Exposição de crianças a múltiplas micotoxinas através do consumo de alimentos: uma abordagem holística à avaliação de risco

Tese de doutoramento em Ciências Veterinárias apresentada ao Departamento de Medicina Veterinária da Universidade de Évora, 2017Co-oientadoras: Paula Cristina da C. O. Soromenho de Alvito e lsa Maria da Cruz Reis Vasco - Departamento de Alimentação e Nutruição do INSA.The research work was mainly developed at the Food and Nutrition Department of the National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal (INSA) and also at the Department of Chemistry, Biotechnology and Food Science of Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, from September 2013 to December 2016. Additional training was obtained at National Food Institute of the Technical University of Denmark, Utrecht University, Wageningen University and Leiden University.Food ingestion is considered a major route of human exposure to chemical contaminants, namely mycotoxins. Considering their toxic and carcinogenic effects, mycotoxins exposure assessment assumes particular importance, especially when vulnerable populations as children, are involved. Although there are increasing evidences of mycotoxins co-contamination in food, scarce data are available concerning children exposure to multiple mycotoxins, their bioaccessibility and the potential toxic effects resulting from intestinal exposure. Addressing these considerations, this thesis main objectives were: to characterize Portuguese children (under 3 years old) exposure to multiple mycotoxins through food consumption; to determine mycotoxins bioaccessibility in foods usually consumed by children; to evaluate intestinal toxic effects associated to mycotoxins exposure; and, to characterize the risk associated to the consumption of foods, considering data from exposure assessment, bioaccessibility and intestinal toxicity assays. The present thesis applied for the first time a holistic approach, gathering results obtained through different first-line methodologies, comprising probabilistic tools to estimate mycotoxins daily intake and in vitro assays to determine bioaccessibility and toxic effects. Results revealed a potential health concern for aflatoxins exposure with regard to the high percentiles of children intake. For the first time, a potential synergism was described relatively to the combined intestinal toxic effects of patulin and ochratoxin A, two known enterotoxins. The obtained results reinforce the importance to use a holistic approach to multiple mycotoxins risk assessment, especially for vulnerable populations as children. Particular attention should be dedicated to evaluate the consequences of intestinal exposure to mycotoxins, in particular to their impact on the development of intestinal diseases.N/