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Kumar S, Jain S, Sinha SK, Chaudhury S. Pagophagia: A case series. Ind Psychiatry J 2024; 33:175-178. [PMID: 38853805 PMCID: PMC11155646 DOI: 10.4103/ipj.ipj_178_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/20/2023] [Accepted: 09/30/2023] [Indexed: 06/11/2024] Open
Abstract
Pica, in the form of ingestion of various non-food items like clay, chalks, etc., is commonly reported in Indian settings, but its other variant, pagophagia (ice eating), gets attention rarely. This case series is about three female patients who presented in psychiatry outpatient clinics with various mental health issues and ice eating habits. A diagnosis of iron deficiency anemia was common among all three cases, and they were managed with oral iron supplementation along with appropriate psychiatric treatments. Pagophagia is an important clinical presentation to be looked for in the changing Indian society.
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Affiliation(s)
- Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Suchita Jain
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Satish Kumar Sinha
- Department of Psychiatry, Jan Nayak Karpoori Thakur Medical College and Hospital, Madhepura, Bihar, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Placek CD. Ethnomedical and Sociocultural Factors of Pica Substances in Rural South India. Ecol Food Nutr 2017; 56:238-255. [DOI: 10.1080/03670244.2017.1311255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Caitlyn D. Placek
- Department of Epidemiology, Florida International University, Miami, Florida, USA
- Department of Anthropology, Washington State University, Pullman, Washington, USA
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Steiner-Asiedu M, Harrison OA, Vuvor F, Tano-Debrah K. Quality evaluation of processed clay soil samples. Pan Afr Med J 2016; 24:118. [PMID: 27642456 PMCID: PMC5012739 DOI: 10.11604/pamj.2016.24.118.8406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/27/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction This study assessed the microbial quality of clay samples sold on two of the major Ghanaian markets. Methods The study was a cross-sectional assessing the evaluation of processed clay and effects it has on the nutrition of the consumers in the political capital town of Ghana. The items for the examination was processed clay soil samples. Results Staphylococcus spp and fecal coliforms including Klebsiella, Escherichia, and Shigella and Enterobacterspp were isolated from the clay samples. Samples from the Kaneshie market in Accra recorded the highest total viable counts 6.5 Log cfu/g and Staphylococcal count 5.8 Log cfu/g. For fecal coliforms, Madina market samples had the highest count 6.5 Log cfu/g and also recorded the highest levels of yeast and mould. For Koforidua, total viable count was highest in the samples from the Zongo market 6.3 Log cfu/g. Central market samples had the highest count of fecal coliforms 4.6 Log cfu/g and yeasts and moulds 6.5 Log cfu/g. “Small” market recorded the highest staphylococcal count 6.2 Log cfu/g. The water activity of the clay samples were low, and ranged between 0.65±0.01 and 0.66±0.00 for samples collected from Koforidua and Accra respectively. Conclusion The clay samples were found to contain Klebsiella spp. Escherichia, Enterobacter, Shigella spp. staphylococcus spp., yeast and mould. These have health implications when consumed.
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Affiliation(s)
- Matilda Steiner-Asiedu
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Obed Akwaa Harrison
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Frederick Vuvor
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Kwaku Tano-Debrah
- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
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Groth SW, Simpson AH, Fernandez ID. The Dietary Choices of Women Who Are Low-Income, Pregnant, and African American. J Midwifery Womens Health 2016; 61:606-612. [PMID: 27448099 DOI: 10.1111/jmwh.12463] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 01/24/2016] [Accepted: 01/28/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Multiple factors influence the dietary choices of pregnant women that may increase the risk of excessive gestational weight gain. Several of these factors converge for African American women who are low income and reside in an urban setting. The objective of this study was to gain an understanding of how factors previously identified affect dietary decision making and determine the barriers that impede adoption of a healthy diet for this population. METHODS Twenty-five in-depth semistructured interviews were conducted with African American women who were low income, pregnant, and residing in an urban setting. The participants were recruited from a university obstetric clinic in a medium-sized urban northeastern city. Interviews were digitally recorded and transcribed. Analysis was a recursive process such that data analysis was done continually during data collection. Individual interviews were conducted until informational redundancy was reached. A directed content analysis approach was used, building from prior research and themes that emerged from focus groups with a similar population. Data were coded and grouped into meaningful clusters. RESULTS The participants indicated that food cravings, taste, and appetite influenced their food choices. Limited knowledge about healthy foods, cravings for unhealthy foods, time, and finances were barriers to making healthy dietary choices. Women indicated that if healthy food tasted better, they got more rest, and their schedules were regular, it would help them make the best possible food choices. DISCUSSION Women who are low income, African American, and pregnant could benefit from interventions targeting food cravings, taste, and appetite, and information about what constitutes a healthy diet. Cravings for calorie-dense, nutrient-poor foods were a driver of dietary choice and potentially increased the risk of excessive gestational weight gain. The complexities of cravings, taste, and appetite that converge with limited funds, tight schedules, and a knowledge deficit of important dietary information are critical to consider when providing care to pregnant women from this population.
