Department of Cardiovascular and Endocrine-metabolic Diseases, and Ageing, Istituto Superiore di Sanita', Rome, Italy.
Department of Food Safety, Nutrition, and Veterinary Public Health, Istituto Superiore di Sanita', Rome, Italy.
Food Chem Toxicol. 2020 Dec;146:111789. doi: 10.1016/j.fct.2020.111789. Epub 2020 Oct 2.
Toxicant exposures may worsen the micronutrient status, especially during the womb-to-childhood development, impairing organism programming and increasing the risk for health disorders in adulthood. Growing evidence calls for an integrated risk analysis of the interplay of environment, behavior and lifestyle, where a) imbalanced diet and micronutrient deficiencies may increase the vulnerability to toxicants and alter body defence systems and b) intake of antinutrients and contaminants may increase nutritional requirements. Such scenarios are especially evident in communities undergoing a fast nutrition transition, such as in many countries of sub-Saharan Africa. Specific challenges of toxicological risk analysis in sub-Saharan Africa still need a thorough assessment, including: rapid changes of lifestyle and consumers' preferences; dumping of foods and consumer' products; risk management under weak or non-existent awareness, legislation enforcement and infrastructures. The significant and growing literature from Africa-led scientific research should be used to build quality-controlled data repositories supporting regulatory top-down actions. Meanwhile, bottom-up actions (eg consumer's empowerment) could exploit social and economic drivers toward a qualified African presence in the global and local markets. A science-based combination of top-down and bottom-up actions on preventable toxicological risk factors will contribute fighting the new forms of malnutrition and prevent multi-factorial diseases. Exposures to toxicants should be included in the integrated approach proposed by WHO to address the urgent health challenge of simultaneously reduce the risk or burden of both malnutrition (ie deficiency of one or more essential nutrients) and overweight, obesity, and diet-related NCDs.
有毒物质的暴露可能会恶化微量营养素的状况，特别是在胎儿到儿童期的发育过程中，损害机体的发育程序，并增加成年后患各种健康障碍的风险。越来越多的证据呼吁对环境、行为和生活方式的相互作用进行综合风险分析，其中：a）不平衡的饮食和微量营养素缺乏可能会增加对有毒物质的脆弱性，并改变身体防御系统；b）摄入抗营养物和污染物可能会增加营养需求。这种情况在经历快速营养转型的社区中尤为明显，例如撒哈拉以南非洲的许多国家。在撒哈拉以南非洲，毒理学风险分析的具体挑战仍需要进行彻底评估，包括：生活方式和消费者偏好的快速变化；食品和消费者产品的倾销；在意识薄弱或不存在、立法执行和基础设施的情况下进行风险管理。来自非洲主导的科学研究的大量且不断增长的文献应被用于构建质量控制数据存储库，以支持监管部门自上而下的行动。与此同时，自下而上的行动（例如消费者赋权）可以利用社会和经济驱动因素，使非洲有资格在全球和地方市场中立足。基于科学的自上而下和自下而上的行动相结合，针对可预防的毒理学风险因素，将有助于应对新形式的营养不良和预防多种因素疾病。有毒物质的暴露应被纳入世卫组织提出的综合方法中，以应对同时降低营养不良（即一种或多种必需营养素缺乏）和超重、肥胖以及与饮食相关的非传染性疾病风险或负担的紧迫健康挑战。
