Non-nutritive Substances Research Articles

Dietary Intake of Toxic Heavy Metals with Major Groups of Food Products-Results of Analytical Determinations.

Food contains a complex matrix of various substances, including essential nutrients, non-nutritive substances, and toxins, including metals. The main purpose of the study was to evaluate the contribution of major groups of food products to an overall intake of toxic heavy metals (Cd, Pb, Hg, and Ni) using a combination of the 24-dietary recall technique, the ICP-OES (Inductively Coupled Plasma Optical Emission Spectrometry) method, and chemometric tools. The obtained results reveal that there is a high potential risk of developing nephrotoxicity through the dietary intake of Pb in the case of both genders. The dietary intake determined for other elements (Cd, Hg, and Ni) was far below the limits established by European Food Safety Authority (EFSA). Principal Component Analysis (PCA) supported analytical determinations and revealed that cereals and vegetables were major contributors to a total intake of Cd (39.6 and 17.4% of the total exposure, respectively), Ni (40.4 and 19.3%), and Hg (16.8 and 19.6%), while water and beverages were major dietary sources of Pb (31% of the total daily intake). In contrast, eggs, fats and oils, and milk and dairy products provided the smallest amounts of Cd, Pb, and Ni. Despite containing high amounts of Hg, considering very low consumption, fish were not found to be an important source of this element.

Foam Rubber Pica and Cautopyreiophagia in a Highly Educated Woman: A Clinical Case Study

Pica, the developmentally and culturally-inappropriate eating of non-nutritive and non-food substances, is most often documented in people with developmental disabilities and children, frequently in institutional and residential settings. To date, there are no randomized clinical trials on pica-specific treatments, and very little literature is available regarding the characteristics or treatment of pica in adults with no intellectual or social deficits, and co-morbid disorders. This case study addresses this gap, and involves a highly educated 30 year-old American woman with foam rubber pica and burned match consumption (cautopyreiophagia) behaviors, along with co-morbid depressive, anxiety, and obsessive-compulsive symptoms, who received treatment in a general intensive outpatient program for adults in a large urban community psychiatry setting. The case study describes how the Biosocial Theory and Transtheoretical Model of Health Behavior Change were used to conceptualize this woman’s symptoms and guide a treatment team of clinicians who did not specialize in pica. Providers in non-specialty clinic settings would benefit from reflecting on ways to adapt evidence-based techniques to the treatment of uncommon symptoms.

Link between Foreign Body Ingestion and Behavioural Disorder in Dogs

Foreign body (FB) ingestion in dogs can threaten the animal's life and often result in an emergency surgery. The causes of pica (ingestion of non-nutritive substance) remain unexplored, although behavioral conditions including hyperactivity, impulsivity, obsessive-compulsive oral/ingestive disorders, anxiety or attachment related troubles have been implicated. Such behavioral causes of pica were investigated with two grids: Lit's owner-based questionnaire, which measures inattention and hyperactivity-impulsivity, and Beata's clinical 4A grid which investigates aggression, anxiety, attachment, and autocontrols of dogs. These grids were fulfilled for 42 FB ingesting dogs and 42 pair-matched control dogs.The main results show that FB ingestion is rarely related to digestive pain (12% of cases) but is primarily of a behavioural nature (88% of cases). Total Scores from both grids are significantly different between FB and control group (Lit scores: Wilcoxon signed-rank test, W = 665.5; P = 0.007; 4A: Wilcoxon signed-rank test, W = 41; P<0.001). Regular shredding of objects is mainly related to a hyperactivity-impulsivity disorder (Lit total score: Mann-Whitney test, U = 99; P = 0.02; 4A Autocontrols Scores: Mann-Whitney test, U = 35; P< 0.001), whereas its absence in FB ingestion suggests anxiety or attachment disorder.Behavioral pathology should be assessed not only for dogs ingesting non-edible objects, but also for those shredding objects. This exacerbated oral exploration is a sufficient sign for veterinarians to consider a behavioral investigation.

