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. 2021 Apr;17(2):e13100.
doi: 10.1111/mcn.13100. Epub 2020 Nov 16.

Risk of dietary and breastmilk exposure to mycotoxins among lactating women and infants 2-4 months in northern India

Rukshan V Mehta  1   2 , Anthony J Wenndt  3 , Amy Webb Girard  1   2 , Sunita Taneja  4 , Samriddhi Ranjan  4 , Usha Ramakrishnan  1   2 , Reynaldo Martorell  1   2 , P Barry Ryan  5 , Kannan Rangiah  6 , Melissa F Young  1   2
Affiliations

Risk of dietary and breastmilk exposure to mycotoxins among lactating women and infants 2-4 months in northern India

Rukshan V Mehta et al. Matern Child Nutr. 2021 Apr.

Abstract

Mycotoxins are carcinogenic secondary metabolites of fungi that have been linked to infant growth faltering. In this study, we quantified co-occurring mycotoxins in breast milk and food samples from Haryana, India, and characterized determinants of exposure. Deterministic risk assessment was conducted for mothers and infants. We examined levels of eight mycotoxins (Aflatoxin B1 , B2 , G1 , G2 , M1 , M2 ; Ochratoxin A, B) in 100 breast milk samples (infants 2-4 months) using ultra-high-performance liquid chromatography tandem mass spectrometry. Aflatoxin B1 (AFB1 ), fumonisin B1 (FB1 ) and deoxynivalenol (DON) were detected in several food items (n = 298) using enzyme-linked immunosorbent assays. We report novel data on the presence of mycotoxins in breast milk samples from India. Whereas breast milk concentrations (AFM1 median: 13.7; range: 3.9-1200 ng/L) remain low, AFM1 was detected above regulatory limits in 27% of animal milk samples. Additionally, 41% of infants were above provisional maximum tolerable daily intake (PMTDI) limits for AFM1 due to consumption of breast milk (mean: 3.04, range: 0.26-80.7 ng kg-1 bw day-1 ). Maternal consumption of breads (p < 0.05) was associated with breast milk AFM1 exposure. AFB1 (μg/kg) was detected in dried red chilies (15.7; 0-302.3), flour (3.13; 0-214.9), groundnuts (0; 0-249.1), maize (56.0; 0-836.7), pearl millet (1.85; 0-160.2), rice (0; 0-195.6), wheat (1.9; 0-196.0) and sorghum (0; 0-63.5). FB1 (mg/kg) was detected in maize (0; 0-61.4), pearl millet (0; 0-35.4) and sorghum (0.95; 0-33.2). DON was not detected in food samples. Mothers in our study exceeded PMTDI recommendations for AFB1 due to consumption of rice and flour (mean: 75.81; range: 35.2-318.2 ng kg-1 bw day-1 ). Our findings show the presence of Aflatoxin B1 and M1 at various levels of the food chain and in breast milk, with estimated intakes exceeding PMTDI recommendations. Aflatoxins are known carcinogens and have also been linked to stunting in children. Their presence across the food system and in breast milk is concerning, thus warranting further research to replicate and expand on our findings and to understand implications for maternal and child health.

Keywords: aflatoxins; breast milk; cereal crops; deoxynivalenol; fumonisins; ochratoxins.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Breast milk Aflatoxin M1 concentrations by montha. aN per month, Monsoon: ‐ July: 7, Aug: 8, Sept: 9, Fall: ‐ Oct: 8, Nov: 9, Winter: ‐ Dec: 9, Jan: 8, Spring: ‐ Feb: 9, March: 8, Summer: ‐ April: 8, May: 9, June: 8
FIGURE 2
FIGURE 2
Breast milk mycotoxin concentrations by seasona,b. aN per month, Monsoon: ‐ July: 7, Aug: 8, Sept: 9, Fall: ‐ Oct: 8, Nov: 9, Winter: ‐ Dec: 9, Jan: 8, Spring: ‐ Feb: 9, March: 8, Summer: ‐ April: 8, May: 9, June: 8. bN for AFM1: 99, after removing outlier ([AFM1] of 1200 pg/ml
See this image and copyright information in PMC

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