJECTIVES

In this study, a systematic review was conducted to collect, meta-analysis and carcinogenic risk assessment of the quantitative data regarding the prevalence and concentration of AFM1 in several types of milk produced in Iran.

CONTENT

In our study, the concentration and prevalence of AFM1 in different types of milk (Raw, pasteurized, and UHT) from 113 original articles in Iran using searching the Web of Science, PubMed, Scopus, Science Direct and Google Scholar (in Persian and English) databases from 2002 to august 2021 were collected. The concentration of AFM1 was meta-analyzed using the random effect model (REM) based on type of milk (raw, pasteurized and UHT) subgroups and Monte Carlo simulation (MCS) approach was used to assess safety risks and investigate carcinogenic effects of AFM1 using Crystal-Ball software (Version 11.1.3, Oracle, Inc., USA).

SUMMARY AND OUTLOOK

The 113 original article (In English and Persian) were included in this review. Meta-analysis indicated lower and upper of AFM1 in subgroups of raw, pasteurized and UHT milk in Iran was 9, 720, 2.7, 230.2, 19.23, and 221.6 ng/kg respectively. The Point estimate for carcinogenic risk of AFM1 showed as result of age increasing, the carcinogenic risk of Aflatoxin M 1 decreases and concentration of Aflatoxin M1 (ng/liter), plays the most effective role in carcinogenic risk of AFM1.

CONCLUSION

The presence of AFM1 in milk and its products due to its high toxicity and carcinogenic properties is a public health concern that the results show that the risk of carcinogenesis is higher at younger ages (less than 20 years). As a result, there is a strong association between consumption of raw milk, pasteurized milk and UHT and the risk of cancer in children and adults in Iran.

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 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. Our findings show that AFM1's EDI, HQ and MOE scored high among Lebanese infants. 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.

Assessment of aflatoxin M1 and B1 in some dairy products with referring to the analytical performances of enzyme-linked immunosorbent assay in comparison to high-performance liquid chromatography

Background and Aim:

Aflatoxin M₁ (AFM₁) is a major fungal metabolite found in milk coming from aflatoxin B₁ (AFB₁) contaminated rations and is subsequently present in milk-based products demonstrating a serious public health hazard. This study aimed to investigate the levels of AFM₁ and AFB₁ in milk and some dairy products consumed widely by infants and children.

Materials and Methods:

This study investigated the incidence of AFM₁ in 105 samples of processed cheese, Ras cheese, and raw milk (35 of each) retailed in the Egyptian markets. The degree of sensitivity and accuracy was evaluated using the enzyme-linked immunosorbent assay (ELISA) method followed by the estimation of the positive samples using the high-performance liquid chromatography (HPLC) with fluorescence detection. Mold count was determined in the examined samples by investigating AFB₁ content using HPLC.

Results:

AFM₁ was found in all investigated Ras cheese, raw milk, and 82.86% of the processed cheese samples with mean values of 51.05±6.19, 40.27±3.996, and 10.77±1.39 ng/kg, respectively. Moreover, there was statistically no significant difference between AFM₁ levels in the core and crust parts of the tested Ras cheese. AFM₁ contaminated Ras cheese and raw milk samples were 48.57% and 25.71%, which exceeded the European and Egyptian tolerance levels. Results showed an acceptable correlation between ELISA and HPLC methods with no significant difference (p>0.05). Alternatively, none of the examined samples proved to be contaminated with AFB₁ despite the presence of mold with mean counts of 3.79±3.29, 4.39±4.34, and 4.84±4.29 log CFU/g in the examined processed cheese, Ras cheese, and raw milk samples, respectively.

Conclusion:

Therefore, it is urgent to regularly inspect the contamination of animal feeds with AFB₁ and apply special measures and novel techniques to protect the feed and food from public health hazards.

Determination of Aflatoxin M1 in Raw Milk from Different Provinces of Ecuador

Aflatoxin M1 (AFM1) is a mycotoxin from Aspergillus flavus and A. parasiticus, classified as carcinogenic and hepatotoxic. The objective of the present investigation was to determine its presence in raw milk from north-central Ecuador, constituted by the provinces of Pichincha, Manabí, and Santo Domingo de los Tsáchilas. These areas represent approximately 30% of Ecuadorian milk production. By the end of the investigation, a total of 209 raw milk samples were collected, obtained both during the dry (June and August) and rainy seasons (April and November) of 2019. AFM1 concentrations were measured with lateral flow immunochromatographic assays, and 100% of the samples were positive for this mycotoxin, presenting a mean value of 0.0774 μg/kg with a range of 0.023 to 0.751 μg/kg. These AFM1 levels exceeded the European Union regulatory limit of 0.05 μg/kg in 59.3% (124/209) of samples, while only 1.9% (4/209) exceeded the Ecuadorian legal limit of 0.5 μg/kg. By using non-parametric tests, significant differences were determined (p ≤ 0.05) between the provinces for months of study, climatic season (being higher in the dry season), and climatic region (greater in the coast region). On the other hand, there were no significant differences (p ≥ 0.05) between the types of producers or between production systems. Therefore, AFM1 contamination in raw milk does not present a serious public health problem in Ecuador, but a monitoring and surveillance program for this mycotoxin in milk should be developed to prevent consumer health problems.

