Peer-reviewed article
Aflatoxin exposure and child nutrition: measuring anthropometric and long-bone growth over time in Nepal
Johanna Y Andrews-Trevino, Patrick M. Webb, Gerald Shively, Ahmed Kablan, Kedar Prasad Baral et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed 1,675 mother-infant pairs in rural Nepal from pregnancy until age 2 years to examine whether aflatoxin exposure affects child growth. Aflatoxins are naturally occurring toxins found in foods like grains and nuts. The researchers measured aflatoxin levels in blood samples and tracked children's length, weight, and growth indicators over time. They found that higher aflatoxin exposure was associated with slower growth in length and weight, and with increased stunting rates.
Key points
- Aflatoxin B1 was detected in blood samples from 75-85% of children across different ages and 94% of pregnant women
- Each unit increase in child aflatoxin exposure was associated with a 0.05 decrease in length-for-age z-score and 0.19 cm reduction in length
- Higher aflatoxin concentrations were associated with 18% increased odds of stunting
- Effects persisted even when accounting for child weight, and lagged exposure affected subsequent length and bone growth
- Results suggest chronic aflatoxin exposure is significantly correlated with negative growth outcomes
Limitations
The study is observational and cannot establish causation. While the study measured aflatoxin exposure through biomarkers rather than dietary intake, it did not identify specific food sources or measure dietary aflatoxin levels directly.
Abstract
BACKGROUND: Naturally occurring aflatoxins may contribute to poor growth and nutritional statuses in children. OBJECTIVES: We analyzed the relationship between contemporary and lagged aflatoxin exposure and 1) length-for-age z-score (LAZ); and 2) length, knee-heel length, stunting, weight-for-age z-score (WAZ), and weight-for-length z-score (WLZ). METHODS: We conducted a longitudinal birth cohort study involving 1675 mother-infant dyads in rural Nepal. Participants were repeatedly visited from pregnancy to 2 years of age (2015-2019). One blood sample was collected during pregnancy and 4 samples were collected from the children at 3, 6, 12, and 18-22 months of age to measure concentrations of aflatoxin B1 (AFB1)-lysine adduct. Multivariate linear fixed-effects and logistic models with generalized estimating equations were used to identify associations between child growth and aflatoxin exposure. RESULTS: AFB1-lysine adducts were detected in the majority of children (at 3 months, 80.5%; at 6 months, 75.3%; at 12 months, 81.1%; and at 18-22 months, 85.1%) and in 94.3% of pregnant women. Changes in contemporary ln child AFB1-lysine adduct concentrations were significantly associated with changes in LAZ (β, -0.05; 95% CI, -0.09 to -0.02; P = 0.003), length (β, -0.19; 95% CI, -0.29 to -0.10; P < 0.001), knee-heel length (β, -0.09; 95% CI, -0.13 to -0.05; P < 0.001), and WAZ (β, -0.04; 95% CI, -0.07 to -0.005; P = 0.022). Serum aflatoxin concentrations were associated with stunting (OR, 1.18; 95% CI, 1.05-1.32; P = 0.005). Similar results were found in the models using changes in contemporary ln AFB1 adjusted for changes in child weight, with significant associations with changes in WLZ (β, -0.07; 95% CI, -0.10 to -0.03; P < 0.001). Changes in time-lagged ln AFB1 (unadjusted and adjusted for changes in child weight) were associated with changes in length and knee-heel length. CONCLUSIONS: Our results add to the growing body of evidence confirming chronic aflatoxin exposure and suggest that exposure is significantly correlated with various negative growth outcomes, which may vary by child weight status. This trial was registered at clinicaltrials.gov as NCT03312049.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Measurement and analysis of aflatoxin exposure through blood biomarkers in relation to longitudinal growth monitoring
- Population
- 1,675 mother-infant dyads in rural Nepal, followed from pregnancy to 2 years of age (2015-2019)
Key finding
AFB1-lysine adducts detected in 75-85% of children and 94% of pregnant women