Eating non-food items: What Pica reveals about your health

You may have seen someone chewing chalk, eating clay, or even craving ash, and wondered why they’d engage in such behaviour. While these actions may seem strange or unsettling, for some individuals, consuming non-food substances is linked to a various factors, including nutritional deficiencies or psychological conditions. Others may view it as unhealthy or peculiar. Pica is more than just a strange habit; it is an eating disorder that often signals deeper health concerns.

Pica involves the consumption of non-food substances like dirt, ice, paint, soap, glue, charcoal or paper and is particularly common among children and pregnant women. Kepha Nyanumba, a consultant nutritionist at the Crystal Health Medical Centre, explains, “Pica is an eating disorder characterized by the consumption of non-food substances such as chalk, clay, ice and even hair.”

“While it is more commonly seen in younger children, especially those with developmental delays or disabilities, it can affect anyone. In some cases, it may result from underlying nutritional deficiencies or emotional stress.” Pica in younger children is particularly common among those with developmental delays or disabilities. It may also arise from nutritional deficiencies or simply be a result of exploratory behaviour, like oral sensory exploration. Nyanumba emphasizes that frequent engagement in such behaviours, especially among children, warrants professional advice to address potential deficiencies or emotional distress.

Globally, pica affects an estimated 1-2 per cent of the population, with higher prevalence in areas affected by malnutrition. The World Health Organization (WHO) notes that pica is more common in lower-income regions with limited access to nutritious food. A meta-analysis found that about 27.8 per cent of pregnant women worldwide engage in pica behaviour.

In Kenya, the situation is concerning with pregnant women consuming non-food substances like clay and ash, often to cope with perceived nutritional deficiencies or stress.  “The prevalence rates of pica vary across different regions. For instance, in Nairobi, 74 per cent of pregnant women consume non-food substances,” Nyanumba explains, highlighting the urgent need for public awareness and nutritional interventions.

The causes of pica vary and often include nutritional deficiencies, emotional distress or developmental conditions. Nutritional deficiencies, particularly of iron, zinc and calcium, are common triggers. “People with pica often have increased nutrient demands, which may lead them to seek non-food substances to satisfy these cravings,” says Nyanumba. Emotional or psychological factors can also contribute, with some individuals using pica as a coping mechanism for stress or trauma. “Sometimes, the body’s response to emotional pain or stress is to engage in unusual behaviours like eating non-food substances,” he adds.

The symptoms of pica can manifest physically and behaviourally. Pale skin, persistent fatigue, headaches and heart palpitations often indicate iron deficiency linked to pica. Digestive complications, including constipation, abdominal pain and intestinal blockages, may arise from ingesting inedible substances. Chewing hard or abrasive materials, like clay or rocks, can lead to dental problems such as worn enamel and broken teeth. “These symptoms often point to deeper underlying issues, and it’s important to address them promptly to avoid further complications,” Nyanumba advises.

Certain groups are more vulnerable to pica, including pregnant women, children and individuals with mental health conditions. Pregnancy often increases nutritional demands, leading to unusual cravings for non-food items.

Children, especially those with developmental disabilities, may engage in pica due to exploratory behaviour or heightened sensory needs. Mental health conditions, such as autism and intellectual disabilities, also heighten the risk of pica due to unique sensory or emotional challenges.

If left untreated, pica can lead to severe complications. Consuming non-food substances exposes individuals to harmful bacteria and parasites, increasing the risk of infections. Nutritional imbalances can worsen, leading to further deficiencies and associated health issues.

Treatment for pica focuses on addressing its root causes. For individuals with nutritional deficiencies, dietary adjustments or supplements can help restore balance. Emotional or psychological factors may require therapy, stress management or counselling. Prevention begins with a healthy, balanced diet and raising awareness about the dangers of consuming non-food substances. Addressing underlying mental health or emotional challenges can also reduce the risk of pica.

Nyanumba urges addressing the root causes of pica, whether due to nutritional deficiencies, emotional distress, or other factors. Proper intervention and prevention can improve health outcomes and quality of life for those affected.