{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:12:05Z","timestamp":1778821925613,"version":"3.51.4"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Lebanese diet, rich in cereals, pulses, and dairy, is highly vulnerable to mycotoxin contamination due to the country\u2019s temperate climate and humidity. The ongoing economic crisis in Lebanon has intensified food insecurity and malnutrition, increasing health risks related to mycotoxins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationally representative cross-sectional study assessed exposure to multiple mycotoxins, including aflatoxin B1 (AFB1), aflatoxin M1 (AFM1), ochratoxin A (OTA), deoxynivalenol (DON), T-2, HT-2, zearalenone (ZEA), and fumonisins (FUM) among 442 Lebanese adolescents (mean age 14.56\u202fyears) and related risks, with attention to associations with stunting and thinness. Data were collected via a food frequency questionnaire and 24-h recall, whereas contamination levels were sourced from previous studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results showed a stunting prevalence of 4.07% and a thinness at 2.71%, with adolescents consuming an average of 317.56\u202fg\/day of cereals. Contamination analysis revealed that AFM1 in dairy products averaged 0.09\u202f\u03bcg\/kg, exceeding the European limit, and AFB1 in thyme exceeded Lebanese standards at 11.63\u202f\u03bcg\/kg. Overall, mytotoxin exposure levels were concerning and were associated with MOE values below 10,000, indicating a major public health risk. Notably, AFB1 exposure was linked to additional estimated liver cancer cases per 100,000 people per year. After adjusting for gender, age category, residence, adolescent education, parents\u2019 education, and monthly income, stunting was significantly associated with the estimated daily intake of AFB1 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.07,\n                      <jats:italic>t<\/jats:italic>\n                      \u202f=\u202f\u22123.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), OTA (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.09,\n                      <jats:italic>t<\/jats:italic>\n                      \u202f=\u202f\u22124.619,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and DON (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.001,\n                      <jats:italic>t<\/jats:italic>\n                      \u202f=\u202f\u22123.373,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Thinness was associated with exposure to all mycotoxins; the strongest were observed for DON, OTA, AFM1, and AFB1. These findings underscore the urgent need for control measures and public health policies to mitigate mycotoxin exposure among Lebanese adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1822160","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T04:28:16Z","timestamp":1778819296000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The economic crisis in Lebanon and adolescent nutritional health: a multi-mycotoxin exposure and risk assessment of stunting and thinness"],"prefix":"10.3389","volume":"13","author":[{"given":"Maha","family":"Hoteit","sequence":"first","affiliation":[{"name":"PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University","place":["Beirut, Lebanon"]},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School","place":["Nicosia, Cyprus"]},{"name":"INSPECT-LB (Institut National de Sant\u00e9 Publique, d'\u00c9pid\u00e9miologie Clinique et de Toxicologie-Liban)","place":["Beirut, Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Abou Yassin","sequence":"additional","affiliation":[{"name":"PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University","place":["Beirut, Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rouaa","family":"Daou","sequence":"additional","affiliation":[{"name":"Centre d\u2019Analyses et de Recherche (CAR), Unit\u00e9 de Recherche Technologies et Valorisation Agro-Alimentaire (UR-TVA), Faculty of Sciences, Campus of Sciences and Technologies, Saint-Joseph University of Beirut","place":["Mar Roukos, Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Tzenios","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Charisma University","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Haddad","sequence":"additional","affiliation":[{"name":"Directorate of Preventive Healthcare, Ministry of Public Health","place":["Beirut, Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilal","family":"Hotayt","sequence":"additional","affiliation":[{"name":"PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University","place":["Beirut, Lebanon"]},{"name":"Badaro Endoscopic Center, Moarbes Hospital","place":["Beirut, Lebanon"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Centre d\u2019Analyses et de Recherche (CAR), Unit\u00e9 de Recherche Technologies et Valorisation Agro-Alimentaire (UR-TVA), Faculty of Sciences, Campus of Sciences and Technologies, Saint-Joseph University of Beirut","place":["Mar Roukos, 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