Relationship between pica activity, iron deficiency anemia, and the nutritional status of Utah children
Creators: name: Jacobs, Timothy Andrew
Publisher: name: University of Utah
Year: 2012
Subjects: Utah
Ingestion of Non-Food Substances

description: This investigation endeavored to study the relationship between pica activity, iron deficiency anemia, and the nutritional status of children one and one-half through six years of age living in the Salt Lake Valley of Utah.  In this research, pica the persistent ingestion of non-food substances of not nutrient value, was considered a manifestation of iron deficiency anemia and frequent concomitant of poor nutrition.  Pica is an important and potentially serious hazard among young children.  The incidence of pica practices among children in the Salt Lake Valley had never been investigated, and was unknown.  This sample in the investigation consisted of 32 well children from low as well as middle-income level families, among which were 18 boys and 14 girls with not history of behavioral or psychiatric problems.  None of the children had been treated with drugs which would alter their hematological status; and none had experienced recent illnesses, accidents, or hospitalization.  The study setting was a pediatric clinic in a suburb of Salt Lake City, Utah.  Specific data relative to possible pica practices were collected from the parents using a structured Pica History form and interview.  The interview revealed which children wee pica practitioners and which were not.  The subjects were divided into pica and non-pica groups.  The nutritional status of each child was assessed using a 24-hour, and a three-day nutrition and diet history.  The data for calories and for nine nutrients were compared with the 1974 Recommended Dietary Allowance for age.  Five anthropometric measurements:  height, weight, chest circumference, hip width, and left calf circumference, were obtained using a steel tape measure, clinical scales, and obstetric calipers.  A blood sample obtained by finger-prick was nod to evaluate the presence or absence of anemia, as reflected by abnormal hemoglobin, microhematocrit, or calculated mean corpuscular hemoglobin concentrations (MCHC).  All data were analyzed by computer and/or calculator.  Chi-square values were computed for the incidences of pica occurrences; regression analyses were calculated for the nutritional and hematological data; and the difference between body measurements of the pica and non-pica groups were calculated by sue of the t-test.  The level of significance was set at .05.  Analysis of the data, and test of the three hypothesis revealed the following majors findings:  1) Hypothesis One, that there is a low incidence of pica among young children in the Salt Lake Valley of Utah, was not supported by the data; 2) Hypothesis Two, that there is an association between the dietary nutrient intake of children in the sample and the three book variables, did not receive any support from the data.  None of the correlations between the hematological and nutrient variables reached statistical significance; 3) Hypothesis Three, that there will be no significant differences between the body measurements of the pica and the non-pica children, was partially supported.  Two measurements, the weights and chest circumference, of the non-pica subjects, were greater than those of the pica group; the differences between groups were statistically significant at levels greater than .02 and .01, respectively.  The incidence of pica among the sample of 32 subjects was in excess of 53 percent.  Pica practices were twice as great among boys than among girls.  It terms of ethnicity, Caucasian children comprised 82.3 percent of the sample.  Geophagia, or dirt-eating, was the most predominant form of pica, and was practiced by 41.1 percent of the children.  Greater than 64 percent of the pica practitioners were between the ages of 2 ½ through 3 ½ years.  Nutritionally, the non-pica group demonstrated mean three-day caloric and nutrient intakes which were inferior to those of the pica subjects, with the exception of iron.  For the sample of 31 subjects 61.2 percent were dietary-iron deficient.  Among the pica practitioners, 75 percent had dietary iron intakes.  For the total sample, dietary levels which were below the RDA existed for calories and for eight of the nine nutrients.  The hematologic status of the pica practitioners was grossly inferior to that of the non-pica subjects.  Among the pica practitioners there were large numbers of subject who exhibited borderline hemoglobin (17.6 percent), microhematocrit (31.2 percent), and MCHC (12.5 percent) values.  The incidence of anemia among the pica practicing children was 12.5 percent.  The data suggest the following:  1) pica activity is common among children between the ages of one and one-half through six years; 2) there was an association between pica and iron deficiency anemia among the practitioners in this study; 3) pica practices may have resulted in anemia by dietary replacement of foods which are high in nutrient and caloric value with materials of no nutrient value; 4) the pica children achieved a less adequate growth status than those who did not practice pica.