Pica and attention deficit hyperactivity disorder: is there a link? Comorbidity and treatment outcomes with methylphenidate

Introduction: Pica is the persistent ingestion of non-nutritive substances. It is common during childhood and may be related to nutritional deficits, intellectual disability, stress, and psychosis. However, no causative biological condition is identified in most cases and there is limited evidence to support pharmacological intervention. As several authors describe pica as an impulse control disorder and impulsive symptoms are a core aspect of the diagnostic criteria of attention deficit hyperactivity disorder (ADHD), this study reviews literature data on pica, ADHD, and treatment response during childhood and adolescence and adds two case reports to this body of evidence. Methods: Systematic literature review using the key terms “pica”, “attention deficit”, “hyperactivity”, “child”, and “adolescent”. A retrospective analysis of clinical data of two patients with pica and ADHD followed at the Child and Adolescent Psychiatry Department of Hospital Pediatrico was also conducted. Results: As far as the authors are aware, only three cases are currently reported in the literature describing comorbid pica and ADHD in children. Of these, two reported complete pica symptom remission after methylphenidate treatment. Two other cases of children with pica and ADHD observed at the Child and Adolescent Psychiatry Department of our institution were reported in this study, one of which had complete symptom remission after psychostimulant treatment optimization. Discussion: The suggested association between pica and ADHD may have underlying etiology in poor impulse control and dopaminergic system dysfunctions. Therefore, a pharmacological approach capable of improving dopaminergic functioning may be an alternative treatment for pica. Psychostimulants may improve pica by eliciting an increase in brain dopamine levels and a decrease in impulsivity.

Severe pica in long-term schizophrenia, a case report

IntroductionPica is a strange eating disorder that consists of eating non-nutritive substances, inappropriate to the developmental level/ cultural normative of the individual. The prevalence is not widely studied, but might occur in the context of other mental disorders, such as schizophrenia, that hinders the management and treatment of these patients.ObjectivesTo report a severe pica in a patient with late schizophrenia, and highlight the impact this syndrome might cause on the life of these patients.MethodsWe present a case of a 65 year-old-woman with schizophrenia attended in the emergency area for dysphagia due to the intake of a metal washer. Reviewing the patient medical history, an early and severe schizophrenia was described. Within years, disorganization and residual symptoms have become the main disabilities, developing a pica eating disorder with preference in greater metal objects (images are included).ResultsThe management has been hindered due to the consequences of pica eating disorder. The patient describes an unstoppable urge to make the intake when she sights wide metallic objects (batteries, docks, washers…). Different antipsychotic drugs have been used, combined with psychotherapy and family education. Despite this, the patient has required multiple attentions in the emergency area due to esophagueal impaction, intestinal obstruction, perforation and peritonitis, that have led to countless surgeries and hospitalizations.ConclusionsPica can become a highly dysfunctional syndrome that may lead to severe organic and life impact. The comorbidity with schizophrenia is understudied, but further investigation might be useful to show up specific management strategies of these patients.DisclosureNo significant relationships.

Management of Pica associated with relational stress in an adult woman: A case report

Pica is a feeding and eating disorder where there is the consumption of non-nutritive substances not consistent with cultural practices or social norms. Its etiology is still unknown, and its presence seems to vary with patients’ characteristics and the specific behaviors involved. Here, we are reporting a late-onset case of a 23-year-old female, presenting with consumption of wall scrapings, with some underlying early maladaptive schemas, and psychosocial triggers leading to eating scrapings off the walls.

Dramatic oral findings belonging to a pica patient: A case report

Pica is a compulsive eating of non-nutritive substances and can have serious medical implications. The causes are not known, but the symptom is often associated iron-deficiency. Pica is an under-diagnosed problem. Although few dental problems associated with pica have been reported, because of its potential impact on blood measures, dental professionals must be aware of this common, but commonly missed, condition. This is an unusual case of a patient diagnosed with aggressive periodontitis (AgP) who had a dirt eating habit (geophagia) and was diagnosed as having pica.

Pica Disorder among African American Women: A Call for Action and Further Research

ABSTRACT Pica is simply defined as the consumption of none food products such as laundry starch, clay dirt, ice, soap, and chalk. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies Pica as the habitual consumption of nonfood and non-nutritive substances for at least one year. Pica disorder is usually unnoticed, under-reported, causes serious harm to clients especially African American women, and seldom discussed in social work scholarship. It is, therefore, important to begin to sensitize social workers to the harmful effects of Pica, especially because it is often unrecognized and misdiagnoses can cause harm. This article provides a panoramic overview of Pica, the signs and symptoms of the disorder specifically among African American women and also address some of the adverse effects, and highlights some of the evidence-based effective treatment strategies. Finally, an urgent clarion call to social workers to conduct more research on Pica disorders among African American women is articulated.

Sakız Yutma ile Karakterize Bir Pika Olgusu

Objective: Pica is characterized as persistent eating of non-nutritive substances for a period of at least one month and sometimes lasts for several months and resolves spontaneously, rarely can continue until adulthood. Herein, we presented a pica case characterized by chewing gum swallowing who had psychiatric comorbidity.

