Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study

Background: Limited evidence suggests that probiotic Lacticaseibacillus paracasei strain Shirota (LcS) may reduce aflatoxin exposure in Malaysians, though individual factors influencing aflatoxin exposure remain unclear. Objectives: This study evaluated the effect of LcS on aflatoxin biomarker conce...

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Main Authors: Chang, Wei Lin, Akiyama, Takuya, Wang, Jia-Sheng, Yong, Heng Yaw, Hassan, Faezah, Abu Saad, Hazizi, Jamaluddin, Rosita, Sabran, Mohd Redzwan
Format: Article
Published: Elsevier B.V. 2025
Online Access:http://psasir.upm.edu.my/id/eprint/120792/
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author Chang, Wei Lin
Akiyama, Takuya
Wang, Jia-Sheng
Yong, Heng Yaw
Hassan, Faezah
Abu Saad, Hazizi
Jamaluddin, Rosita
Sabran, Mohd Redzwan
author_facet Chang, Wei Lin
Akiyama, Takuya
Wang, Jia-Sheng
Yong, Heng Yaw
Hassan, Faezah
Abu Saad, Hazizi
Jamaluddin, Rosita
Sabran, Mohd Redzwan
author_sort Chang, Wei Lin
building UPM Institutional Repository
collection Online Access
description Background: Limited evidence suggests that probiotic Lacticaseibacillus paracasei strain Shirota (LcS) may reduce aflatoxin exposure in Malaysians, though individual factors influencing aflatoxin exposure remain unclear. Objectives: This study evaluated the effect of LcS on aflatoxin biomarker concentrations over a 12-wk intervention among healthy Malaysian adults. A secondary objective was to explore the individual factors associated with aflatoxin exposure using baseline data. Methods: A randomized, double-blind, placebo-controlled intervention involved healthy Malaysian adults (aged 20–60) of Chinese, Malay, or Indian ethnicities with elevated urinary aflatoxin M1 (AFM1) and serum aflatoxin B1 (AFB1)-albumin concentrations. Hundred and seventy-four (n = 174) subjects were randomly and equally assigned (n = 87/group) to consume either fermented milk with LcS (probiotic) (3 × 1010 CFU/80 mL/bottle) or milk without LcS (placebo) twice/d for 12 wk, with a 4-wk follow-up. Baseline data included sociodemographic characteristics, knowledge, attitude, and practice related to aflatoxin contamination, dietary intake, body weight, and physical activity status. Urine and fasting blood samples were collected every 2 and 4 wk for AFM1 and AFB1-lysine adduct analyses, respectively. Results: Eighty-five (n = 85) and 82 (n = 82) subjects in the probiotic and placebo groups completed the intervention, respectively. After adjusting for covariates, a significant effect was observed at postintervention in the probiotic group with a 23% reduction in urinary AFM1 concentrations compared with the placebo group (B = –0.26; Exp(B) = 0.77; P = 0.04). Serum AFB1-lysine adduct concentrations remained lower in the probiotic group throughout the study. Both aflatoxin biomarkers significantly differed by ethnicity (AFM1: P = 0.001; AFB1: P = 0.01). Subjects with lower aflatoxin knowledge had significantly higher AFB1-lysine concentrations (mean rank = 95.99) than those with higher knowledge (mean rank = 73.57) (P = 0.04). Urinary AFM1 concentrations were higher with cereal intake (ρ = 0.17, P = 0.03) but lower with protein intake (ρ = –0.18, P = 0.02). Conclusions: Ethnicity, knowledge level, and dietary intake influenced aflatoxin exposure. The benefits of consuming LcS to reduce aflatoxin exposure deserve further attention. Trial registration number: This trial is registered in the National Medical Research Register (NMRR-16-2693-3230) and clinicaltrials.gov (NCT03882294).
