Introduction : Noncommunicable diseases (NCDs) caused at least 43 million deaths in 2021, equivalent to 75% of non-pandemic-related deaths globally. Cardiovascular diseases account for most NCD deaths, or at least 19 million deaths in 2021, followed by cancers (10 million), chronic respiratory diseases (4 million), and diabetes (over 2 million including kidney disease deaths caused by diabetes). These four groups of diseases account for 80% of all premature NCD deaths. According to the Fourth National Survey on the Prevalence of Noncommunicable Diseases, Injuries, and Their Risk Factors: 14.0% of adults aged 15–69 have experienced a heart attack or stroke, 11.0% report taking aspirin to prevent or manage cardiovascular disease (CVD), 2.2% use lipid-lowering medications (statins) for CVD prevention or treatment, among adults aged 40–69, 19.3% are at high risk of developing CVD within the next 10 years. These findings underscore the urgent need to strengthen cardiovascular disease prevention efforts and improve the management of key risk factors in Mongolia. Goal: To determine the population’s knowledge, attitudes, and practices related to cardiovascular disease risk factors and healthy lifestyle behaviors. Materials and Methods: This descriptive cross-sectional study included 2,532 participants aged 18–69 years from all 21 provinces of Mongolia and Ulaanbaatar city, as part of the “Cardiology, Cardiac Surgery, and Telemedicine in Mongolia” (MON/007) Project. Data were collected using a structured questionnaire comprising six sub-sections, designed to assess knowledge, attitudes, and practices related to 10 modifiable cardiovascular risk factors. Ethical approval was obtained prior to the study, and data were analyzed using SPSS version 23. Results: Thirty-three percent of study participants reported having no knowledge of cardiovascular disease, indicating that roughly one in three adults consider themselves to have little or no understanding of cardiovascular health. In the study, 53.0% of participants reported being unaware of the symptoms of a heart attack, while 42.0% did not recognize the symptoms of a stroke. Among participants who could identify these symptoms, 68.0% indicated dizziness as a sign of hypertension, 65.0% reported headache, and 58.0% noted blurred vision. Among the respondents, 31.0% knew that the normal arterial blood pressure for an adult is 120/80 mmHg, 57.0% were aware that an adult should sleep 7–8 hours per day, 13.0% knew about body mass index (BMI), 30.0% were aware of fasting blood glucose levels, and 44.0% recognized that adults should engage in 30 minutes of physical activity daily. Knowledge of key physiological indicators was significantly associated with educational attainment, gender, and age group, with lower levels of awareness observed among participants with lower education, males, and younger adults (p=0.001). The majority of participants (75.0%-96.0%) reported being aware of the modifiable risk factors for cardiovascular disease. Among the study participants, nine out of ten agreed that maintaining a healthy lifestyle includes regular physical activity, exercising, walking short distances, and understanding that hypertension is harmful and smoking adversely affects the heart. Furthermore, 80–85% reported avoiding excessive alcohol consumption, and 79% believed that cardiovascular disease is preventable. To prevent or reduce obesity, a risk factor for cardiovascular disease, 49.0% of participants reported engaging in regular physical activity, while 33.0% reported following a healthy diet. Among all study participants, 61.0% had never checked their cholesterol levels, 49.0% had never measured their blood glucose, and 15.0% had never monitored their blood pressure. Among respondents exhibiting 1–3 common risk factors, the majority were female, aged 25–34 years, living in rural areas or ger districts, with secondary or specialized secondary education, employed in government institutions, and had a normal BMI. In contrast, among those with 7 or more common risk factors, the majority were male, aged 35–44 years, residing in Ulaanbaatar, living in ger districts, and employed in private organizations. Conclusion Most of surveyed participants had sufficient knowledge and positive attitudes toward modifiable risk factors for cardiovascular diseases (p=0.001). However, they exhibited inadequate preventive practices related to these risk factors. This indicates the importance of targeted intervention on behavior change to address this gap.

Afl atoxins are a type of mycotoxin produced by Aspergillus species of fungi, such as A. fl avus andA.parasiticus. Afl atoxins are the most potent hepatocarcinogen and mutagen among mycotoxins.Afl atoxins can effects a wide range of commodities, including crops, cereals, peanuts, maize, beans,and milk and fruits. Thus, we carried out a monitoring surveillance survey on the afl atoxins level in somefood commodities. In early stage of this survey we tested a total of 112 samples of foods including fl our,rice, peanuts, maize, dried fruits, milk, and cereals. According to the preliminary results of this survey,59 (52.7%) samples of foods including fl our, rice, peanuts, maize, dried fruits, milk, and cereals’ sampleswere positive for a total afl atoxins (AFB1+AFB2+AFG1+AFG2). Although levels of total afl atoxins in allsamples were at permissible limits by the commission regulation of EU, the strategies for the preventionand control of mycotoxin are required in Public health system and Agricultural organization in Mongolia.Since afl atoxins is the most well-known mycotoxin ever thoroughly studied and its prevention and controlhas been most successfully practiced in various countries, therefore, this paper will focus on the strategyfor the prevention and control of afl atoxins’s mycotoxin contamination food in Mongolia.

