Aluminum
This page draws on the EFSA AFC Panel 2008 Scientific Opinion on the Safety of Aluminium from Dietary Intake (EFSA 2008), the ATSDR 2008 Toxicological Profile for Aluminum (ATSDR 2008), and the JECFA Combined Compendium of Food Additive Specifications (JECFA FA Compendium).
Chapter-level cross-metal toxicology context for aluminum exposure, poor oral absorption, transferrin binding, renal excretion, dialysis dementia, bone effects, neurotoxicity, and chelation treatment is connected from Ufelle & Barchowsky 2021.
Overview
Aluminum is the third most abundant element in Earth’s crust and a non-essential metal that enters the human food system through aluminum-containing food additives, aluminum-amended drinking water (used as a flocculant in water treatment), aluminum cookware and food packaging in contact with acidic foods, antacid medications, and natural occurrence in some plant-based foods. Aluminum is poorly absorbed from the gastrointestinal tract (typically less than 1 percent), but cumulative exposure across the food supply produces dietary intakes that the EFSA AFC Panel 2008 concluded routinely exceed the established tolerable weekly intake of 1 mg Al/kg body weight per week in significant portions of the European population.
The toxicological concerns associated with aluminum focus on neurotoxicity (most clearly documented in dialysis-related encephalopathy from aluminum-contaminated dialysate fluid in the 1970s and 1980s, and in chronic occupational exposure), reproductive and developmental effects, and bone effects (aluminum-induced osteomalacia in dialysis patients was a significant clinical entity before water treatment for dialysis was redesigned). The EFSA TWI of 1 mg/kg b.w./week replaced an earlier JECFA provisional tolerable weekly intake of 7 mg/kg b.w./week with a sevenfold reduction; JECFA subsequently aligned its PTWI to 1 mg/kg b.w./week.
Aluminum’s health profile is qualitatively different from the other metals on this wiki. The clearest documented adverse health effects (dialysis encephalopathy, dialysis osteomalacia) occur in patient populations with impaired aluminum excretion (renal failure) and intravenous-route exposure that bypasses GI absorption barriers; for the general population with normal renal function and oral exposure, the dose-response evidence for aluminum-related disease is weaker than for cadmium, lead, mercury, or arsenic, and the regulatory TWI rests largely on extrapolation from animal neurotoxicity studies rather than on robust human cohort data at typical dietary exposure levels.
Ufelle & Barchowsky 2021 is attached here as textbook-level toxicology context only. It does not supply aluminum occurrence values for foods or product categories.
At a glance
Three facts that matter most for a consumer trying to interpret aluminum exposure.
First, aluminum exposure for most consumers is dominated by aluminum-containing food additives (sodium aluminium phosphate as a leavening agent in baked goods, sodium aluminium silicate as an anti-caking agent in salt and powdered foods, aluminium-containing colorants), antacid medications, and aluminum-cookware contact with acidic foods (tomato sauce, pickles, citrus). Naturally occurring aluminum in plants is generally a smaller contributor. EFSA 2008 concluded that the population-level TWI of 1 mg/kg b.w./week is exceeded in significant fractions of the European population, particularly among consumers of foods containing aluminium-based additives.
Second, the clearest documented adverse health effects of aluminum (dialysis encephalopathy, dialysis osteomalacia) occur in patient populations with impaired renal excretion of aluminum and via routes (intravenous dialysate) that bypass the protective GI absorption barrier of typical dietary exposure. For the general consumer with normal renal function and oral exposure only, the regulatory TWI is the primary benchmark; documented neurological or musculoskeletal disease from typical dietary aluminum is uncommon and difficult to attribute to aluminum specifically rather than to confounding factors.
Third, aluminum cookware does contribute to dietary aluminum, particularly when cooking acidic foods (tomato sauce, citrus dishes, vinegar-based preparations) for prolonged periods. Anodized aluminum cookware substantially reduces this leaching; stainless steel and cast iron alternatives eliminate it. The leaching contribution is generally modest relative to additive and antacid contributions for the average consumer.
Toxicology
The EFSA AFC Panel 2008 TWI of 1 mg Al/kg b.w./week is anchored on neurotoxic, reproductive, and developmental effects in animal studies. The Panel did not derive a single critical study and reference point; the TWI integrates evidence across multiple animal endpoints with safety factors for interspecies extrapolation and human variability. The replacement of the prior JECFA PTWI of 7 mg/kg b.w./week with the EFSA value of 1 mg/kg b.w./week reflects accumulated evidence at lower exposures and a more conservative evaluation.