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Odongo AO, Moturi WN, Mbuthia EK. Heavy metals and parasitic geohelminths toxicity among geophagous pregnant women: a case study of Nakuru Municipality, Kenya. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2016; 38:123-131. [PMID: 25750054 DOI: 10.1007/s10653-015-9690-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 02/25/2015] [Indexed: 06/04/2023]
Abstract
Geophagia is defined as deliberate consumption of earths' materials, e.g. soil, clay and soft stones. The practice is widespread among pregnant women, and there are conflicting views as to whether it is beneficial to health or not. Geophagic materials may be a source of micronutrients though the materials may bind the micronutrients thus reducing or hindering their bioavailability in the body. Geophagia is closely associated with geohelminthic infections among pregnant women and heavy metal poisoning, which constitute significant public health problem in many developing countries such as Kenya. In our research, the geophagic materials consumed by the pregnant women were studied. A total of 38 geophagic materials in the possession by different pregnant women were analysed. The collected samples were subjected to standard digestion procedures and analysed for zinc, lead and iron by atomic absorption spectroscopy. Results indicated that the geophagic materials contained elevated levels of Fe at mean concentration value of 80.10 ppm, Pb at 3.28 ppm and Zn 1.81 ppm for a 1.00 g sample. An average of 20 g of the geophagic materials was being consumed per day. Based on the average consumption, the pregnant women were exposed to 65.52 ppm Pb per day, 36.2 ppm Zn per day and 1602 ppm Fe per day. Lead exceeded the WHO-lead exposure limits of 25 ppm/day for pregnant women. The materials were also subjected to microscopic examination for Ascaris lumbricoides, Trichuris trichiura, Taenia Spp., Necator americanus and Ancylostoma duodenale. In conclusion, the women were exposed to heavy metals-iron, zinc and lead, but there was no observable eggs, larvae or adult species of the geohelminths. The key recommendation was that there is need to integrate public health education on geophagia, lead screening and testing with antenatal support care systems. This will enhance maternal and child health, thus reducing infant and maternal morbidity and mortality rates.
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Affiliation(s)
- A O Odongo
- Department of Environmental Science, Egerton University, Box 536, Njoro, Kenya.
| | - W N Moturi
- Department of Environmental Science, Egerton University, Box 536, Njoro, Kenya
| | - E K Mbuthia
- Department of Human Nutrition, Egerton University, Box 536, Njoro, Kenya
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Santos AM, Benute GRG, Nomura RMY, Santos NO, De Lucia MCS, Francisco RPV. Pica and Eating Attitudes: A Study of High-Risk Pregnancies. Matern Child Health J 2015; 20:577-82. [PMID: 26558792 DOI: 10.1007/s10995-015-1856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. METHODS A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. RESULTS Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: "to be considered too thin by others" (p < 0.02), and "to spend too much time thinking about food" (p = 0.05); and the association between pica and the risk of both anorexia nervosa and bulimia nervosa (p < 0.01) were statistically significant. CONCLUSIONS The absence of validated instruments in the literature for assessing pica reinforces the difficulty of investigating this practice and the need for further studies. Moreover, additional efforts need to focus in the improvement of screening for other eating disorders with obstetric consequences associated with pica and be incorporated into the routine of healthcare professionals.
