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African Journal of Food, Agriculture, Nutrition and Development
Rural Outreach Program
ISSN: 1684-5358 EISSN: 1684-5374
Vol. 4, Num. 1, 2004

African Journal of Food Agriculture Nutrition and Development, Vol. 4, No. 1, 2004

Student Section

PICA: MOTIVATING FACTORS AND HEALTH ISSUES

Francis Tayie

Francis Tayie
Department of Food Science and Human Nutrition, Iowa State University, USA

Code Number: nd04010

Ingestion of non-food substances is an eating disorder manifested as the craving for a non-food or food items unusual in kind or quantity [1,2]. The subdivisions of pica include pagophagia - the excessive consumption of ice, freezer frost or iced drinks; amylophagia - consumption of uncooked starch and dough; plasticophagia - the nibbling and sucking of plastics; and geophagia - the consumption of clay, mud, dirt and other pieces of the lithosphere [3,4].

Pica is widespread in Africa and other parts of the world and is associated with medicinal treatment, spiritual and ceremonial behavior as well as chronic hunger, folk medicine, traditional cultural activities and social customs. Psychological upset, physiological changes during pregnancy and abnormal appetite induced by intestinal worm infestation [2, 5, 6] have been reported to motivate pica. Explorers and missionaries in the 18 th and early 20 th century reported clay pica in Nigeria , Ghana , Sierra-Leone and Southern Africa [5]. Starvation, poverty and famine are additional factors, in which the pica substances function as bulking agents to supplement insufficient food [4,7]. In Malawi , it was unusual for a pregnant woman not to practice pica since it was an indicator for pregnancy and the taste of clay was claimed to diminish gestational nausea [5]. In Ghana , it was observed that among 502 pregnant women studied, 48% had pica and clay eating formed the major form (28.5%) [8]. The prevalence of pica among urban and rural South African women was reported to be 38.3% and 44% respectively, compared with 2.2% and 1.6% among Indian and white women respectively [2]. In the Southern parts of the United States of America , pregnant women who had pica believed it helped to prevent vomiting, cured gestational oedema, and ensured beautiful babies [4]. In Australia , some aborigines eat white clay found in the coastal areas of the north territory and riverbeds for medicinal purpose [9].

Pica, especially geophagia has been associated with lead poisoning, blockage of the large intestines, hyperkalemia, phosphorous intoxication and dental injury. In a study conducted on primary school children in Western Kenya , Geissler et. al.[10] observed that geophagia was associated with iron depletion and the soils ingested were contaminated with the eggs of Ascaris lumbricoides . Among 553 African-American women admitted to prenatal clinics in Washington DC , those with pagophagia had lower iron stores during pregnancy [11]. In a cross sectional study in an antenatal clinic at Kilifi District Hospital , Kenya , low iron status and anaemia were reported among 56% of pregnant women who had pica [10]. Amylophagia may contribute to the development of iron deficiency because the starch provides energy without iron [12]. Conversely, geophagia has been used as a remedy for diarrhoea and stomach discomfort, a practice attributed to the ability of kaolin in clay to absorb dietary and bacterial toxins associated with gastro-intestinal disturbance [5]. Hunter [5] indicated that 100 grams of white copper belt clay ingested could contribute 15 mg of calcium, 48 mg of iron and 42 mg of zinc which may be significant amounts where such deficiencies exist. Studies on pica have been cross-sectional and observational, therefore causal relationship of pica with anaemia, iron depletion, worm infestation and other diseases is difficult to state. Commonly, persons who have pica are most often females and are more likely to be of African origin, live in rural areas, have a family history of pica and are likely to pass on the habit to descendants [13].

REFERENCES

  1. Menge H, Lang A and H Cuntze Pica in Germany : Amylophagia-associated Iron Deficiency Anemia. J Gastroenterol , 1998; 36: 635-640.
  2. Walker ARP, Walker BF, Sookaria FI and RJ Canaan Pica. J . Roy Health , 997; 117: 280-284.
  3. Glickman LT, Chaudry IH, Costantino J, Clack FB, Cypress RH and L Winslow Pica Patterns, Toxocariasis and Elevated Blood Lead in Children. Am J Trop Med Hyg , 1981; 30: 191-195.
  4. Mcloughlin IJ The pica. Hosp Med , 1987; 37: 286- 290.
  5. Hunter JM Macroterm Geophagy and Pregnancy Clays in Southern Africa . J Cultural Geography , 1993; 14: 69- 92.
  6. Crosby WH When Friends or Patients ask about Pica. JAMA , 1976; 233 :2765.
  7. Hawass SED, Alnozha MM, and T Kalowole Adult Geophagia: A Report of Three Cases with Review of Pregnant Women. J Am Diet Assoc , 1987; 91 :34-38.
  8. Tayie FAK and A Lartey Pica Practice among Pregnant Ghanaians:Relationship with Infant Birth- Weight and Maternal Haemoglobin Level. Ghana Medical Journal , 1999; 33(2 ): 67-76.
  9. Beteson EM and T Lebroy Clay Eating by the Aboriginals of the Northern Territory . Med J Aust , 1978; 1 :51-3.
  10. Geissler PW, Shulman CE, Prince RJ, Mutemi W, Mzani C, Friis H and B Lowe Geophagy, Iron Status and Anaemia among Pregnant Women on the Coast of Kenya. Trans R Soc Trop Med Hyg , 1998; 92(5): 549-553.
  11. Edwards CH, McDonald S, and Mitchell Jr Clay and Cornstarch Eating Women. J. Am Diet Assoc , 1959; 35 :810-815.
  12. Talkington KM, Gant, FN and DE Scott Effect of Ingestion of Starch and Some Clays on Iron Absorption. In: Maternal Nutrition and the Course of Pregnancy. Food and Nutrition Board. National Academy of Science , 1971, Washington DC .
  13. Horner RD, Lackey CJ, Kolash K and K Warren Pica Practices of Pregnant Women. J Am Diet Assoc , 1991; 91 :34 - 38

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