TY - JOUR
T1 - Exposure to aflatoxins and fumonisins and linear growth of children in rural Ethiopia
T2 - A longitudinal study
AU - Tessema, Masresha
AU - De Groote, Hugo
AU - Brouwer, Inge D.
AU - De Boevre, Marthe
AU - Corominas, Arnau Vidal
AU - Stoecker, Barbara J.
AU - Feskens, Edith J.M.
AU - Belachew, Tefera
AU - Karakitsou, Anastasia
AU - Gunaratna, Nilupa S.
PY - 2021
Y1 - 2021
N2 - Objective: We hypothesise that exposure to aflatoxins and fumonisins, measured in serum, alters protein synthesis, reducing serum protein and insulin-like growth factor 1 (IGF-1), increasing inflammation and infection, leading to child's linear growth failure. Design: Children 6-35 months, stratified by baseline stunting, were subsampled from an intervention trial on quality protein maize consumption and evaluated at two time-points. Setting: Blood samples and anthropometric data were collected in the pre-harvest (August-September 2015) and post-harvest (February 2016) seasons in rural Ethiopia. Participants: 102 children (50 stunted and 52 non-stunted). Results: Proportions of children exposed to aflatoxin G1, aflatoxin G2 and aflatoxin M1 were higher in the pre-harvest (8, 33 and 7, respectively) compared to post-harvest season (4, 28 and 4, respectively). The proportion of children exposed to any aflatoxin was higher in the pre-harvest than post-harvest season (51 % v. 41 %). Fumonisin exposure ranged from 0 % to 11 %. In joint statistical tests, aflatoxin exposure was associated with serum biomarkers of inflammation (C-reactive protein, α-1-glycoprotein) and protein status (transthyretin, lysine, tryptophan), IGF-1 and linear growth (all P < 0·01). However, exposure to specific aflatoxins was not significantly associated with any biomarkers or outcomes (all P > 0·05). Conclusions: Aflatoxin exposure among rural Ethiopian children was high, with large variation between seasons and individual aflatoxins. Fumonisin exposure was low. There was no clear association between aflatoxin exposure and protein status, inflammation or linear growth. A larger study may be needed to examine the potential biological interactions, and the assessment of aflatoxins in food is needed to determine sources of high exposure.
AB - Objective: We hypothesise that exposure to aflatoxins and fumonisins, measured in serum, alters protein synthesis, reducing serum protein and insulin-like growth factor 1 (IGF-1), increasing inflammation and infection, leading to child's linear growth failure. Design: Children 6-35 months, stratified by baseline stunting, were subsampled from an intervention trial on quality protein maize consumption and evaluated at two time-points. Setting: Blood samples and anthropometric data were collected in the pre-harvest (August-September 2015) and post-harvest (February 2016) seasons in rural Ethiopia. Participants: 102 children (50 stunted and 52 non-stunted). Results: Proportions of children exposed to aflatoxin G1, aflatoxin G2 and aflatoxin M1 were higher in the pre-harvest (8, 33 and 7, respectively) compared to post-harvest season (4, 28 and 4, respectively). The proportion of children exposed to any aflatoxin was higher in the pre-harvest than post-harvest season (51 % v. 41 %). Fumonisin exposure ranged from 0 % to 11 %. In joint statistical tests, aflatoxin exposure was associated with serum biomarkers of inflammation (C-reactive protein, α-1-glycoprotein) and protein status (transthyretin, lysine, tryptophan), IGF-1 and linear growth (all P < 0·01). However, exposure to specific aflatoxins was not significantly associated with any biomarkers or outcomes (all P > 0·05). Conclusions: Aflatoxin exposure among rural Ethiopian children was high, with large variation between seasons and individual aflatoxins. Fumonisin exposure was low. There was no clear association between aflatoxin exposure and protein status, inflammation or linear growth. A larger study may be needed to examine the potential biological interactions, and the assessment of aflatoxins in food is needed to determine sources of high exposure.
KW - Aflatoxin
KW - Ethiopia
KW - Fumonisin
KW - Inflammation
KW - Linear growth
KW - Protein status
U2 - 10.1017/S1368980021000422
DO - 10.1017/S1368980021000422
M3 - Article
AN - SCOPUS:85106203571
SN - 1368-9800
VL - 24
SP - 3662
EP - 3673
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 12
M1 - 2100042
ER -