Gallic acid enhances reproductive function by modulating oxido-inflammatory and apoptosis mediators in rats exposed to aflatoxin-B1

IMPACT STATEMENT

Infertility resulting from reproductive deficiency can be stressful. Exposure to aflatoxin B1, a dietary mycotoxin prevalent in improperly stored grains, is reported to elicit reproductive insufficiencies and infertility. We, therefore, examined the likely beneficial effect of gallic acid (GA) a phytochemical, recognized to exhibit in vitro and in vivo pharmacological bioactivities against oxidative stress and related inflammatory damages in rats, since AFB1 toxicities are predicated on oxidative epoxide formation, in a bid to proffer new evidence to advance the field of nutriceutical application from plant-derived chemopreventive agents. Our findings will advance the field of chemoprevention by presenting data absent in the literature on GA. Our results demonstrate further evidence for GA conferred protection against AFB1-mediated histological lesions in testes, epididymis, and hypothalamus of treated rats; suppresses oxidative damages, relieved inflammatory and apoptotic responses, restored sperm functional characteristics, and hormonal levels relevant for reproductive integrity and function.

Aflatoxin M1 Determination in Infant Formulae Distributed in Monterrey, Mexico

The occurrence of aflatoxin M1 (AFM1) in infant formulae commercialized in the metropolitan area of Monterrey (Nuevo León, Mexico) was determined by using immunoaffinity column clean-up followed by HPLC determination with fluorimetric detection. For this, 55 infant formula powders were classified in two groups, starter (49 samples) and follow-on (6 samples) formulae. Eleven of the evaluated samples (20%) presented values above the permissible limit set by the European Union for infant formulae (25 ng/L), ranging from 40 to 450 ng/L. The estimated daily intake (EDI) for AFM1 was determined employing the average body weight (bw) of the groups of age in the ranges of 0-6 and 6-12 months, and 1-2 years. The results evidenced high intake values, ranging from 1.56 to 14 ng/kg bw/day, depending on the group. Finally, with the EDI value, the carcinogenic risk index was determined, presenting a high risk for all the evaluated groups. Based on these results, it is a necessary extra effort by the regulatory agencies to reduce the AFM1 presence in infant formulae consumed in Mexico.

Sulfamethazine contamination level and exposure assessment in domestic and imported poultry meats in Jordan

BACKGROUND AND AIM

Sulfamethazine (SMZ) is an important and widely used antibiotic in poultry industry due to its high efficacy in fighting diseases and promoting growth. In addition, SMZ is a possible human carcinogen and has been found in many food types including poultry meat. Accordingly, this study aimed to survey the contamination level and estimated daily intake (EDI) of SMZ in domestic and imported poultry meat samples in Jordan.

MATERIALS AND METHODS

A total of 120 samples; 60, 30, and 30 of fresh and frozen domestic and frozen imported poultry samples, respectively, were collected from different cities in Jordan. Poultry samples were analyzed for SMZ incidence rate and contamination level using a competitive enzyme-linked immunosorbent assay technique. EDI values were calculated from the SMZ concentration, average poultry daily consumption rate, and adult body weight (b.w.).

RESULTS

Of the 120 surveyed samples, 20 samples (16.7%) were SMZ violative positive and exceeded the European Union maximum limit (100 µg/kg) and accordingly were unfit for human consumption. Whereas, 51 samples (42.5%) were with SMZ concentrations of 10-100 µg/kg. The average SMZ concentration was 235.58 µg/kg, with a range of 11.47-800 µg/kg poultry meat. It is also noteworthy the high EDI of SMZ by Jordanian adults, 0.286 µg SMZ/kg b.w./day. Moreover, results prevailed that the highest SMZ incidence rate and contamination level were for imported poultry samples followed by domestic poultry samples, which may indicate that SMZ contamination in poultry meat is an international issue.

CONCLUSION

The current study prevailed high SMZ incidence rate, contamination level, and EDI values, which is likely due to indiscriminate use of SMZ in poultry production. Results also prevailed the high risk that consumers in Jordan may expose due to SMZ residues. Therefore, more strict program and good agricultural practices should be applied to monitor antibiotic withdrawal periods in animals used for human consumption to ensure the legal residue requirements of these antibiotics.