The clearest documented human aluminum disease entities are dialysis encephalopathy and dialysis osteomalacia, both observed in chronic hemodialysis patients exposed to aluminum-contaminated dialysate fluid in the 1970s and 1980s before water treatment for dialysis was redesigned (ATSDR 2008). Dialysis encephalopathy presented with progressive dementia, dysarthria, myoclonus, and seizures; dialysis osteomalacia produced bone pain, fractures, and characteristic radiographic and histological findings. Both entities are essentially eliminated in modern dialysis practice because dialysate water is now routinely treated to remove aluminum.
Typical exposure routes
Dietary intake is the dominant route. EFSA 2008 estimated typical adult European dietary aluminum exposure at 0.2 to 1.5 mg/kg b.w./week (potentially higher in some sub-populations), with substantial variation across Member States driven by aluminum-additive use patterns. Antacid medications can contribute substantially to aluminum intake in users (typical aluminum-containing antacid daily aluminum delivery 100 to 1000 mg, dwarfing typical dietary intake of 5 to 15 mg/day) (ATSDR 2008). Drinking water aluminum (from aluminum-based water-treatment flocculants in some municipal systems) is typically below 0.2 mg/L and a smaller contributor than dietary additives (ATSDR 2008).
GI absorption of aluminum is typically less than 1 percent (ATSDR 2008: 0.07-0.39 percent for drinking water, ~0.1 percent for diet).
Excretion is primarily renal. Renal failure is the major risk factor for aluminum body-burden accumulation; this is why dialysis-related encephalopathy and osteomalacia were the canonical aluminum disease entities before dialysate-water treatment was implemented (ATSDR 2008).
Food sources
| Matrix | Aluminum concern |
|---|---|
| Foods with aluminium-based additives | Sodium aluminium phosphate (leavening), sodium aluminium silicate (anti-caking), aluminium-containing colorants |
| Aluminum-containing antacids | Single largest aluminum exposure source for users (100 to 1000 mg/day) |
| Acidic foods cooked or stored in aluminum | Tomato sauce, citrus, vinegar-based preparations cooked for prolonged periods in non-anodized aluminum cookware |
| Drinking water (post-aluminum-flocculation treatment) | Typically <0.2 mg/L; varies by treatment-plant practice |
| Tea | Naturally elevated aluminum content; brewed tea can deliver 1 to 5 mg/L |
| Processed cheese (aluminium-containing emulsifying salts) | Sodium aluminium phosphate as emulsifier in some products |
| Baked goods with aluminium-based leavening | Cakes, biscuits, pancakes using aluminum baking powder |
| Infant formula | Variable by product; some soy-based formulas higher than milk-based; prescription formulas span 41.4 to 1956 µg/L (Redgrove 2019) |
EFSA 2008 estimated dietary exposure at 0.3 to 0.9 mg/kg b.w./week for milk-based infant formulas and 1.1 mg/kg b.w./week for soya-based formulas; breast-fed infants were estimated at less than 0.07 mg/kg b.w./week.
Primary occurrence: complementary infant foods (Brazilian market)
de Paiva et al. 2020 surveyed 95 infant food samples across 9 commercial brands in Campinas, Brazil, covering salty purees, fruit purees, infant drinks (including soy-based), and petit-suisse. Total Al by ICP-OES after microwave digestion; bioaccessibility by optimized in vitro gastrointestinal digestion. The highest total Al concentrations: petit-suisse 4170 µg/kg, soy-based drink 2860 µg/kg, mixed-vegetable salty purees 2310-2760 µg/kg, dark chocolate milk drink 2175 µg/kg, fruit purees 1900-2500 µg/kg. The bioaccessibility findings substantially modify the exposure picture: percent of total Al released to gut absorption ranges from 0.5 percent (apple-and-plum puree) to 48 percent (cereal milk drink), a 96-fold spread driven by matrix composition. High-cellulose plant purees and high-protein dairy reduce bioaccessibility through Al-cellulose and Al-protein binding; high-polyphenol or low-fiber matrices increase it. Consumption of three portions per day of soy-based drink delivers a substantial fraction of the EFSA TWI; handmade-gourmet brands carried 2-3x higher Al than industrial counterparts at similar compositions, reflecting variable contamination control across production scales. The bioaccessibility distinction is methodologically important and currently absent from EU and US regulatory frameworks for Al in infant food.
