Impacts of unit operation of cheese manufacturing on the aflatoxin M1 level: A global systematic review and meta-analysis

In this study, alterations in aflatoxin M1 (AFM1) levels during the manufacturing of cheese were assessed through a systematic review and meta-analysis. The overall result based on weighted response ratio (R*) demonstrated an increase of 77.2 (R* = 1.772, P semi-hard (68.7) > soft (60.6). A higher increase in AFM1 level was found in cheese produced from the milk without starter culture (156.5, R* = 2.565, P < 0.001) compared to that produced from the milk contained starter culture (37, R* = 1.370, P < 0.001). The increased AFM1 level in cheese produced from naturally contaminated milk was 2.1 folds higher than that produced from artificially contaminated milk. The overall result based on the rate of AFM1 change () demonstrated a significant reduction of AFM1 level after ripening/storage period (�11, P = 0.007); moreover, this reduction was noticeable (�21.1, P = 0.009) in cheese made from the milk contained starter culture