Aflatoxins and growth impairment: A review

Abstract

Aflatoxins, fungal toxins produced by Aspergillus flavus and Aspergillus parasiticus in a variety of food crops, are well known as potent human hepatocarcinogens. Relatively less highlighted in the literature is the association between aflatoxin and growth impairment in children. Foodborne aflatoxin exposure, especially through maize and groundnuts, is common in much of Africa and Asia—areas where childhood stunting and underweight are also common, due to a variety of possibly interacting factors such as enteric diseases, socioeconomic status, and suboptimal nutrition. The effects of aflatoxin on growth impairment in animals and human children are reviewed, including studies that assess aflatoxin exposure in utero and through breastfeeding. Childhood weaning diets in various regions of the world are briefly discussed. This review suggests that aflatoxin exposure and its association with growth impairment in children could contribute a significant public health burden in less developed countries.

Keywords::

• Aflatoxin
• growth impairment
• less developed countries
• malnutrition
• stunting
• underweight

Acknowledgment

The authors wish to acknowledge the assistance of the members of the World Health Organization Foodborne Disease Burden Epidemiology Reference Group for their helpful comments on the manuscript.

Declaration of interest

This publication was made possible by the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group (FERG) and grants R01 CA153073-01 from the National Cancer Institute (NCI) and KL2 RR024154 from the National Center for Research Resources (NCRR) of the United States National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not represent the official view of WHO, NCI, NCRR or NIH.