Antimony: a cryptic metabolism disruptor ubiquitous in food contact materials

Antimony (Sb) is a group 15 metalloid that is used as a catalyst in the production of polyethylene terephthalate (PET) plastic, a common food contact material (FCM). PET accounts for over 44% of single-use beverage packaging units and is also used in the production of food trays, storage containers, and other items. Due to its frequent co-occurrence with other metals, Sb is also a common contaminant in crystalware, ceramics, and metal FCMs. In light of the increasing use of Sb-containing FCMs in modern society, a thorough evaluation of Sb's potential effect on public health is warranted. Burgeoning evidence suggests Sb is linked to common cardiometabolic conditions, including dyslipidemia, obesity, diabetes, hypertension, heart failure, and atherosclerotic cardiovascular disease. Thus, this review aims to (1) perform a comprehensive systematic assessment of Sb migration from FCMs into foodstuffs and food simulants, (2) obtain an overview of antimony-related health risks, and (3) inform the generation of harm-reduction guidelines at the individual and systems levels.