Abstract
Breastfeeding is the gold standard practice and it is recommended that
all infants should continue breastfeeding at the first 6 months. It is
important to identify undesirable toxins and metabolites that may be present in
the human milk and pass to the baby. Studies about the content of mycotoxins in
the human milk are limited and show differences between countries. The aim of
this study was to evaluate the human milk aflatoxin M1 (AFM1) levels, and also
to evaluate potential relationship with maternal dietary habits. In this study 3-5 ml human milk
samples has been received from mothers for AFM1 evaluation, and stored -20,
until the analysis. All mothers fulfilled the questionnaire about the
consumption of some foods, which might be related with mycotoxin exposure.
Aflatoxin M1 toxin has been tested with the HELICA Aflatoxin M1 Assay (solid
phase competitive enzyme immunoassay) and Multi-residue Method Based on Chip
Technology (Randox, UK). Total daily intake for AFM1 has been calculated among
exclusively breast-fed infants. Ninety mothers aged
between 17 to 41 years, who have 7 to 90 days old newborn babies, have been
enrolled. Median human milk AFM1 levels were 3.59 ng/L, ranged between 2.76 to
5.99 ng/L. There are only 3 samples with ELISA, which are above 5 ng/L which was
defined as threshold levels. All samples were negative with human milk AFM1
levels with Multi-residue Method Based on Chip Technology. Among 63 breast-fed
infants, median total daily intake of AFM1 was 0.54 ng/kg (0.41-0.90 ng/kg/day)
and were lower than previously defined threshold levels. Human milk AFM1 levels
were not associated with maternal dieatary habits (p>0.05). While our previous studies about human
milk mycotoxin levels, showed higher human milk ochratoxine, zearalenone and
deoxynivalenol levels, human milk AFM1 levels were within the normal limits
with different detection tests. Variable findings on human milk aflatoxin
levels indicate geographical differences in dietary aflatoxin exposure of
nursing women, possibly depending on dietary habits. Since breastfeeding is an
essential nutrient for infants and health benefits of exclusive breastfeeding
likely far surpass the putative health risk from modest levels of mycotoxin
transfer, exposure to mycotoxin should be as low as possible and potential food
safety strategies should be implemented.
Keywords
References
- KAYNAKLAR1. Eidelman AI. Breastfeeding and the use of human milk: an analysis of the American Academy of Pediatrics 2012 Breastfeeding Policy Statement. Breastfeed Med. 2012; 7: 323-324. 2. Dieterich CM, Felice JP, O'Sullivan E, Rasmussen KM. Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am. 2013; 60: 31-48.3. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001; 108: 776-789.4. Warth B, Braun D, Ezekiel CN, Turner PC, Degen GH, Marko D. Biomonitoring of mycotoxins in human breast milk: current state and future perspectives. Chem Res Toxicol. 2016; 29: 1087-1097. 5. Schatzmayr G, Streit E. Global occurrence of mycotoxins in the food and feed chain: facts and figures. World Mycotoxin J. 2013; 6: 213-222.6. Marchese S, Polo A, Ariano A, Velotto S, Costantini S, Severino L. Aflatoxin B1 and M1: Biological Properties and Their Involvement in Cancer Development. Toxins (Basel). 2018;10(6). pii: E214. 7. Kılıç Altun S, Gürbüz S, Ayağ E. Aflatoxin M(1) in human breast milk in southeastern Turkey. Mycotoxin Res. 2017; 33: 103-107. 8. Gürbay A, Sabuncuoğlu SA, Girgin G, Sahin G, Yiğit S, Yurdakök M, Tekinalp G. Exposure of newborns to aflatoxin M1 and B1 from mothers' breast milk in Ankara, Turkey. Food Chem Toxicol. 2010; 48: 314-319.9. Atasever M, Yildirim Y, Atasever M, Tastekin A. Assessment of aflatoxin M1 in maternal breast milk in Eastern Turkey. Food Chem Toxicol. 2014; 66: 147-149. 