Primary occurrence: prescription infant formulas
Redgrove et al. 2019 surveyed 24 UK prescription infant formulas (ready-to-drink and powdered) by transversely heated graphite furnace atomic absorption spectrometry following microwave-assisted acid/peroxide digestion. Ready-to-drink concentrations ranged from 49.9 µg/L (Cow & Gate Nutriprem 1 for preterm infants) to 1956.3 µg/L (Abbott PediaSure Plus Juice Apple, a weight-gain supplement), a roughly 40-fold range across products fed to medically vulnerable infants. Abbott PediaSure Plus Juice Apple delivers 391 µg Al per 200 mL serving. The fortified-weight-gain product subcategory (Danone Nutricia Fortini range, Abbott PediaSure Plus, Nutrinovo ProSource) consistently exceeded 500 µg/L. The amino-acid-based and peptide-based powdered subcategory (SMA Alfamino, Neocate LCP, Aptamil Pepti 1) showed the lowest concentrations: SMA Alfamino at 41.4 µg/L was the lowest-Al formula measured in the Keele group’s accumulated literature. The roughly 50-fold range from cleanest to most contaminated demonstrates that infant formula Al contamination is not inevitable; selected ingredients can produce dramatically lower Al concentrations even within prescription-grade products. The likely sources of contamination identified by Redgrove include whey protein hydrolysate ingredients (the Keele group separately measured 4.1 to 8.1 µg/g Al in whey hydrolysates supplied to a major formula manufacturer), fruit and fruit-flavoring components, packaging, and aluminum-based processing equipment.
What this means for food choice
For consumers with normal renal function: the EFSA TWI exceedance documented at the population level does not translate to a clear individual action threshold for most consumers. The leverage points in approximate order of impact:
For frequent antacid users: aluminum-containing antacids deliver 100 to 1000 mg of aluminum per daily dose, dwarfing dietary intake. Switching to non-aluminum antacids (calcium carbonate, magnesium hydroxide, proton pump inhibitors) eliminates this exposure. Patients with chronic acid-related symptoms should discuss antacid choice with their physician, particularly if renal function is impaired.
For consumers concerned about additive intake: reading ingredient labels for sodium aluminium phosphate (SALP), sodium aluminium silicate, aluminium ammonium sulfate, and aluminum-containing colorants (including some FD&C lake colors) identifies the additive sources. Choosing baked goods with non-aluminum leavening (cream of tartar plus baking soda, or “aluminum-free” baking powder), and choosing salt and powdered products without anti-caking-agent aluminum, are the operative substitutions. Many “aluminum-free” baking powders are now available in mainstream markets.
For aluminum cookware users: anodized aluminum cookware substantially reduces aluminum leaching into food. Stainless steel, cast iron, glass, and ceramic cookware eliminate aluminum leaching. The cookware contribution is generally modest relative to additive and antacid contributions, but for consumers cooking acidic foods (tomato sauce, citrus, vinegar) regularly in non-anodized aluminum, switching cookware is a reasonable precaution.
For pregnant women and parents of infants: soy-based infant formulas were documented by EFSA 2008 to deliver higher aluminum than milk-based formulas, which deliver higher aluminum than breastfeeding. For non-breastfeeding situations, milk-based formula is the lower-aluminum choice unless other clinical factors (allergy, intolerance) require soy.
Regulatory limits
| Jurisdiction / Body | Type | Value | Page |
|---|---|---|---|
| EFSA (EU) | Dietary TWI | 1 mg Al/kg b.w./week | efsa-aluminium-twi |
| JECFA (international) | PTWI | 1 mg Al/kg b.w./week (aligned with EFSA after 2008) | Pending separate ingest |
| Prior JECFA PTWI (replaced) | 7 mg Al/kg b.w./week | Replaced 2008 | |
| US ATSDR | Chronic oral MRL | 1 mg Al/kg/day | atsdr-aluminum-mrls |
| US ATSDR | Intermediate oral MRL | 1 mg Al/kg/day | atsdr-aluminum-mrls |
| EU | Maximum levels for aluminium in food contact materials | Regulation (EU) 10/2011 amendments | Pending separate ingest |
What the reference values mean in practice
The EFSA TWI of 1 mg Al/kg b.w./week corresponds to 70 mg Al/week or 10 mg Al/day for a 70-kilogram adult. EFSA’s estimate of typical European adult dietary intake is 0.2 to 1.5 mg/kg b.w./week (14 to 105 mg/week for the same adult), placing the population mean at the upper end of the TWI range and the high consumers above. This is the regulatory finding that “the TWI is likely to be exceeded in a significant part of the European population.”
