Characteristics of pica behavior among mothers around lake victoria, Kenya: A cross-sectional study

Esther O. Chung, Brian Mattah, Matthew D. Hickey, Charles R. Salmen, Erin M. Milner, Elizabeth A. Bukusi, Justin S. Brashares, Sera L. Young, Lia C.H. Fernald, Kathryn J. Fiorella

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4 Scopus citations


Background: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described the prevalence of pica among women on Mfangano Island, Kenya, and examined sociodemographic and health correlates. Methods: Our cross-sectional study included 299 pregnant or postpartum women in 2012. We used a 24-h recall to assess pica, defined as consumption of earth (geophagy), charcoal/ash, or raw starches (amylophagy) and built multivariable logistic regression models to examine sociodemographic and health correlates of pica. Results: Eighty-one women (27.1%) engaged in pica in the previous 24 h, with 59.3% reporting amylophagy and 56.8% reporting geophagy, charcoal, and/or ash consumption. The most common substances consumed were raw cassava (n = 30, 36.6%), odowa, a chalky, soft rock-like earth (n = 21, 25.6%), and soil (n = 17, 20.7%). Geophagy, charcoal, and/or ash consumption was negatively associated with breastfeeding (OR = 0.38, 95% CI: 0.18–0.81), and amylophagy was associated with pregnancy (OR = 4.31, 95% CI: 1.24–14.96). Pica was more common within one of six study regions (OR = 3.64, 95% CI: 1.39–9.51). We found no evidence of an association between food insecurity and pica. Conclusion: Pica was a common behavior among women, and the prevalence underscores the need to uncover its dietary, environmental, and cultural etiologies.

Original languageEnglish (US)
Article number2510
JournalInternational journal of environmental research and public health
Issue number14
StatePublished - Jul 2 2019

Bibliographical note

Funding Information:
Funding: This study was supported by an Institute for International Studies Fellowship (E.O.C.), and N.S.F. Graduate Research Fellowship Program, N.S.F. Doctoral Dissertation Research Improvement Award and Cornell University’s Atkinson Center for a Sustainable Future (K.J.F.), and partial support from NSF-GEO grant CNH115057 (J.S.B.).

Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.


  • Amylophagy
  • Breastfeeding
  • Geophagy
  • Kenya
  • Pica
  • Pregnancy


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