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spelling upm-1207922025-10-10T03:18:00Z http://psasir.upm.edu.my/id/eprint/120792/ Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study Chang, Wei Lin Akiyama, Takuya Wang, Jia-Sheng Yong, Heng Yaw Hassan, Faezah Abu Saad, Hazizi Jamaluddin, Rosita Sabran, Mohd Redzwan Background: Limited evidence suggests that probiotic Lacticaseibacillus paracasei strain Shirota (LcS) may reduce aflatoxin exposure in Malaysians, though individual factors influencing aflatoxin exposure remain unclear. Objectives: This study evaluated the effect of LcS on aflatoxin biomarker concentrations over a 12-wk intervention among healthy Malaysian adults. A secondary objective was to explore the individual factors associated with aflatoxin exposure using baseline data. Methods: A randomized, double-blind, placebo-controlled intervention involved healthy Malaysian adults (aged 20–60) of Chinese, Malay, or Indian ethnicities with elevated urinary aflatoxin M1 (AFM1) and serum aflatoxin B1 (AFB1)-albumin concentrations. Hundred and seventy-four (n = 174) subjects were randomly and equally assigned (n = 87/group) to consume either fermented milk with LcS (probiotic) (3 × 1010 CFU/80 mL/bottle) or milk without LcS (placebo) twice/d for 12 wk, with a 4-wk follow-up. Baseline data included sociodemographic characteristics, knowledge, attitude, and practice related to aflatoxin contamination, dietary intake, body weight, and physical activity status. Urine and fasting blood samples were collected every 2 and 4 wk for AFM1 and AFB1-lysine adduct analyses, respectively. Results: Eighty-five (n = 85) and 82 (n = 82) subjects in the probiotic and placebo groups completed the intervention, respectively. After adjusting for covariates, a significant effect was observed at postintervention in the probiotic group with a 23% reduction in urinary AFM1 concentrations compared with the placebo group (B = –0.26; Exp(B) = 0.77; P = 0.04). Serum AFB1-lysine adduct concentrations remained lower in the probiotic group throughout the study. Both aflatoxin biomarkers significantly differed by ethnicity (AFM1: P = 0.001; AFB1: P = 0.01). Subjects with lower aflatoxin knowledge had significantly higher AFB1-lysine concentrations (mean rank = 95.99) than those with higher knowledge (mean rank = 73.57) (P = 0.04). Urinary AFM1 concentrations were higher with cereal intake (ρ = 0.17, P = 0.03) but lower with protein intake (ρ = –0.18, P = 0.02). Conclusions: Ethnicity, knowledge level, and dietary intake influenced aflatoxin exposure. The benefits of consuming LcS to reduce aflatoxin exposure deserve further attention. Trial registration number: This trial is registered in the National Medical Research Register (NMRR-16-2693-3230) and clinicaltrials.gov (NCT03882294). Elsevier B.V. 2025 Article PeerReviewed Chang, Wei Lin and Akiyama, Takuya and Wang, Jia-Sheng and Yong, Heng Yaw and Hassan, Faezah and Abu Saad, Hazizi and Jamaluddin, Rosita and Sabran, Mohd Redzwan (2025) Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study. Journal of Nutrition, 155 (7). pp. 2110-2121. ISSN 0022-3166; eISSN: 1541-6100 https://www.sciencedirect.com/science/article/abs/pii/S0022316625002251?via%3Dihub 10.1016/j.tjnut.2025.04.014
spellingShingle Chang, Wei Lin
Akiyama, Takuya
Wang, Jia-Sheng
Yong, Heng Yaw
Hassan, Faezah
Abu Saad, Hazizi
Jamaluddin, Rosita
Sabran, Mohd Redzwan
Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title_full Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title_fullStr Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title_full_unstemmed Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title_short Impact of probiotic Lacticaseibacillus paracasei Strain Shirota (LcS) on aflatoxin exposure among healthy Malaysian adults: a randomized, double-blind, placebo-controlled intervention study
title_sort impact of probiotic lacticaseibacillus paracasei strain shirota (lcs) on aflatoxin exposure among healthy malaysian adults: a randomized, double-blind, placebo-controlled intervention study
url http://psasir.upm.edu.my/id/eprint/120792/
http://psasir.upm.edu.my/id/eprint/120792/
http://psasir.upm.edu.my/id/eprint/120792/