For an individual consumer: a daily diet without aluminum-additive-heavy processed foods, without antacid use, and using non-aluminum cookware would typically deliver well under the TWI. Adding aluminum-containing antacids to the dietary baseline can rapidly push intake to 10 to 100 times the TWI; this is why antacid users are the most consequential subpopulation for aluminum exposure regulatory concern.
Testing
Biomonitoring for aluminum exposure typically measures serum or plasma aluminum (operative for dialysis-patient monitoring) or urinary aluminum (recent integrated exposure).
Microbiome effects
Pending dedicated microbiome ingests. Aluminum-microbiome interactions are not a major area of established evidence. The wikibiome-crosswalk anchors are not yet established.
Historical context: dialysis encephalopathy
Dialysis encephalopathy (also called dialysis dementia) was the canonical clinical entity that established aluminum’s neurotoxicity in humans. Beginning in the 1970s, hemodialysis patients in some centers developed progressive dementia with dysarthria, myoclonus, and seizures. The cause was traced to aluminum contamination of dialysate water, which entered patients’ circulation directly via the dialyzer. After the etiology was identified, treatment of dialysate water to remove aluminum (typically with reverse osmosis) eliminated new cases. Concurrent dialysis osteomalacia, with similar dialysate-aluminum etiology, also resolved with the dialysate-water-treatment intervention. These two clinical entities together constitute the strongest human evidence for aluminum’s adverse health effects and are the empirical anchor for aluminum-related neurotoxicity and bone-effect concerns at the regulatory level.
The lessons from dialysis encephalopathy are: (a) aluminum is a potential neurotoxicant and bone-affecting agent in humans at sufficient body-burden levels; (b) renal function is the critical variable controlling aluminum body-burden accumulation; (c) intravenous and dialysis routes bypass the protective GI absorption barrier and produce body-burden far above what oral dietary exposure achieves at any reasonable intake. The TWI is set as a population-protective threshold for normal-renal-function oral-exposure consumers, with the dialysis evidence providing the proof-of-concept that aluminum can produce disease at sufficient body burden.
Vulnerable populations
| Population | Basis |
|---|---|
| Hemodialysis patients (legacy concern) | Dialysate-water aluminum was the cause of dialysis encephalopathy and osteomalacia; modern dialysis water treatment essentially eliminates this exposure |
| Patients with chronic renal impairment | Reduced aluminum excretion produces body-burden accumulation; aluminum-containing antacids and phosphate binders are particular concerns |
| Frequent users of aluminum-containing antacids | Daily aluminum delivery 100 to 1000 mg dwarfs dietary intake |
| Consumers of aluminum-additive-heavy diets | Population-level TWI exceedance documented in EFSA 2008 |
| Infants on soy-based formula | Higher aluminum than milk-based formula or breastfeeding (EFSA 2008) |
| Aluminum-industry workers | Inhalation exposure to aluminum dust in smelter and finishing operations |
If you are in one of these groups
For patients with chronic kidney disease or on dialysis: aluminum is a clinical concern your nephrology team monitors. Aluminum-containing antacids and aluminum-containing phosphate binders are typically avoided in this population; non-aluminum alternatives are standard. Discuss any over-the-counter antacid use with your nephrology team.
For frequent antacid users with normal renal function: consider switching from aluminum-containing antacids (Maalox, Mylanta, Amphojel) to non-aluminum alternatives (calcium carbonate antacids like Tums, magnesium hydroxide preparations, proton pump inhibitors for chronic acid-related conditions). The decision depends on your clinical pattern; discuss with a physician if you use antacids more than occasionally.
For parents of infants: breastfeeding is the lowest-aluminum infant feeding option. When formula feeding is required, milk-based formula carries less aluminum than soy-based formula. Specialized formulas for medical conditions should be chosen on clinical rather than aluminum grounds; aluminum is not a primary consideration for most formula-feeding decisions in non-renal-impaired infants.
For consumers concerned about additive intake: read labels for “sodium aluminium phosphate,” “sodium aluminium silicate,” “aluminium ammonium sulfate,” and aluminum-containing colorants. Choose non-aluminum-leavened baked goods (look for “aluminum-free baking powder” on labels). Anodized aluminum cookware reduces leaching relative to non-anodized; stainless steel, cast iron, and glass eliminate it.
App-layer integration
Machine-readable takeaways from this synthesis for the Heavy Metal Index consumer app pipeline.
