Dietary mycotoxins exposure and child growth, immune system, morbidity, and mortality: a systematic literature review

Abstract

The aim of this study was to systematically review associations between dietary mycotoxins exposure and child growth and morbidity of children aged 5 years or younger. Peer-reviewed literature was searched in MEDLINE, EMBASE, COCHRANE, CINAHL, Web of Science, and PsycINFO. Experimental and observational studies were considered. The exposures were dietary mycotoxins during pregnancy, lactation and childhood, and mycotoxins concentrations in the diet, breast milk, urine, and blood. From a total of 4869 references, 86 full-text papers were extracted of which 50 were included in this review. The methodological quality and risk of bias were evaluated and quality of the collective evidence was assessed using GRADE. Uncertainty remains whether mycotoxins exposure affects child growth, immunity and mortality and the overall quality of the evidence is very low. Overall however, we cannot rule out a possible association between dietary mycotoxins, in particular, AF and FUM and child malnutrition. Our analyses were limited by the reporting quality, difference in findings, heterogeneity of outcomes, mycotoxins detection methods, and the observational nature of most studies. Robust study designs with adequate sample size, use of validated biomarkers of exposure and assessment of co-occurrence of mycotoxins and their synergistic effects are required to provide the further evidence regarding a potential effect of dietary mycotoxins exposure on child growth and immunity.

Keywords:

• Aflatoxin
• child growth
• diet
• mycotoxin exposure
• systematic review

Acknowledgments

We are grateful to dear friend Kaleb Mulat (Ing) for his unfailing support and material assistance during the write-up of the systematic review. The study was conducted in the context of a collaboration of four public universities in Ethiopia coordinated by Jimma University (JU) and five Flemish universities coordinated by Ghent University (UGent).

Disclosure statement

CL and PK were coauthors of some of the studies reviewed in this manuscript. The authors declared that they had no conflicts of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

VLIR-UOS Network program, Ghent University (MYTOX-SOUTH Partnership), and NUFFIC (NICHE/ETH/179) Netherlands Initiative for Capacity development in Higher Education. MYTOX-SOUTH offers research and expertise that deals with the occurrence of mycotoxins and its effect on human health. The funder has no role in the design and manuscript.