A study of serum mineral, antioxidant capacity, and hematobiochemical parameters in horses with pica in China

Pica is defined as abnormal appetite or consumption of nonnutritive substances inappropriate for development. There is no consensus on the etiology of pica in animals. The present study investigated the status of serum minerals together with the hematological and biochemical parameters and antioxidant enzymes in horses with and without pica. Eight horses with pica and eight healthy horses were used in the study. The serum levels of calcium, phosphorus, copper, iron, the calcium/phosphorus ratio, and the copper/zinc ratio were lower in the pica group compared with the control group (P < 0.05). Compared to the control group, CAT and MDA levels were significantly higher in the pica group (P < 0.05), whereas the T-SOD level was decreased (P < 0.05). A significant positive correlation was found between serum copper and T-SOD levels, between copper and total protein, and between iron and RBC. The serum levels of AST and ALT were higher in pica horses (P < 0.05), and the value of MCHC was lower in pica horses than that of control group (P < 0.05). Consequently, the serum imbalance of calcium and phosphorus, accompanied by iron and copper deficiency, may play a vital role in the pica horses studied. Mineral deficiency exerts its harmful effects on the organism with adverse effects on antioxidant capacity, leading to the pica. These effects should be kept in mind to use mineral supplements and antioxidants to prevent pica of horses.

Nutrition and osteoporosis prevention and treatment

Introduction: Osteoporosis falls among the major general health issues, specifically in the elderly, and is a widespread disease these days. According to various studies, good nutrition plays a significant role in osteoporosis prevention and treatment. The aim of this study was to conduct an extensive literature review on the effects of different nutrients to understand how macronutrients, micronutrients, and non-nutritive substances affect bone health.&#x0D; Methodology: To find relevant studies, the main keyword “osteoporosis” was searched in combination with “zinc,” “vitamin K,” “phosphorus,” “vitamin D,” “calcium,” “lipid,” “protein,” and “phytoestrogens” in PubMed (MEDLINE), Web of Science, SID, and Iran Medex databases.&#x0D; Findings: The most important element for bone health is calcium, which has a direct link to the bone mass density (BMD). In the case of calcium deficiency, high phosphorus content can damage bone tissue. The acceptable ratio of phosphorus to calcium is 0.5-1.5:1. Vitamin D is another important nutrient for bones; serum levels of vitamin D less than 20 ng/ml reduce bone density and increase the risk of fracture. High protein intake results in calcium excretion and loss of bone mass. In addition, calcium deficiency increases the risk of osteoporosis, specifically in the elderly. According to the literature, there is an inverse correlation between saturated fats and BMD. Vitamin K and magnesium deficiencies are correlated with BMD reduction and increased risk of osteoporosis. Copper and zinc are used as co-factors in the formation of collagen and elastin, and in mineralization of bone. As a result, deficiency of these elements may disrupt the process of incorporating minerals into the bone matrix.&#x0D; Conclusion: Good nutrition may play a significant role in osteoporosis prevention and treatment. Indeed, a healthy diet containing calcium (1,200 mg/day); vitamin D (600 IU); and certain amounts of protein, magnesium, and vitamin K can contribute greatly to bone health.

1482 Chalk Eating: A Culturally-Accepted Form of Pica in Georgia?

INTRODUCTION: Pica is the persistent intake of nonnutritive and nonfood substances seen commonly in children, pregnant women, institutionalized persons, patients with developmental disabilities and iron deficiency. Kaolin ingestion in the form of chalk, white dirt or white clay, is a lesser known form of pica but a common occurrence in Central Georgia. We present a case of a young black female from Georgia who presented with a partial bowel obstruction from eating chalk. CASE DESCRIPTION/METHODS: A 35-year-old black female from Augusta Georgia with iron deficiency anemia and depression presented with worsening abdominal pain, distention and constipation with the last bowel movement 2 weeks prior to presentation. She ate 5 lbs of chalk with each meal for the previous 10 years, like her mother. Her cravings for chalk increased with worsening anemia. Physical exam was pertinent for abdominal distention and tenderness. Laboratory tests revealed iron deficiency anemia but normal calcium and vitamin D level. The abdominal x-ray showed radiopaque material opacifying the lumen of the colon with nonobstructive bowel gas pattern. Flexible sigmoidoscopy was performed for mechanical disimpaction using endoscopic accessories was unsuccessful. Gastrograffin enema was then performed twice with resulting bowel movements. The patient received intravenous iron therapy and was evaluated by psychiatry. She was discharged home on iron supplements and laxatives. DISCUSSION: Kaolin is a soft white clay and an important ingredient in making porcelain, paper and rubber. It is not absorbed systemically but acts locally in the intestines where it adsorbs toxins and is used as an anti-diarrheal agent. The prevalence of kaolin ingestion especially among black female residents in Central Georgia represents a cultural-bound syndrome shared by family members or friends such as in our patient. Although our patient had iron deficiency anemia which could be associated with pica, the cultural practice of eating chalk is widely accepted in their community and believed that ingesting chalk helps with nausea, indigestion, and even constipation! Complications from this form of pica include anemia, malnutrition, constipation, intestinal obstruction, and even colon perforation. Management include medical, endoscopic or surgical removal of these substances and most importantly cognitive behavioral treatment. It is important to have a high index of suspicion for pica when multiple opacities are noted in the colon especially among residents of Georgia.