The aluminum reference value is a single TWI of 1 mg/kg b.w./week (EFSA, JECFA-aligned). The app can present a “percent of TWI” benchmark as the primary aluminum signal. Default reference: 1 mg Al/kg b.w./week.
Critical app handling: aluminum-containing antacid use is the dominant single exposure source for users and dwarfs dietary intake. The app should explicitly query antacid use as a separate input and add antacid-derived aluminum to dietary aluminum for total exposure estimation. Without this query, dietary-only estimates substantially understate total aluminum intake for antacid users.
Pediatric multipliers: EFSA 2008 documented soy-based formula aluminum at approximately 1.1 mg/kg b.w./week vs milk-based at 0.3 to 0.9 vs breast milk at less than 0.07. App pediatric mode should query feeding modality and apply formula-specific exposure defaults.
Structured outputs:
- GI absorption (general): less than 1 percent.
- GI absorption (citrate-complexed): higher, up to several percent.
- Antacid daily aluminum delivery (typical user): 100 to 1000 mg/day.
- High-Al food categories: foods with aluminium-additives, processed cheese with aluminum emulsifiers, baked goods with aluminum baking powder, tea, soy-based infant formula.
- Cookware contribution flag: non-anodized aluminum + acidic food + prolonged cooking = elevated leaching.
- Renal function multiplier: in CKD, body-burden accumulation rate is amplified; this is a clinical population not generally targeted by the consumer app.
Open questions
Two load-bearing open questions for aluminum:
First, the population-level TWI exceedance documented by EFSA 2008 is a regulatory finding that has not produced a clear policy intervention. Reducing dietary aluminum below the TWI through ordinary food choice is difficult given aluminum’s broad use as a food additive; whether the TWI is too conservative, or whether population aluminum exposure warrants additive-restriction policy, is an active regulatory debate.
Second, the relationship between dietary aluminum exposure and Alzheimer’s disease has been investigated extensively over decades without a definitive consensus emerging. Current dominant view is that aluminum is not a primary causal factor in Alzheimer’s, but the literature remains contested in some quarters. The wiki tracks this as a live methodological question without taking a position pending stronger meta-analytic synthesis.
Sources
Auto-generated from source-page frontmatter. The “Used on this page for” column is populated by the orchestrator’s POPULATE-SOURCE-LEGEND action; pending entries appear as *[awaiting synthesis]*.
| # | Citation | Year | Type | Used on this page for |
|---|---|---|---|---|
| 1 | WHO 2026. GEMS/Food Contaminants database heavy-metal exports, GEMS/Food Contamination Monitoring and Assessment Programme | 2026 | Government dataset | WHO GEMS/Food contaminants database: global Al occurrence monitoring data across food commodities |
| 2 | Ali et al. 2025. Carbon Dots Fluorometric Sensor for Simultaneous Detection of Aluminum and Cobalt in Canned Foods | 2025 | Peer-reviewed | Analytical sensor method for Al detection, cited for analytical-methods context |
| 3 | Asadi et al. 2025. Human health risk assessment of arsenic and potentially toxic elements exposure in bread and wheat flour in Northeast Iran, PLoS ONE | 2025 | Peer-reviewed | Al concentrations and health risk assessment in bread (n=270) |
| 4 | Erol et al. 2025. Safety and Nutritional Profile of Traditional Turkish Cheeses: A Comprehensive Study on Their Mineral Content, Heavy Metal Contamination, and Health Risks of Aho, Golot, and Telli, Food Science & Nutrition | 2025 | Peer-reviewed | Al concentrations and health risk assessment in cheese (n=30) by ICP-MS |
| 5 | Fan et al. 2025. Occurrence, exposure and health risk assessment of heavy metals in green tea samples cultivated in Hangzhou area, Scientific Reports | 2025 | Peer-reviewed | Al concentrations and health risk assessment in green tea (n=120) by ICP-MS |
| 6 | FDA 2025. Compliance Program Guidance Manual: Toxic Elements in Food and Foodware, and Radionuclides in Food – Import and Domestic (Program 7304.019), US Food and Drug Administration | 2025 | Government report | FDA Compliance Program 7304.019: Al surveillance in food and foodware, analytical methods and enforcement thresholds |
