The potential impact of soil ingestion on human mineral nutrition

Hooda, Peter S.; Henry, Christiani Jeyakumar; Seyoum, Teodros A.; Armstrong, LE; Fowler, Mike

doi:10.1016/j.scitotenv.2004.04.023

Cited by 88 publications

(105 citation statements)

References 23 publications

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“…1,22,23 The characteristics of the severe anemia observed in our patients are entirely consistent with those reported in other studies: microcytosis, very low ferritin concentrations, and high levels of transferrin receptors-all features indicative of profound iron deficiency. 5,6,21 Geophagy was the only element in the medical histories of these patients that could account for this iron deficiency.…”

Section: Discussionsupporting

confidence: 91%

Plasma and Urinary Aluminum Concentrations in Severely Anemic Geophagous Pregnant Women in the Bas Maroni Region of French Guiana: A Case-Control Study

Lambert¹,

Boukhari²,

Nacher³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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The clays consumed by geophagous individuals contain large quantities of aluminum, a known neurological and hematological toxin. This is the first study to evaluate the risk of aluminum poisoning in geophagous individuals. Blind determinations of plasma and urinary aluminum concentrations were carried out in 98 anemic geophagous pregnant women and 85 non-anemic non-geophagous pregnant women. Aluminum concentrations were significantly higher (P < 0.0001) in the geophagous anemic women than in the controls, with odds ratios of 6.83 (95% confidence interval [CI] = 2.72–19.31) for plasma concentrations (13.92 ± 14.09 μg/L versus 4.95 ± 7.11 μg/L) and 5.44 (95% CI = 2.17–14.8) for urinary concentrations (92.83 ± 251.21 μg/L versus 12.11 ± 23 μg/L). The ingested clay is the most likely source of this overexposure to aluminum. If confirmed, the clinical consequences of this absorption for pregnant women and their offspring should be explored.

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Section: Discussionsupporting

confidence: 91%

Plasma and Urinary Aluminum Concentrations in Severely Anemic Geophagous Pregnant Women in the Bas Maroni Region of French Guiana: A Case-Control Study

Lambert¹,

Boukhari²,

Nacher³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Additional factors that may exacerbate suboptimal Zn status, especially among population groups living in developing countries in which Zn intakes are inadequate, include increased faecal and/or endogenous losses of Zn through diarrhoea (Castillo-Duran et al 1988) and geophagia (Hooda et al 2004). Malabsorption of Zn resulting from alterations in permeability and absorptive capacity of the intestine may also occur in tropical areas of developing countries.…”

Section: Excessive Lossesmentioning

confidence: 99%

Zinc: the missing link in combating micronutrient malnutrition in developing countries

2006

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The first cases of human Zn deficiency were described in the 1960s in the Middle East. Nevertheless, it was not until 2002 that Zn deficiency was included as a major risk factor in the global burden of disease, and only in 2004 did WHO/UNICEF include Zn supplements in the treatment of acute diarrhoea. Despite this recognition Zn is still not included in the UN micronutrient priority list, an omission that will continue to hinder efforts to reduce child and maternal mortality, combat HIV/AIDS, malaria and other diseases and achieve the UN Millennium Development Goals for improved nutrition in developing countries. Reasons for this omission include a lack of awareness of the importance of Zn in human nutrition, paucity of Zn and phytate food composition values and difficulties in identifying Zn deficiency. Major factors associated with the aetiology of Zn deficiency include dietary inadequacies, disease states inducing excessive losses or impairing utilization and physiological states increasing Zn requirements. To categorize countries according to likely risk of Zn deficiency the International Zinc Nutrition Consultative Group has developed indirect indicators based on the adequacy of Zn in the national food supplies and/or prevalence of childhood growth stunting. For countries identified as at risk confirmation is required through direct measurements of dietary Zn intake and/or serum Zn in a representative sample. Finally, in at risk countries either national or targeted Zn interventions such as supplementation, fortification, dietary diversification or modification, or biofortification should be implemented, where appropriate, by incorporating them into pre-existing micronutrient intervention programmes.

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“…There are other explanations for a pica-anaemia association, which include replacement of nutritious food in the diet with non-nutritious substances, chelation of dietary iron by the pica substance and reduction of iron absorption by the gut (Arcasoy et al, 1990;Berkel et al, 1970;Danford, 1982;Hooda et al, 2004). Determining the association of pica with parasitic nematode infections will help to direct research efforts seeking to understand the association of pica and anaemia as well as those to reduce the transmission of geohelminths.…”

Section: Introductionmentioning

confidence: 99%

Geophagia is not associated with Trichuris or hookworm transmission in Zanzibar, Tanzania

Young

Goodman

Farag

et al. 2007

Transactions of the Royal Society of Tropical Medicine and Hygi

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SummaryGeophagia may be harmful as a method for the transmission of geohelminths. In this study, we pose two questions in a representative sample of 970 pregnant women from Pemba Island, Zanzibar, Tanzania. Can consumed earth be a vector for geohelminth infection? And do geophagists have differential parasitic infection? The parasitological content of 59 non-food substance samples was analysed. Cross-sectional data regarding pica behaviour were collected through interviews conducted by local researchers. Ascaris, Trichuris and hookworm status was ascertained through Kato-Katz smears. The prevalence of geophagia at baseline was 5.6% and the overall prevalence of Ascaris, Trichuris and hookworm infection was 5.6%, 33.2% and 32.9%, respectively. No consumed soil samples contained infectious parasitic stages, and only one of the consumed pica substances (charcoal) contained parasites of potential risk to human health. Neither the prevalence nor the intensity of infection with Ascaris, Trichuris or hookworm differed significantly by geophagia status. Furthermore, in multivariate models, geophagia was not a significant predictor of helminth infection status. We conclude that geophagia is not a source of Trichuris or hookworm infection among pregnant women in Pemba (insufficient power to evaluate the effect of Ascaris), which is in contrast to existing findings of helminth infection and geophagia. KeywordsPica; Geophagia; Helminthiasis; Pregnancy; Parasites; Zanzibar * Corresponding author. Tel.: +1 607 351 0172; fax: +1 607 255 1033. E-mail address: sly3@cornell.edu (S.L. Young). Authors' contributions: SLY conceived the substudy design, oversaw sample collection, collected ethnographic data and drafted the paper; DG determined sample preservation methods, examined pica samples, interpreted parasitology results and wrote the parasitology methods; THF designed and supervised the parasitological sample collection and analysis, and assisted with data analysis and drafting the paper; SMA assisted with substudy design, researcher training and pica sample collection;

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The potential impact of soil ingestion on human mineral nutrition

Cited by 88 publications

References 23 publications

Plasma and Urinary Aluminum Concentrations in Severely Anemic Geophagous Pregnant Women in the Bas Maroni Region of French Guiana: A Case-Control Study

Plasma and Urinary Aluminum Concentrations in Severely Anemic Geophagous Pregnant Women in the Bas Maroni Region of French Guiana: A Case-Control Study

Zinc: the missing link in combating micronutrient malnutrition in developing countries

Geophagia is not associated with Trichuris or hookworm transmission in Zanzibar, Tanzania

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