Geophagy in India: a qualitative exploratory study on motivation and perception of female consumers

Research on feeding and eating disorders in India: A narrative review

Despite growing evidence of their prevalence, research on feeding and eating disorders (FEDs) in India has been sporadic. This narrative review aimed to summarize the research on FED in India and set priorities for future research and translation of evidence. An electronic search was conducted in the MEDLINE, PsycINFO, and Google Scholar databases to identify relevant English peer-reviewed articles from April 1967 to July 2023. The extracted data from these studies included author names, publication year, research location, type of intervention (for interventional studies), nature of comparator treatments, and main outcomes or findings. We found a rising trend in the prevalence of EDs in India. Adolescent age group, female sex, higher socioeconomic status, family history of mental illness or disordered eating, and borderline personality pattern were risk factors for EDs. For feeding disorders (FDs), childhood age group, malnutrition, pregnancy, psychosis, intellectual disability (ID), and obsessive-compulsive disorder (OCD) were putative risk factors. Both physical and psychiatric comorbidities were common in FEDs. Culture appears to exert a pathoplastic effect on symptom presentation in FEDs; an illustrative example is the documented nonfat phobic variant of anorexia nervosa (AN) in India. Research on management has focused on using assessment tools, investigations to rule out medical comorbidities, psychosocial and family-based psychotherapies, nutritional rehabilitation, pharmacotherapy, and neuromodulation approaches. Whereas the publication output on FEDs in India has increased over the last decade, it remains an under-researched area, with a striking paucity of original research. Future research priorities in FEDs include conducting country-wide registry-based studies to offer real-world insights, longitudinal research to identify culturally relevant risk factors, and developing brief, culturally sensitive diagnostic instruments for FEDs in the Indian context. This will help generate locally relevant epidemiological data on FEDs and inform treatment and prevention strategies.

Prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan: a cross-sectional study

BACKGROUND

Pica, the craving for and purposive eating of non-food items, is a common worldwide problem, especially among children and pregnant women. There are few published data on pica among adolescents in sub-Saharan Africa, and no study has been carried- out in Sudan. This study was conducted to determine the prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan.

METHODS

A school‑based cross‑sectional study was conducted from July to September 2022 among adolescent students (aged 10-19 years) in four public primary and secondary schools in Almatamah locality in north Sudan. Sociodemographic information (age, sex, mother's education, mother's occupation, and father's education) was collected through a questionnaire. Weight and height were measured using a standard procedure, and the body mass index Z-score was computed using the World Health Organization's reference values. Logistic regression analysis was performed.

RESULTS

Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. Their median (interquartile range) age was 15.1 (13.1‒16.3) years. The prevalence of symptoms of pica was found to be 30.7%, accounting for 118 adolescents. The most common type of pica was geophagia (eating clay and sand; 102 adolescents, 86.4%), followed by pagophagia (eating ice; 14 adolescents, 11.8%) and flour (starch; two adolescents, 1.6%). In the logistic regression analysis, females (adjusted odds ratio = 3.52, 95% confidence interval (CI) = 2.15‒5.78) and a lower level of father's education (adjusted odds ratio = 2.05, 95% CI = 1.26‒3.34) were associated with symptoms of pica.

CONCLUSION

In Sudan, symptoms of pica are common among adolescents, especially females. Caregivers need to assess pica in adolescents. Further research is needed to develop guidelines, medical training, and practice.

Geochemical and mineralogical composition of geophagic materials from Baringo town, Kenyan Rift Valley and their possible health effects on the consumers

Consumption of geophagic materials can be detrimental to human health. These materials, which are harvested from the natural environment, can contain high concentrations of potentially harmful elements and minerals. In this study, mineralogical and geochemical investigation of geophagic rock materials consumed by the local population in Baringo town, in Kenya, was conducted to assess its possible health effects. Twelve representative samples were purchased from an open market in Baringo town for this investigation. Optical and scanning electron microscope as well as X-ray diffractometer was used to determine the mineralogy as well as the morphology of the minerals present in the studied samples. The material is composed of about 10 to 20% coarse to very coarse (0.38-3.00 mm) and semi-rounded to angular crystals of quartz, feldspars, and amphiboles, together with lithic fragments occurring in a fine-grained matrix. X-ray fluorescence and inductively coupled plasma mass spectrometry were used to determine the major and trace elements composition, respectively. The analyses show that elements such as Si, Fe, Mn, Al, Hg, Cr, Cd, and Pb are particularly above their recommended daily allowances. This study assumes 100% bioavailability of elements in the geophagic materials, in the absence of a bioaccessibility test. Therefore, the consumption of some of the revealed elements, based on this assumption, can be detrimental due to possible short- and/or long-term health effects. From a mineralogical point of view, the presence of feldspar and quartz with Moh's hardness of 6 and 7, respectively, and their coarse and angular morphology may cause damage to the dental enamel and the gastrointestinal tract. From a geochemical point of view, the high concentrations of the revealed chemical elements can have various health effects including, but not limited to neurotoxic effects, which are critical in prenatal exposure, neurodegenerative diseases, and cancer amongst other serious diseases.

Healthy, safe and responsible: the modern female traveller

One-half of all travellers are women; yet, there is a distinct lack of detailed travel health knowledge on topics of unique relevance to women. While there is medical advice relating to stages in the female lifecycle, it neglects women-specific practical aspects despite their ability to harm travellers’ health and cause inconvenience. This paper discusses comprehensively three major aspects of travel as they relate to women. First, it suggests the management of personal hygiene, bodily functions, menstruation and sexual behaviour, and alerts to the limited knowledge on travel mental health issues.

Second, apart from travelling in a female body with its specific demands, being a woman requires special attention to safety and security. Within various travel contexts, women have many opportunities for minimising potential risks.

Finally, guided by travel medicine’s acknowledgment of its role in the concept of responsible travel, this article goes beyond the usual general statements and broad advice and offers detailed and practical suggestions on how the female traveller can contribute to the overall goal of minimising any potential harm to fellow humans and the natural environment. Recognising the scarcity of women-specific travel information, pathways to better education, and a range of suggestions for urgent research facilitate the provision of high-quality travel health care tailored specifically to women’s needs.