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Affiliation(s)
- Amanda M Santos
- Department of Obstetrics and Gynecology, Clinics Hospital of Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 155 - PAMB - Ground Floor, São Paulo, SP, 05403-000, Brazil.
| | - Gláucia R G Benute
- Department of Obstetrics and Gynecology, Clinics Hospital of Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 155 - PAMB - Ground Floor, São Paulo, SP, 05403-000, Brazil.,Psychology Division, Clinics Hospital of Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Roseli M Y Nomura
- Department of Obstetrics and Gynecology, Clinics Hospital of Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 155 - PAMB - Ground Floor, São Paulo, SP, 05403-000, Brazil
| | - Niraldo O Santos
- Psychology Division, Clinics Hospital of Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mara C S De Lucia
- Psychology Division, Clinics Hospital of Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rossana P V Francisco
- Department of Obstetrics and Gynecology, Clinics Hospital of Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 155 - PAMB - Ground Floor, São Paulo, SP, 05403-000, Brazil
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Rabel A, Leitman SF, Miller JL. Ask about ice, then consider iron. J Am Assoc Nurse Pract 2015; 28:116-20. [PMID: 25943566 DOI: 10.1002/2327-6924.12268] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/13/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The study aims to review a condition defined by the desire to consume ice in order to satisfy an addictive-like compulsion, rather than for purposes of hydration or pain relief. This condition is called ice pica, or pagophagia. Associations between ice pica and iron deficiency, suggestions for clinical screening of at risk populations, and recommendations for treatment and follow-up care are provided. DATA SOURCES An extensive literature review of original research articles, reviews, clinical practice manuscripts, and scientific publications on pica and pagophagia. CONCLUSIONS A compulsion or craving for the consumption of ice is often overlooked in clinical practice. It is therefore important for clinicians to include ice pica as part of the review of systems for certain patient populations. Ice pica is frequently associated with iron deficiency, and iron supplementation is an effective therapy in most cases. IMPLICATIONS FOR PRACTICE Knowledge gained from screening for ice pica can generate valuable patient information and lead to the diagnosis and treatment of iron deficiency. The populations at risk include young women and blood donors of either sex.
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Affiliation(s)
- Antoinette Rabel
- Molecular Medicine Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Susan F Leitman
- NIH Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Jeffery L Miller
- Molecular Medicine Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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Yoseph HH. Prevalence of food aversions, cravings and pica during pregnancy and their association with nutritional status of pregnant women in Dale Woreda, Sidama zone, SNNPRS, Ethiopia. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/ijnam2014.0162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Gastrointestinal distress in pregnancy: prevalence, assessment, and treatment of 5 common minor discomforts. J Perinat Neonatal Nurs 2015; 29:23-31. [PMID: 25633397 DOI: 10.1097/jpn.0000000000000078] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Gastrointestinal discomforts are a very common complaint in pregnancy. In fact, most pregnant women will experience at least one discomfort. This article focuses on 5 common conditions that occur in pregnancy: gastroesophageal reflux disease, diarrhea, constipation, hemorrhoids, and pica. While these conditions do occur in men and nonpregnant women, they occur more frequently in pregnancy because of the anatomic and physiologic changes associated with gestation. The type and severity of symptoms can vary from individual to individual, making treatment a challenge for healthcare providers, particularly when caring for pregnant women because the effects of medications and other treatments on the developing fetus are often not extensively studied. While these discomforts are rarely life-threatening, they can cause significant distress and impair quality of life. The goal of this article was to provide a summary of the anatomic and physiological changes during pregnancy that contribute to the increasing incidence of these discomforts and to provide information about each condition including prevalence, symptoms, and treatment modalities.
