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

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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, HEPATITIS-B INFECTION, AFLATOXIN EXPOSURE, YOUNG-CHILDREN, MOLECULAR EPIDEMIOLOGY, COMPLEMENTARY FOODS, NEONATAL JAUNDICE, ALBUMIN ADDUCTS, IMPAIRED GROWTH, BREAST-MILK, HUMAN URINE

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MLA
Hadush, Kokeb Tesfamariam, et al. “Dietary Mycotoxins Exposure and Child Growth, Immune System, Morbidity, and Mortality : A Systematic Literature Review.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION, 2019.
APA
Hadush, K. T., De Boevre, M., Kolsteren, P., Belachew, T., Mesfin, A., De Saeger, S., & Lachat, C. (2019). Dietary mycotoxins exposure and child growth, immune system, morbidity, and mortality : a systematic literature review. CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION.
Chicago author-date
Hadush, Kokeb Tesfamariam, Marthe De Boevre, Patrick Kolsteren, Tefera Belachew, Addisalem Mesfin, Sarah De Saeger, and Carl Lachat. 2019. “Dietary Mycotoxins Exposure and Child Growth, Immune System, Morbidity, and Mortality : A Systematic Literature Review.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION.
Chicago author-date (all authors)
Hadush, Kokeb Tesfamariam, Marthe De Boevre, Patrick Kolsteren, Tefera Belachew, Addisalem Mesfin, Sarah De Saeger, and Carl Lachat. 2019. “Dietary Mycotoxins Exposure and Child Growth, Immune System, Morbidity, and Mortality : A Systematic Literature Review.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION.
Vancouver
1.
Hadush KT, De Boevre M, Kolsteren P, Belachew T, Mesfin A, De Saeger S, et al. Dietary mycotoxins exposure and child growth, immune system, morbidity, and mortality : a systematic literature review. CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION. 2019;
IEEE
[1]
K. T. Hadush et al., “Dietary mycotoxins exposure and child growth, immune system, morbidity, and mortality : a systematic literature review,” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION, 2019.
@article{8634645,
  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.},
  author       = {Hadush, Kokeb Tesfamariam and De Boevre, Marthe and Kolsteren, Patrick and Belachew, Tefera and Mesfin, Addisalem and De Saeger, Sarah and Lachat, Carl},
  issn         = {1040-8398},
  journal      = {CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION},
  keywords     = {Aflatoxin,child growth,diet,mycotoxin exposure,systematic review,HEPATITIS-B INFECTION,AFLATOXIN EXPOSURE,YOUNG-CHILDREN,MOLECULAR EPIDEMIOLOGY,COMPLEMENTARY FOODS,NEONATAL JAUNDICE,ALBUMIN ADDUCTS,IMPAIRED GROWTH,BREAST-MILK,HUMAN URINE},
  language     = {eng},
  title        = {Dietary mycotoxins exposure and child growth, immune system, morbidity, and mortality : a systematic literature review},
  url          = {http://dx.doi.org/10.1080/10408398.2019.1685455},
  year         = {2019},
}

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