Maize consumption and circulating aflatoxin levels in Mexican middle- and older-aged adults: a cross-sectional analysis

• Published in: The American journal of clinical nutrition 2025-02, Vol.121 (2), p.454-462
• Main Authors: Solís-Martínez, Obed, Monge, Adriana, Groopman, John D, McGlynn, Katherine A, Romero-Martínez, Martín, Palacios-Rojas, Natalia, Batis, Carolina, Lamadrid-Figueroa, Héctor, Riojas-Rodríguez, Horacio, Lajous, Martín
• Format: Article
• Language: English
• Subjects: Adult; AFB1; AFB1-lys adduct; aflatoxin; aflatoxin B1; Aflatoxin B1 - blood; Aged; cross-sectional; Cross-Sectional Studies; Diet; Female; Food Contamination; Humans; maize; maize tortilla; Male; Mexico; Middle Aged; survey; Zea mays - chemistry
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.1016/j.ajcnut.2024.12.018

Maize is frequently contaminated by aflatoxin B1 (AFB1), an established liver carcinogen. The objective of this study is to estimate the effect of maize and maize tortilla consumption on AFB1-lysine adduct (AFB1-lys) concentrations in middle- and older-aged adults living in south and eastern Mexico. We conducted a cross-sectional analysis in a representative sample of 915 adults aged ≥40 y living in south and eastern Mexico in 2018–2019. Maize and maize tortilla intake were estimated using a food frequency questionnaire. Intake of maize tortillas made from store-purchased masa or bought in a tortilleria, from homemade masa, and from store-bought maize flour was assessed. AFB1-lys in serum was quantified using state-of-the-art isotope-dilution liquid chromatography-mass spectrometry. We assessed the relationship between maize and maize tortilla consumption and AFB1-lys by fitting linear regression models that accounted for the complex survey design. Median maize intake was 307 g/d [quartile 1 (Q1)–quartile 3 (Q3) = 165, 554]. Maize tortillas represented 77% of total maize consumption, with a median consumption of 252 g/d (Q1–Q2 = 120, 462). After multivariable adjustment, for every 30 g of maize consumed (1 tortilla equivalent), circulating AFB1-lys incremented by 2.1% [95% confidence interval (CI): 0.9%, 3.4%]. For every maize tortilla consumed, the concentration of circulating AFB1-lys was 2.0% (95% CI: 0.6%, 3.4%) higher. The corresponding estimate for homemade masa tortilla was 2.8% (95% CI: 1.1%, 4.6%). The magnitude of the estimates for tortillas made from store-purchased masa or bought in a tortilleria and those made from store-bought maize flour was minimal. Maize and maize tortilla intake was associated with AFB1-lys concentrations. This association appears to be driven by the consumption of tortillas made from homemade masa.