This cross-sectional survey was conducted in seven district of the capital city Ulaanbaatar ofMongolia, and border post in Zamiin-Uud, and Altanbulag province from March to December 2015.A total of 380 samples including 70 flours, 114 rice’, 41 various peanuts, 15 maize and maizeproducts, 24 milks, 6 yoghurts, 39 beers, 27 dried fruits and 44 herbal teas were randomly collectedfrom supermarkets, hypermarkets, department stores, factories, and bazaars in Ulaanbaatar city,and Zamiin-Uud, and Altanbulag province.HPLC (High performance liquid chromatography), and enzyme-linked immunosorbent assay (ELISA)were used for the total aflatoxins (B1+B2) and aflatoxin M1 detection.The survey found that (148) 38.9% of all analysed food samples were contained aflatoxins (B1+B2),and aflatoxin M1 were ranging from 0.0094 μg kg-1to 2.4μg kg-1. The levels of aflatoxins (B1+B2)were below the maximum tolerance limit in EU and worldwide regulations. Mean concentrationlevel of aflatoxins (B1+B2) was 0.17 μg kg-1 in all positive samples. Mean daily low and high foodintake were respectively, 63 g and 245 g. Based on the daily food consumption data, estimatedexposure dose of aflatoxins (B1+B2) was 0.16734 mg kg-1bw day-1 in individuals with a daily low foodintake, and 0.65078 mg kg-1bw day-1 in individuals with a daily high food intake (95th percentile). Theexposure dose of aflatoxins from daily high food intake exceeds the estimated provisional maximumtolerable daily intakes, 0.4 μg kg-1 body weight day-1 for adults with hepatitis B (Kuiper-Goodman,1998). Furthermore, estimated excess cancer risk values to liver cancer incidence by ingestion ofthese foods for aflatoxins (B1+B2) and aflatoxin M1were calculated to be 0.0448 mg kg-1bw day-1forindividuals negative for hepatitis Band 1.344 mg kg-1bw day-1 for individuals positive for hepatitis B.Thus, the findings of our survey showed that the potential hazard associated with aflatoxin in foodin Mongolia has not been serious. However, most researchers suggested that no level of aflatoxinexposure is considered safe.Conclusion: Currently, the levels of the total aflatoxins and aflatoxin M1 were lower than the maximumpermissible levels in UE and the USFDA, and worldwide regulations. Currently, estimated exposuredose of the total aflatoxins and M1aflatoxin through daily high food intake was risked in populationwith hepatitis B virus. However, in Mongolian population has not been excess liver cancer risk.

ObjectiveThis study aimed to assess the prevalence of the total aflatoxin in peanuts, and their concentration level.Material and MethodThis cross-sectional survey was conducted in seven district of Ulaanbaatar, the capital city of Mongolia,from March to December 2015.A total of 41 samples of peanuts were randomly collected from the survey area, from March to December2015. An ELISA test was used for detection the total aflatoxins(B1+B2). The relative humidity andtemperatures of the storage areas were measured at the time of sampling the peanut.ResultsThe Frequency statistics analysis showed that 61% of all analyzed peanut samples had detectablelevels of the total aflatoxinat 0.05 μg kg-1. The prevalence of samples contaminated with the totalaflatoxins(B1+B2) were higher among analysed samples of the tree nuts, peanuts imported from China,and canned nuts (P<=0.01). Levels of the total aflatoxins were less than the maximum permissible limitsof 15 μg kg by the regulation of European Union and worldwide. The mean values of the storage relativehumidityat the time of sampling peanuts were higher than the recommended storage relative humidity incorn cereals (<13%). Furthermore, the mean values of the storage temperatures at the time of samplingpeanuts were higher in groundnut peanuts, cedar’s nut and peanuts imported from China than therecommended level of the storage temperature in corn cereals (10°C-21°C).Conclusion:The prevalence of the total aflatoxin in peanuts was higher. The level of the total aflatoxins were less thanthe maximum permissible limits of 15 μg kg-1 by the regulation of European Union and worldwide. Thestorage relative humidity and temperatures of peanuts may encourage the growth of fungi-producingaflatoxins. Thus, a national strategy for the elimination of aflatoxin in foods is needed in Mongolia.

Aflatoxins are the secondary metabolites of the fungi namely, Aspergillus flavus and A. parasiticus. They can colonize and contaminate grain before harvest or during storage. There are about twenty related secondary forms of aflatoxins, and subtypes B₁, B₂, G₁, G₂. These aflatoxins frequently contaminate the foods and feeds (Yu J et al, 2000, Imanaka BT et al, 2007). Aflatoxin B1, the most toxic, is a potent hepatocarcinogenic and genotoxigenic metabolites that have been classified as group I carcinogens by International Agency of Research on Cancer (International Agency for Research on cancer, 1993). Aflatoxin M1 is found in milk of lactating cows that have consumed feeds contaminated with aflatoxin B₁. Aflatoxin M₁ was originally classified as a Group 2B human carcinogen in 1993, but subsequent evidences of its cytotoxic, genotoxic and carcinogenic effects led to a new categorization of aflaoxin M1 as Group I (International Agency for Research on cancer, 2002). Aflatoxins can affect a wide range of commodities, including crops, cereals, oilseeds, spices, tree nuts, milk, meat, and dried fruit (Wilson DM et al, 1994, Bao L et al, 2010). Mongolia has been imported foods about 60 percent of food demands including wheat, flour, rice, milk, dairy products, peanuts and maize. This situation is required to study aflatoxin contamination in food in Mongolia. Epidemiological studies have found that dietary exposure to aflatoxin and chronic infection with hepatitis B, C virus are three major risk factors for HCC (Viviani et al. 1997; Hall et al. 2003). HCC as a result of chronic aflatoxin exposure has been well documented, presenting most often in persons with chronic hepatitis B virus (HBV) infection (Wild and Gong, 2010). The risk of liver cancer in individuals exposed to chronic HBV infection and aflatoxin is up to 30 times greater than the risk in individuals exposed to aflatoxin (Groopman et al., 2008). According to the WHO, the national liver cancer incidence rates was 54.1 per 100.000 population, the prevalence of HBV and HCV infection in 11.8%, 15.6% were respectively (J.Abarsanaa, 2012). This situation is a serous public health problem in Mongolia. Thus, we aimed to carry out the monitoring surveillance survey on the aflatoxin contamination level in some food.