10. Barut-Uyar B, Karaagaoglu N, Girgin G, Gurbay A, Karaagaoglu E. Aflatoxin M1 and ochratoxin A levels in breast milk in Ankara, Turkey. The FASEB Journal 2014; 28(Suppl 1): 1017.8.11. Keskin Y, Başkaya R, Karsli S, Yurdun T, Ozyaral O. Detection of aflatoxin M1 in human breast milk and raw cow's milk in Istanbul, Turkey. J Food Prot. 2009; 72(4): 885-9.12. Ozdemir M, Kuyucuoglu N. Afyonkarahisar ilindeki hastanelerde doğum yapan kadınların sütlerinde Aflatoksin M1 düzeylerinin belirlenmesi. Kocatepe Tıp Dergisi 2015; 8(1). 13. Degen GH, Partosch F, Muñoz K, Gundert-Remy U. Daily uptake of mycotoxins -TDI might not be protective for nursed infants. Toxicol Lett. 2017; 277: 69-75.14. Marroquín-Cardona AG, Johnson NM, Phillips TD, Hayes AW. Mycotoxins in a changing global environment--a review. Food Chem Toxicol. 2014l; 69: 220-30.15. Kunter İ, Hürer N, Gülcan HO, Öztürk B, Doğan İ, Şahin G. Assessment of Aflatoxin M1 and Heavy Metal Levels in Mothers Breast Milk in Famagusta, Cyprus. Biol Trace Elem Res. 2017; 175(1): 42-49. 16. Radonić JR, Kocić Tanackov SD, Mihajlović IJ, Grujić ZS, Vojinović Miloradov MB, Škrinjar MM, Turk Sekulić MM. Occurrence of aflatoxin M1 in human milk samples in Vojvodina, Serbia: Estimation of average daily intake by babies. J Environ Sci Health B. 2017; 52(1): 59-63.17. Elaridi J, Bassil M, Kharma JA, Daou F, Hassan HF. Analysis of Aflatoxin M(1) in Breast Milk and Its Association with Nutritional and Socioeconomic Status of Lactating Mothers in Lebanon. J Food Prot. 2017; 80(10): 1737-1741.
Anne Sütü Aflatoksin M1 (AFM1) Düzeyleri ve Annenin Beslenme Alışkanlıkları ile İlişkisinin Değerlendirilmesi
Abstract
Emzirme yenidoğan ve süt çocuğu beslenmesinde altın standart olup ve tüm
bebeklerin ilk altı ayda tek başına anne sütü ile beslenmesi önerilmektedir. Anne
sütü içerisinde bulunabilecek ve bebeğe geçebilecek istenmeyen toksin ve
metabolitlerin belirlenmesi önemlidir. Anne sütü mikotoksin düzeyleri ile
ilgili çalışmalar kısıtlıdır ve ülkeler arasında farklılıklar bulunabilmektedir.
Bu çalışmada, anne sütü aflatoksin M1 (AFM1) düzeylerinin belirlenmesi ve annenin
diyet alışkanlıkları ile olası ilişkisinin değerlendirilmesi planlandı. Bu çalışmada AFM1 çalışılmak üzere 3-5
ml anne sütü örneği alındı ve analize kadar saklandı. Tüm annelere, hamilelik
ve doğum sonrası dönemde mikotoksin maruziyeti ile ilişkili olabilecek bazı
gıdaların tüketimiyle ilgili anket uygulandı. AFM1 toksini, HELICA Aflatoksin
M1 ELISA Testi ile ve “Multi-residue Method Based on Chip” teknolojisi ile değerlendirildi.
Yalnız ane sütü ile beslnenen bebeklerde günlük total AFM1 alımı hesaplandı. Çalışmaya 7-90 günlük bebekleri olan 17-41 yaş
arası 90 anne çalışmaya dahil edildi. Anne sütü AFM1 düzeyi medyan 3,59 ng/L
olup, 2,76 ile 5,99 ng/L arasındaydı. Tüm çalışma grubunda ELISA yöntemi ile eşik
değer olarak saptanmış olan 5 ng/L’nin üzerinde olan sadece üç örnek mevcuttu. Rezidü
düzeylerinin “multichip” teknolojisi ile değerlendirildiği ikinci yöntem ile
hiçbir anne sütü örneğinde AFM1 saptanmadı. Yalnız anne sütü ile beslenen 63 bebeğin,
anne sütü ile günlük total AFM1 alımı medyan 0,54 ng/kg (0,41-0,90 ng/kg/gün)
olup, besinler için belirlenen günlük alım limiti düzeyinin çok altında idi.
Anne sütü AFM1 düzeyleri annenin beslenme özellikleri arasında ilişki
saptanmadı (p>0.05). Anne sütü mikotoksin düzeyleri ile ilgili daha önceki
çalışmalarımızda yüksek anne sütü okratoksin, zearalenone ve deoksinivalenol
düzeylerini gösterilmiş olmasına rağmen, anne sütü AFM1 düzeyleri farklı
saptama testleri ile normal sınırlardaydı. Anne sütü aflatoksin düzeylerindeki bölgeler
arasındaki farklı bulgular, annelerin gebelik ve lohusalık dönemindeki farklı
beslenme alışkanlıkları ile ilişkili olabilir. Anne sütü tüm bebekler için
temel besin ögesi olduğundan ve anne sütü içerisindeki toksin ve endokrin
bozucuların belirli aralıklar ile değerlendirilmesi ve anne beslenmesindeki muhtemel
toksin kaynaklarının diyetten uzaklaştırılması gereklidir.
