Occurrence of mycotoxins, phytoestrogens and other fungal metabolites in Ready-to-Use Therapeutic Foods for severely and acutely malnourished children

Ready-to-Use Therapeutic Foods (RUTFs) are mainly legumes-or nut-based low moisture, high energy and nutrient dense ready-to-eat foods strictly designed to treat severe acute malnutrition (SAM) in children. Despite the critical application of this food in a highly vulnerable population, there is no information on the spectrum of mycotoxins in RUTFs globally. This study therefore assessed 41 RUTF samples available in northern Nigeria for multiple mycotoxins using LC-MS/MS. Sixteen mycotoxins and 31 other metabolites comprising phytoestrogenic phenols, plant toxins and metabolites from diverse fungi were detected in the RUTF samples. The mycotoxins include aflatoxin B1 (AFB1), citrinin (CIT), deoxynivalenol, enniatins, alternariol methyl ether, moniliformin, sterigmatocystin, zearalenone, and their derivatives. AFB1 was detected in 5% of the samples at concentrations below the Codex Alimentarius maximum limit of 5 mu g/kg, but exceeded the stricter 0.1 mu g/kg European Union limit for baby/infant foods by 4-19 times. The highest mean mycotoxin concentration (42 mu g/kg) was recorded for CIT, whereas enniatin B was the most occurring (73%). For other metabolites, abscisic acid and cordycepin were the most frequently occurring (100%), while genistin, a phytoestrogenic isoflavone, had the highest mean of 15,751 mu g/kg. RUTF from composite flour blends had more mycotoxins compared to those made from peanuts. This is the first study on mycotoxin occurrence in RUTFs. Further studies are needed to assess the presence of mycotoxins and other metabolites in RUTFs on a larger scale as well as the associated risks from their occurrence in view of the high vulnerability of SAM children who consume the foods.