| 7 | Gundogdu et al. 2025. ICP-MS Method for Aluminum, Sodium, and Potassium Determination in Human Albumin Infusion Solutions | 2025 | Peer-reviewed | ICP-MS method for Al in pharmaceutical parenteral solutions, cited for analytical method context |
| 8 | Ibrahim et al. 2025. Dietary Exposure and Health Risk Assessment of Selected Toxic and Essential Metals in Various Flavored Dairy Products, Biological Trace Element Research | 2025 | Peer-reviewed | Al concentrations and health risk assessment in milk (n=180) by ICP-MS |
| 9 | Li et al. 2025. A ratiometric fluorescent sensor for Al3+ and Cu2+ detection in food samples, Frontiers in Nutrition | 2025 | Peer-reviewed | Analytical sensor method for Al detection, cited for analytical-methods context |
| 10 | Naccari et al. 2025. Study of Toxic Metals and Microelements in Honey as a Tool to Support Beekeeping Production and Consumer Safety, Foods 2025, 14, 1986 | 2025 | Peer-reviewed | Al concentrations in honey (n=38) by ICP-MS |
| 11 | Uthayarajan et al. 2025. Quality and sources of food and water consumed by people with chronic kidney disease of unknown etiology in Sri Lanka: a systematic review, Environmental Science and Pollution Research | 2025 | Peer-reviewed | [awaiting synthesis] |
| 12 | Yan et al. 2025. Association between infants’ serum levels of 26 metals and gut microbiota: a hospital-based cross-sectional study in China, Frontiers in Microbiology 16:1669475 | 2025 | Peer-reviewed | Infant serum Al and gut microbiota composition associations, hospital-based cross-sectional study |
| 13 | Alinezhad et al. 2024. Heavy metals contamination in pasteurized and sterilized cow’s milk: a systematic review, PLOS ONE | 2024 | Peer-reviewed | Systematic review of Al in milk: synthesised occurrence, health effects, and exposure data |
| 14 | Atanasov et al. 2024. Surface-Enhanced Raman Spectroscopy of Ammonium Nitrate Using Al Structures, Fabricated by Laser Processing of AlN Ceramic, Materials | 2024 | Peer-reviewed | SERS substrate using AlN nanostructures for ammonium nitrate detection, cited for analytical-methods context only |
| 15 | Hussein et al. 2024. Risk assessment of some toxic metals in canned fish products retailed in Mansoura, Egypt, Open Veterinary Journal | 2024 | Peer-reviewed | Al concentrations and health risk assessment in canned fish products (n=100) by AAS |
| 16 | Kovacik et al. 2024. Microelements, Fatty Acid Profile, and Selected Biomarkers in Grass Carp (Ctenopharyngodon idella) Muscle Tissue: Seasonal Variations and Health Risk Assessment, Research (journal not specified in text; published online 9 May 2024) | 2024 | Peer-reviewed | State-of-the-science review on metal biomarkers: Al measurement matrices (blood, urine, hair) for exposure assessment |
| 17 | Laoye et al. 2024. Assessment of heavy metal contamination in fish, fruits, and vegetables in Southwest Nigeria: A systematic review, F1000Research | 2024 | Peer-reviewed | [awaiting synthesis] |
| 18 | Meli et al. 2024. Chemical characterization of baby food consumed in Italy, PLOS ONE | 2024 | Peer-reviewed | Al concentrations in baby food |
| 19 | Toledo et al. 2024. Essential and Toxic Elements in Infant Cereal in Brazil: Exposure Risk Assessment, International Journal of Environmental Research and Public Health 21(4):381 | 2024 | Peer-reviewed | Al concentrations and health risk assessment in infant rice cereal (n=18) |
| 20 | Brzezinska-Rojek et al. 2023. Evaluation of the Safety and Potential Benefits of Beetroot-Based Dietary Supplements According to Their Elemental Composition, Biological Trace Element Research (published online 7 October 2023) | 2023 | Peer-reviewed | Al concentrations in dietary supplements (n=37) |
| 21 | Henríquez-Hernández et al. 2023. Concentration of Essential, Toxic, and Rare Earth Elements in Ready-to-Eat Baby Purees from the Spanish Market, Nutrients 15(14):3251 | 2023 | Peer-reviewed | Al concentrations in ready-to-eat baby purees (n=159) by ICP-MS |
| 22 | Hussein et al. 2023. Risk assessment of toxic residues among some freshwater and marine water fish species, Frontiers in Veterinary Science | 2023 | Peer-reviewed | [awaiting synthesis] |
