Early life exposure to dietary aflatoxins, health impact and control perspectives: A review

Abstract Background The initial stages of human life including the fetal period, infancy and early childhood are the most critical periods of human growth and development. Due to immature immune system and rapid development phase, this is the most sensitive phase to health challenges. The exposure to xenobiotics of high toxicity, such as aflatoxins (AFs), can interfere with normal development of the body and potentially lead to severe health complications. Scope and approach This article provides a comprehensive review on the occurrence and health implications of AFs exposure in the early stages of life, including the impacts on child growth, development, immune and hepatic systems. The mechanisms involved in AFs’ toxicity and control measures in infant foods are also described, along with a discussion on recent intervention strategies to mitigate the early life exposure to dietary AFs. Key findings and conclusions Human AFs exposure via utero and through breast milk, infant formula milk and infant foods has been linked to a number of health implications including adverse birth outcomes, impaired growth and development, suppressed immune system, and hepatic dysfunction, especially in African and Asian countries. The occurrence of AFs in infant foods in developing countries, even when reasonably strict regulations are in place, indicate that much needs to be done to ensure the proper implementation of the regulations, in order to achieve significant reductions in exposure. This carries with it many economic and cultural challenges that need to be addressed, including implementation of good agricultural practices and intervention programs aiming to supplement nutrients to reduce child malnutrition and decrease the consumption of aflatoxin-contaminated foods.