A coin crisis: a case report of pica with minireview

Pica is defined as a feeding and eating disorder where there is consumption of nonnutritive substances not consistent with cultural practices or social norms. Its aetiology is still unknown, as its prevalence and optimal treatment, which seem to vary with patients' characteristics and the specific behaviours involved. The authors present a case report of pica treated with copper supplementation, with further diagnostic and treatment considerations. Clinical records and interviews were used. A review was conducted using PubMed database. A 59-year-old patient, diagnosed with paranoid schizophrenia, presented with sideroblastic anaemia secondary to zinc-induced copper deficiency in the context of pica. These behaviours ceased with copper supplementation. After 2-year remission, the patient was discontinued on oral copper. One week after, pica behaviours reoccurred, with further remission with renewed copper treatment. Based on temporal relationship, we propose that there might be an association between copper supplementation and pica, not related to its plasma levels. As far as we know, this is the first case report in the literature with such a long-term follow-up of pica treatment. Our findings challenge the cause-effect relation between micronutrient deficiency and pica and prompts further research in the non-adaptive theories of this poorly understood clinical entity.

Effects of Early Initiation of Breastfeeding on Exclusive Breastfeeding Practices of Mothers in Rural Haiti

Rates and relationships of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) of mothers in rural Haiti were examined. Prelacteal and complementary feedings were identified. With a cross-sectional descriptive design, survey data from mothers (N = 195) were collected at three intervals after birth. Data were analyzed for indicators of EIBF, EBF, and complementary feedings. Overall, 148 (75.9%) mothers reported EIBF, and 75 (38.5%) reported EBF. EIBF was associated with EBF, with an adjusted relative risk 1.35 (95% confidence interval = [0.84, 2.18]). Several nutritive and nonnutritive substances interrupted EBF during the first 6 months of life. Haiti has an under-five mortality rate of 67.0/1,000 live births, exceeding the mean of 46.5/1,000 live births for developing regions. Both EIBF and EBF are associated with decreased neonatal and early infant mortality. Country-specific data are needed to inform and develop breastfeeding initiatives and community-level campaigns to improve the prevalence of EIBF and EBF in Haiti.

Hematobiochemical profiles, mineral concentrations and oxidative stress indicators in beef cattle with pica

Pica, or “depraved appetite”, is defined as ingestion of non-nutritive substances. Many factors influencing pica in animals have been identified , but the etiology is controversial. This study was conducted to evaluate haematological and biochemical parameters, trace element concentrations, the total antioxidant status (TAS), total oxidative status (TOS) and oxidative stress index (OSI) in beef cattle with and without pica. Ten beef cattle with pica (group I) and another ten healthy beef cattle (Group II) were used in the study. Serum TAS and TOS were measured by a colorimetric method. In group I, haemoglobin value and serum iron, copper and selenium concentrations were significantly lower than those of group II (p < .05). Cortisol level and the other biochemical parameters were not statistically different between the groups (p > .05). Compared to the healthy controls mean TAS values were significantly decreased in the group I (p < .05), whereas the TOS and OSI values did not differ statistically between the two groups (p > .05). Parasitological analysis revealed that Trichostrongylidae spp eggs were more common in group I. In conclusion, serum iron, copper and selenium deficiency with decreased antioxidant capacity may cause the symptoms of pica in beef cattle. Prophylactic use of trace mineral supplement containing iron, copper, selenium and antioxidants in beef cattle may be beneficial in preventing deviated appetite and in strengthening the antioxidant defence system.