Keywords
References
- KAYNAKLAR1. Eidelman AI. Breastfeeding and the use of human milk: an analysis of the American Academy of Pediatrics 2012 Breastfeeding Policy Statement. Breastfeed Med. 2012; 7: 323-324. 2. Dieterich CM, Felice JP, O'Sullivan E, Rasmussen KM. Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am. 2013; 60: 31-48.3. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001; 108: 776-789.4. Warth B, Braun D, Ezekiel CN, Turner PC, Degen GH, Marko D. Biomonitoring of mycotoxins in human breast milk: current state and future perspectives. Chem Res Toxicol. 2016; 29: 1087-1097. 5. Schatzmayr G, Streit E. Global occurrence of mycotoxins in the food and feed chain: facts and figures. World Mycotoxin J. 2013; 6: 213-222.6. Marchese S, Polo A, Ariano A, Velotto S, Costantini S, Severino L. Aflatoxin B1 and M1: Biological Properties and Their Involvement in Cancer Development. Toxins (Basel). 2018;10(6). pii: E214. 7. Kılıç Altun S, Gürbüz S, Ayağ E. Aflatoxin M(1) in human breast milk in southeastern Turkey. Mycotoxin Res. 2017; 33: 103-107. 8. Gürbay A, Sabuncuoğlu SA, Girgin G, Sahin G, Yiğit S, Yurdakök M, Tekinalp G. Exposure of newborns to aflatoxin M1 and B1 from mothers' breast milk in Ankara, Turkey. Food Chem Toxicol. 2010; 48: 314-319.9. Atasever M, Yildirim Y, Atasever M, Tastekin A. Assessment of aflatoxin M1 in maternal breast milk in Eastern Turkey. Food Chem Toxicol. 2014; 66: 147-149. 10. Barut-Uyar B, Karaagaoglu N, Girgin G, Gurbay A, Karaagaoglu E. Aflatoxin M1 and ochratoxin A levels in breast milk in Ankara, Turkey. The FASEB Journal 2014; 28(Suppl 1): 1017.8.11. Keskin Y, Başkaya R, Karsli S, Yurdun T, Ozyaral O. Detection of aflatoxin M1 in human breast milk and raw cow's milk in Istanbul, Turkey. J Food Prot. 2009; 72(4): 885-9.12. Ozdemir M, Kuyucuoglu N. Afyonkarahisar ilindeki hastanelerde doğum yapan kadınların sütlerinde Aflatoksin M1 düzeylerinin belirlenmesi. Kocatepe Tıp Dergisi 2015; 8(1). 13. Degen GH, Partosch F, Muñoz K, Gundert-Remy U. Daily uptake of mycotoxins -TDI might not be protective for nursed infants. Toxicol Lett. 2017; 277: 69-75.14. Marroquín-Cardona AG, Johnson NM, Phillips TD, Hayes AW. Mycotoxins in a changing global environment--a review. Food Chem Toxicol. 2014l; 69: 220-30.15. Kunter İ, Hürer N, Gülcan HO, Öztürk B, Doğan İ, Şahin G. Assessment of Aflatoxin M1 and Heavy Metal Levels in Mothers Breast Milk in Famagusta, Cyprus. Biol Trace Elem Res. 2017; 175(1): 42-49. 16. Radonić JR, Kocić Tanackov SD, Mihajlović IJ, Grujić ZS, Vojinović Miloradov MB, Škrinjar MM, Turk Sekulić MM. Occurrence of aflatoxin M1 in human milk samples in Vojvodina, Serbia: Estimation of average daily intake by babies. J Environ Sci Health B. 2017; 52(1): 59-63.17. Elaridi J, Bassil M, Kharma JA, Daou F, Hassan HF. Analysis of Aflatoxin M(1) in Breast Milk and Its Association with Nutritional and Socioeconomic Status of Lactating Mothers in Lebanon. J Food Prot. 2017; 80(10): 1737-1741.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | ORİJİNAL MAKALE |
| Authors | |
| Publication Date | September 1, 2018 |
| Published in Issue | Year 2018 Volume: 40 Issue: 3 |