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Orloff NC, Hormes JM. Pickles and ice cream! Food cravings in pregnancy: hypotheses, preliminary evidence, and directions for future research. Front Psychol 2014; 5:1076. [PMID: 25295023 PMCID: PMC4172095 DOI: 10.3389/fpsyg.2014.01076] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/08/2014] [Indexed: 12/20/2022] Open
Abstract
Women in the United States experience an increase in food cravings at two specific times during their life, (1) perimenstrually and (2) prenatally. The prevalence of excess gestational weight gain (GWG) is a growing concern due to its association with adverse health outcomes in both mothers and children. To the extent that prenatal food cravings may be a determinant of energy intake in pregnancy, a better understanding of craving etiology could be crucial in addressing the issue of excessive GWG. This paper reviews the available literature to corroborate and/or dispute some of the most commonly accepted hypotheses regarding the causes of food cravings during pregnancy, including a role of (1) hormonal changes, (2) nutritional deficits, (3) pharmacologically active ingredients in the desired foods, and (4) cultural and psychosocial factors. An existing model of perimenstrual chocolate craving etiology serves to structure the discussion of these hypotheses. The main hypotheses discussed receive little support, with the notable exception of a postulated role of cultural and psychosocial factors. The presence of cravings during pregnancy is a common phenomenon across different cultures, but the types of foods desired and the adverse impact of cravings on health may be culture-specific. Various psychosocial factors appear to correlate with excess GWG, including the presence of restrained eating. Findings strongly suggest that more research be conducted in this area. We propose that future investigations fall into one of the four following categories: (1) validation of food craving and eating-related measures specifically in pregnant populations, (2) use of ecological momentary assessment to obtain real time data on cravings during pregnancy, (3) implementation of longitudinal studies to address causality between eating disorder symptoms, food cravings, and GWG, and (4) development of interventions to ensure proper prenatal nutrition and prevent excess GWG.
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Affiliation(s)
- Natalia C. Orloff
- Health Behaviors Laboratory, Department of Psychology, University at Albany – State University of New YorkAlbany, NY, USA
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Moya J, Phillips L, Sanford J, Wooton M, Gregg A, Schuda L. A review of physiological and behavioral changes during pregnancy and lactation: potential exposure factors and data gaps. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2014; 24:449-458. [PMID: 24424408 DOI: 10.1038/jes.2013.92] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 10/28/2013] [Accepted: 11/02/2013] [Indexed: 06/03/2023]
Abstract
Exposures to environmental contaminants can pose risks to pregnant women's health, their developing fetuses, children, and adults later in their lives. Assessing risks to this potentially susceptible population requires a sound understanding of the physiological and behavioral changes that occur during pregnancy and lactation. Many physiological and anatomical changes occur in a woman's organ systems during the course of pregnancy and lactation. For example, blood volume and cardiac output increase during pregnancy, and other metabolic functions are altered to provide for the demands of the fetus. During lactation, nutritional demands are greater than during pregnancy. There are also changes in behavior during both pregnancy and lactation. For example, water consumption during pregnancy and lactation increases. These behavioral and physiological changes can lead to different environmental exposures than these women might otherwise experience in the absence of pregnancy or lactation. This paper provides a summary of information from the published literature related to behavioral and physiological changes in pregnant and lactating women that may affect their exposure or susceptibility to environmental contaminants, provides potentially useful exposure factor data for this population of women, and highlights data gaps.
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Affiliation(s)
- Jacqueline Moya
- US Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Mailcode 8623P, 1200 Pennsylvania Avenue Northwest, Washington, DC 20460, USA
| | - Linda Phillips
- US Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Mailcode 8623P, 1200 Pennsylvania Avenue Northwest, Washington, DC 20460, USA
| | - Jessica Sanford
- Battelle Memorial Institute, 505 King Avenue, Columbus, Ohio 43201, USA
| | - Maureen Wooton
- Battelle Memorial Institute, 505 King Avenue, Columbus, Ohio 43201, USA
| | - Anne Gregg
- Battelle Memorial Institute, 505 King Avenue, Columbus, Ohio 43201, USA
| | - Laurie Schuda
- US Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Mailcode 8623P, 1200 Pennsylvania Avenue Northwest, Washington, DC 20460, USA
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Abstract
Nutritional concerns in pregnancy are gaining increasing importance as problems with obesity, poor nutrition, and improper weight gain during pregnancy have been shown to result in morbidity for mother and infant during the pregnancy. More recent studies show that the impact of poor nutrition in pregnancy extends for decades to follow for the mother and the offspring. Clearly, prevention of problems is the best approach. This article discusses aspects of, and controversies concerning, prenatal weight gain and specific nutrients, and special patient groups who may benefit from intervention by a registered dietitian.
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Affiliation(s)
- Jean T Cox
- Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, NM 87131, USA.
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