Parapheromones Suppress Chemotherapy Side Effects

The cytotoxic drugs used in chemotherapy are often accompanied by nausea and vomiting. Despite the use of antiemetic drugs, chemotherapy-induced nausea and vomiting (CINV) remain significant side effects for cancer patients and are associated with serotonin type 3 receptor (5-HT3R) activation in the brainstem. Farnesol and nerolidol are sesquiterpene alcohols found in essential oils of plants such as roses, citronella, and lemon grass and are used as antiemetic parapheromones. Medicinal plants often are effective in treating gastrointestinal disorders, including CINV, although the mechanism of action remains unclear. In the current work, the antiemetic efficacy of the naturally occurring racemic mixture of farnesol (m-farnesol) and nerolidol (m-nerolidol) against cisplatin CINV was tested using the pica behavior (consumption of nonnutritive substances) of rats. Animals treated with m-farnesol or m-nerolidol consumed a smaller amount of kaolin than of saline-treated control animals. This result is consistent with the antiemetic efficacy of farnesol and nerolidol. Compared with controls, m-farnesol- but not m-nerolidol-treated animals consumed more food and lost less body weight. Thus, farnesol effectively reduced appetite suppression and weight loss induced by cisplatin. In separate experiments, isomers of farnesol and nerolidol were tested on 5-HT-induced responses of acutely isolated nodose neurons using patch-clamp methods. All the tested constituents inhibited 5-HT3R-mediated current in a noncompetitive manner. Thus, both farnesol and nerolidol may exert antiemetic efficacy by inhibiting 5-HT signaling in cranial visceral afferents, resulting in interruption of emetogenic signaling; however, nerolidol failed to suppress cisplatin-induced anorexia and weight loss, suggesting that additional mechanisms may contribute.

A case study of an unusual incident of Pica

This article is a case study of a patient who initially attended a minor illness clinic with restless leg syndrome. During the consultation it became obvious that the patient had pica. Pica is an eating disorder where people ingest a non-nutritive substance for at least 1 month. Angela (pseudonym) had been eating one full sheet of sand paper a day. The case study reviews the assessment and management of the patient. The usual management is a multidisciplinary approach to care.

The woman with habit of eating uncooked rice

&lt;p class="abstract"&gt;&lt;span lang="EN-IN"&gt;Eating of non-nutritive substance (pica) is unusual in adult. Usually eating of non-nutritive substance in adult is associated with pregnancy, psychosis or mental retardation. In this case report we are presenting an adult female who presented with eating of uncooked rice regularly for last two years. Our patient is a housewife, non pregnant and mother of an eight year old girl. After receiving treatment with Fluvoxamine patient showed marked improvement, suggesting similarity between pica and obsessive compulsive disorder&lt;/span&gt;&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Effect of Propolis Oral Intake on Physiological Condition of Young Worker Honey Bees, Apis Mellifera L.

Abstract Honey bees collect resin from various plant species and transform it into propolis that is incorporated into the nest. The role of resins in the bee health field is poorly understood. The aim was to evaluate the effects of forced consumption of propolis on the physiological condition and short-term survival of Apis mellifera worker bees. It was tested if the number of circulating hemocytes in hemolymph, the abdominal fat bodies and the hypopharyngeal glands development were affected by the feeding with propolis extracts in laboratory conditions during the warm and the cold seasons. Propolis added to sugar candy was consumed by workers for fourteen days without affecting the bee survival. The number of circulating hemocytes in hemolymph remained constant despite the differential diet during the experiment. However, the development of fat bodies and hypopharyngeal glands was altered by propolis ingestion. The abdominal fat body development in winter bees diminished after fourteen days of propolis consumption, while it increased in summer bees. The hypopharyngeal gland development decreased for the assayed period in workers from both seasons. Our results encourage us to continue exploring this research field and learn how long-term forced ingestion of a plant-derived compound, a non-nutritive substance, can modify physiological bee parameters. A broader understanding of the multiple roles of propolis in the health of the honey bee colonies could be obtained by studying the ways in which it is processed and metabolized and the effect that generates in another physiological responses.

Isolation and Characterization of Bioactive Compounds from Medicinal Plants of Ethiopia- A Review

Some plants having the medicinal value in form of chemical substances that produce a definite physiological action on the human body are called phytochemicals. Since the ancient time these phytochemicals are used to cure the disease in herbal and homeopathic medicines. These are non-nutritive substances, have protective or disease preventive property