Pica: A Hypothesis

Bonsdorff, Bertel von

doi:10.1111/j.1365-2141.1977.tb00611.x

Cited by 24 publications

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“…Conversely, it has been suggested that micronutrient deficiencies cause humans to seek out minerals from nonfood substances (Cavdar et al, ; Hunter, ; Prasad et al, ). Others have suggested that pica may be a nonadaptive response to micronutrient deficiencies, perhaps operating through neurological disturbances (Chisholm and Martin, ; Prasad et al, ; von Bonsdorff, ; Youdim and Iancu, ).…”

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confidence: 99%

A meta‐analysis of pica and micronutrient status

Miao

Young

Golden³

2014

American J Hum Biol

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Objectives Pica is the craving for and consumption of non-food items, including the ingestion of earth (geophagy), raw starch (amylophagy), and ice (pagophagy). Pica has long been associated with micronutrient deficiencies, but the strength of this relationship is unclear. We aimed to evaluate the association between pica behavior and the risk of being anemic or having low hemoglobin (Hb), hematocrit (Hct), or plasma zinc (Zn) concentrations. Methods We systematically reviewed studies in which micronutrient levels were reported by pica status. We calculated the pooled odds ratio for anemia or weighted mean difference in Hb, Hct, or Zn concentrations between groups practicing or not practicing pica behaviors. Results Forty-three studies including 6407 individuals with pica behaviors and 10,277 controls were identified. Pica was associated with 2.4 times greater odds of anemia (95% CI: 1.94–2.85, p<0.001), lower Hb concentration (−0.65 g/dL, 95% CI: −0.83–−0.48 g/dL, p<0.001), lower Hct concentration (−1.15%, 95% CI: −1.61–−0.70%, p<0.001), and lower Zn concentration (−34.3 μg/dL, 95% CI: −59.58–−9.02 μg/dL, p=0.008). Statistical significance persisted after excluding outliers and in subgroup analyses by pica type and life stage. Conclusions Pica is significantly associated with increased risk for anemia and low Hb, Hct, and plasma Zn. Although the direction of the causal relationship between pica and micronutrient deficiency is unknown, the magnitude of these relationships is comparable to other well-recognized causes of micronutrient deficiencies. Pica warrants greater public health attention; specifically a potential physiological mechanism causing the relationship between pica and micronutrient deficiencies merits further study.

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confidence: 99%

A meta‐analysis of pica and micronutrient status

Miao

Young

Golden³

2014

American J Hum Biol

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“…B u c cal cytochrome oxidase affected by iron deficiency m y be the biochemical background (Coltman 1969). According to another hypothesis pica is related t o a l t e r a t i o n s of the central nervous system irduced by iron deficiency (von Bonsdorff 1977, Cski 1979. According to von Bonsdorff (1977) the nuclear masses in the hypothalms d i f f e r from other brain centres i n their high i r o n content.…”

Section: Results and Discussion Of T H E Resultsmentioning

confidence: 99%

Diagnosis of Iron Deficiency

Rybo

1985

Scandinavian Journal of Haematology

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Haematological variables were studied in a randomised population sample of 372 38‐year‐old women resident in Gothenburg, Sweden during the period 1968–69. The participation rate was 91.4 %. The study was performed to evaluate the laboratory diagnosis of iron deficiency. The haematological investigation included determination of haemoglobin concentration, erythro‐cyte and reticulocyte counts, serum iron concentration, total iron binding capacity, packed cell volume, sternal bone marrow aspiration with estimation of stainable iron in the reticuloendothelial cells, sideroblast count, iron absorption test with 59Fe in a whole‐body counter and determination of menstrual blood loss. Serum ferritin concentrations were later determined on samples which had been frozen for 10 years. Eighty‐nine women with no or only traces of reticuloendothelial iron in the bone marrow completed a double‐blind supplementation trial, in which iron and placebo therapy were compared. Determination of stainable iron in the reticuloendothelial cells of the bone marrow was used as a direct method for the evaluation of iron stores. In 31.5 % of the women there was no reticulendothelial iron and in 14.3 % there were only traces. Of the indirect methods compared with the bone marrow method the serum ferritin concentration and iron absorption gave the highest correlations. A high correlation was also observed between menstrual blood loss and the content of reticuloendothelial iron. An arbitrarily chosen scale for the estimation of the amount of stainable reticuloendothelial iron in the bone marrow was used for these correlation analyses. The differences in mean corpuscular haemoglobin, transferrin saturation, sideroblast count, iron absorption, and menstrual blood loss were all highly statistically significant when the series of women with no or only traces of reticuloendothelial iron in the bone marrow were compared to those with clearly visible or abundant amounts of stainable iron. There were no significant differences concerning these variables between women who had no traces of stainable iron and those who had only traces of stain‐able iron. Increased iron absorption was found in women with a lack of stainable iron in the reticuloendothelial cells compared to women with stainable iron, irrespective of sideroblast count. The results from the iron supplementation study indicates that the haemoglobin concentration values of many of the women, although being within the normal range, were suboptimal for the individual woman. However, we considered it not possible to ascertain which women were responders to iron therapy, as a comparison between the effects of iron and placebo could not be made for the individual subject. According to multivariate analysis, determination of serum ferritin concentration was the most valuable indirect method for the diagnosis of depleted iron stores, and we are of the opinion that serum ferritin determination may replace bone marrow examination in the diagnosis of iron deficiency in women with or without anaem...

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“…Also shown was a dysfunction in monoaminergic neurotransmitters (5-hydroxytryptamine and dopamine) caused by iron deficiency (Lozoff and Brittenham 1987;Youdim 1977). The fact that brain tissues near the appetite centers are rich in iron (Bonsdorff 1977) lends weight to the hypothesis that iron depletion in these zones could cause geophagy. In any case, the physicochemical properties and chemical composition of clays can explain their therapeutic use.…”

Section: Some Factors Encouraging the Consumption Of Claysmentioning

confidence: 96%

From edible clay to a clay-containing formulation for optimization of oral delivery of some trace elements: a review

Kikouama

Balde

2010

International Journal of Food Sciences and Nutrition

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The present review describes the double beneficial effect of using clays for purposes of health and human nutrition: first, their chemical composition, which can enable the release of trace elements; and second, their mineralogical composition, which allows them to be used in the treatment of digestive diseases. The last part of the review is devoted to the release of trace elements contained in clay: clay-containing pellets designed for oral delivery of the trace elements iron and zinc. This multiple-unit pellet system is designed to be retained by flotation in the stomach cavity for a few hours (5 h), with simultaneous control of the release of the trace elements in order to optimize their gastrointestinal absorption. Finally, it is shown that the total amount of ions released from the clay was increased when the formulations were added, in comparison with raw clay, respectively as follows: Zn(2+) (60% versus 40%), Fe(3+) (70% versus 30%) and Fe(2+) (95% versus 40%).

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Pica: A Hypothesis

Cited by 24 publications

References 0 publications

A meta‐analysis of pica and micronutrient status

A meta‐analysis of pica and micronutrient status

Diagnosis of Iron Deficiency

From edible clay to a clay-containing formulation for optimization of oral delivery of some trace elements: a review

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