| 23 | Kamaly et al. 2023. Health risk assessment of metals in chicken meat and liver in Egypt, Environmental Science and Pollution Research | 2023 | Peer-reviewed | [awaiting synthesis] |
| 24 | Kazeminia et al. 2023. Heavy metals and their adverse effects: sources, risks, and strategies to reduce accumulation in tea herb — a systematic review, Carpathian Journal of Food Science and Technology | 2023 | Peer-reviewed | Systematic review of Al in tea herb: synthesised occurrence, health effects, and exposure data |
| 25 | Marriott et al. 2023. Considerations for environmental biogeochemistry and food security for aquaculture around Lake Victoria, Kenya, Environmental Geochemistry and Health | 2023 | Peer-reviewed | [awaiting synthesis] |
| 26 | Milani et al. 2023. Trace Elements in Soy-Based Beverages: A Comprehensive Study of Total Content and In Vitro Bioaccessibility, International Journal of Environmental Research and Public Health | 2023 | Peer-reviewed | Al data: This A-tier peer-reviewed paper is the first promoted Category 5 occurrence source for the soy-based plant-milk row. |
| 27 | Salmani et al. 2023. Comparison of Essential and Toxic Metals Levels in some Herbal Teas: a Systematic Review, Biological Trace Element Research | 2023 | Review | Systematic review of Al in black tea: synthesised occurrence, health effects, and exposure data |
| 28 | Suomi et al. 2023. Cumulative risk assessment of the dietary heavy metal and aluminum exposure of Finnish adults, Environmental Science and Pollution Research | 2023 | Peer-reviewed | [awaiting synthesis] |
| 29 | Zergui et al. 2023. Evaluation of trace metallic element levels in coffee by ICP-MS: a comparative study among different origins, forms, and packaging types and consumer risk assessment, Biological Trace Element Research | 2023 | Peer-reviewed | Al concentrations and health risk assessment in coffee (n=44) by ICP-MS |
| 30 | Almeida et al. 2022. Toxic Metals and Metalloids in Infant Formulas Marketed in Brazil, and Child Health Risks According to the Target Hazard Quotients and Target Cancer Risk, International Journal of Environmental Research and Public Health 19(18):11178 | 2022 | Peer-reviewed | Al concentrations and health risk assessment in infant formula |
| 31 | FDA 2022. Total Diet Study Report: Fiscal Years 2018-2020 Elements Data, U.S. Food and Drug Administration, Total Diet Study Program | 2022 | Government report | FDA Total Diet Study FY2018-2020: Al concentrations and estimated dietary exposures across commercial food categories |
| 32 | FDA 2022. FY2018-FY2020 TDS Elements Analytical Results Key, FDA Total Diet Study supporting documentation | 2022 | Government report | FDA TDS FY2018-2020 analytical key: Al measurement LODs and QA/QC parameters by food category |
| 33 | Astolfi et al. 2021. Determination of 40 Elements in Powdered Infant Formulas and Related Risk Assessment, International Journal of Environmental Research and Public Health | 2021 | Peer-reviewed | Al concentrations and health risk assessment in infant formula (n=22) |
| 34 | Stanton et al. 2021. The Metallome as a Link Between the Omes in Autism Spectrum Disorders, Frontiers in Molecular Neuroscience 14:695873 | 2021 | Peer-reviewed | Al dyshomeostasis in neurodevelopmental conditions: metallome dysregulation context |
| 35 | Ufelle et al. 2021. Toxic Effects of Metals (Chapter 23), in Casarett & Doull’s Essentials of Toxicology, Fourth Edition, Casarett & Doull’s Essentials of Toxicology, Fourth Edition. McGraw Hill Education | 2021 | Textbook chapter | Toxicology reference text on aluminum: mechanisms of toxicity, target organs, and clinical manifestations |
| 36 | Paiva et al. 2020. Aluminium in infant foods: Total content, effect of in vitro digestion on bioaccessible fraction and preliminary exposure assessment, Journal of Food Composition and Analysis 90:103493 | 2020 | Peer-reviewed | Al concentrations in infant/baby food |
| 37 | de et al. 2020. Aluminum content and effect of in vitro digestion on bioaccessible fraction in cereal-based baby foods, Food Research International 131:108965 | 2020 | Peer-reviewed | Al concentrations in baby food (n=35) |
| 38 | Elsheikh et al. 2020. Evaluation of Some Toxic and Essential Trace Elements in Children Foods and Infant Formulae by Using ICP-OES, Asian Journal of Chemistry 32(6):1273-1278 | 2020 | Peer-reviewed | Al concentrations in powdered infant formula (n=57) |
| 39 | Igweze et al. 2020. Public Health and Paediatric Risk Assessment of Aluminium, Arsenic and Mercury in Infant Formulas Marketed in Nigeria, Sultan Qaboos University Medical Journal 20(1):e63-e70 | 2020 | Peer-reviewed | Al concentrations and health risk assessment in infant formula (n=26) |
| 40 | Chekri et al. 2019. Trace element contents in foods from the first French Total Diet Study on infants and toddlers, Journal of Food Composition and Analysis | 2019 | Peer-reviewed | Al occurrence data from a Total Diet Study on infants and toddlers: concentrations across food categories |
| 41 | Fechner et al. 2019. Dietary exposure assessment of aluminium and cadmium from cocoa in relation to cocoa origin, PLoS ONE | 2019 | Peer-reviewed | Al dietary exposure estimates in cocoa/chocolate |
| 42 | Redgrove et al. 2019. Prescription Infant Formulas Are Contaminated with Aluminium, International Journal of Environmental Research and Public Health 16(5):899 | 2019 | Peer-reviewed | Al concentrations in infant formula |
| 43 | Zhang et al. 2018. Accumulation of Heavy Metals in Tea Leaves and Potential Health Risk Assessment: A Case Study from Puan County, Guizhou Province, China, International Journal of Environmental Research and Public Health | 2018 | Peer-reviewed | Al concentrations and health risk assessment in tea (n=26) by ICP-MS |
| 44 | FSA 2016. Survey of metals in commercial infant foods, infant formula and non-infant specific foods, UK Food Standards Agency report FS102048 | 2016 | Government report | UK Food Standards Agency 2016 survey: Al concentrations in infant foods and formula |
| 45 | Li et al. 2015. A comparison of the potential health risk of aluminum and heavy metals in tea leaves and tea infusion of commercially available green tea in Jiangxi, China, Environmental Monitoring and Assessment | 2015 | Peer-reviewed | Al concentrations and health risk assessment in tea infusions (n=26) by ICP-MS |
| 46 | Sipahi et al. 2014. Safety assessment of essential and toxic metals in infant formulas, The Turkish Journal of Pediatrics 56(4):385-391 | 2014 | Peer-reviewed | Al concentrations in infant formula (n=63) |
| 47 | Carroquino et al. 2013. Environmental Toxicology: Children at Risk, Encyclopedia of Sustainability Science and Technology, Chapter 11 (Springer) | 2013 | Peer-reviewed | Toxicology reference text on aluminum: mechanisms of toxicity, target organs, and clinical manifestations |
| 48 | Chuchu et al. 2013. The aluminium content of infant formulas remains too high, BMC Pediatrics | 2013 | Peer-reviewed | Al concentrations in infant formula (n=30) |
| 49 | Yuan et al. 2012. Aluminum Overload Increases Oxidative Stress in Four Functional Brain Areas of Neonatal Rats, Journal of Biomedical Science 19(1):51 | 2012 | Peer-reviewed | Al toxicological mechanisms, target organ effects, and dose-response evidence |
| 50 | Dabeka et al. 2011. Lead, cadmium and aluminum in Canadian infant formulae, oral electrolytes and glucose solutions, Food Additives & Contaminants: Part A | 2011 | Peer-reviewed | Al concentrations in infant formula (n=243) |
| 51 | Burrell et al. 2010. There is (still) too much aluminium in infant formulas, BMC Pediatrics | 2010 | Peer-reviewed | Al concentrations in infant formula (n=15) |
| 52 | Kazi et al. 2009. Determination of toxic elements in infant formulae by using electrothermal atomic absorption spectrometer, Food and Chemical Toxicology | 2009 | Peer-reviewed | Al concentrations in infant formula (n=17) |
| 53 | ATSDR 2008. Toxicological Profile for Aluminum, U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry | 2008 | Government report | ATSDR toxicological profile for aluminum: exposure routes, health effects, dose-response, and MRL derivation |
| 54 | EFSA 2008. Safety of Aluminium from Dietary Intake, The EFSA Journal (2008) 754, 1-34 | 2008 | Government report | EFSA 2008 scientific opinion on Al: tolerable weekly intake of 1 mg/kg bw/week, neurotoxicity basis, and dietary exposure |
| 55 | Kim et al.. Evaluation of selected ultra-trace minerals in commercially available dry dog foods, Veterinary Medicine: Research and Reports | — | Peer-reviewed | Al concentrations in dry pet food (n=49) |