Case Reports in Medicine

Case Reports in Medicine / 2016 / Article

Case Report | Open Access

Volume 2016 |Article ID 8159302 | 5 pages | https://doi.org/10.1155/2016/8159302

Pica for Uncooked Basmati Rice in Two Women with Iron Deficiency and a Review of Ryzophagia

Academic Editor: Walter Zidek
Received23 Aug 2015
Accepted14 Dec 2015
Published04 Jan 2016

Abstract

Reports of pica for uncooked rice (ryzophagia) in adults who reside in European and derivative countries are uncommon. We evaluated and treated two nonpregnant women with pica for uncooked basmati rice. Both women reported fatigue, abdominal discomfort after consuming large quantities of uncooked basmati rice, and hair loss. One woman was from India and the other was from Pakistan. Both women were vegetarians. Basmati was the local rice in their native countries and their usual rice in the USA. Both women had tooth damage due to eating uncooked rice and iron deficiency with microcytic anemia attributed to menorrhagia and multiparity. Ryzophagia and other manifestations (except tooth damage) resolved after iron dextran therapy. We review and discuss other reports of ryzophagia associated with iron deficiency, pregnancy, race/ethnicity, geographic origin, and local traditions. We conclude that adults with ryzophagia in European and derivative countries are likely to be non-Europeans.

1. Introduction

Pica is the compulsive, repetitive eating of nonfood substances or large amounts of specific foods or condiments daily for more than one month [14]. In adults, pica for items not part of one’s habitual diet or preferences is a common but incompletely understood accompaniment of iron deficiency [59] and pregnancy [1014]. Pica items in adults with iron deficiency are diverse, typically contain little or no absorbable iron, and vary according to personal choice, race/ethnicity, culture, item availability and convenience, and geographic location [1519]. Although pica for uncooked rice (ryzophagia) has been reported in nonpregnant adolescents and adults with iron deficiency [19, 20] and in pregnancy [21], other aspects of ryzophagia are undescribed.

We report the evaluation and treatment of two women with iron deficiency, one from India and the other from Pakistan, who developed pica for uncooked basmati rice. We discuss particular aspects of basmati ryzophagia in the context of the two present women and review ryzophagia in adults of European and non-European ancestry and its relationships to iron deficiency, pregnancy, race/ethnicity, local traditions, geographic origin, and other conditions.

2. Case Reports

Patient 1. A 39-year-old woman, a native of Mumbai, India, presented with severe fatigue and hair loss. She reported pica for uncooked milled basmati rice, the predominant local rice in Mumbai and her usual rice in the USA. This manifestation had occurred for many years and was more intense during pregnancy. She often developed abdominal pain after eating large quantities of uncooked rice. She was a vegetarian. She reported that her mother, grandmother, and other women in Mumbai also craved uncooked basmati rice. Physical examination revealed moderate pallor and several teeth chipped by eating uncooked rice. Her iron deficiency and microcytic anemia (Table 1) were attributed to menorrhagia and multiparity. She was intolerant of oral iron supplements and thus was treated with intravenous iron (1500 mg Fe, total) [18]. Pica resolved after the first infusion of 500 mg of iron [18]. Other manifestations (except tooth damage) resolved after completion of iron dextran therapy.


AnalytePatient 1Patient 2

Hb, g/dL8.29.5
RBC × 106/µL 4.443.83
MCV, fL61.079.8
RDW, %18.115.0
WBC × 103/µL5.16.6
Platelets × 103/µL239324
Serum iron, µg/dL252
TS, %55
Serum ferritin, µg/L85

Iron deficiency was defined as both TS <10% and SF <20 µg/L [6]. Hb: hemoglobin; RBC: red blood cells; MCV: mean corpuscular volume; RDW: red blood cell distribution width; WBC: white blood cells; TS: transferrin saturation.

Patient 2. A 44-year-old woman, a native of Karachi, Pakistan, presented with fatigue, dizziness, cold intolerance, hair loss, and decreased growth and thinning of nails. She reported having pica for uncooked milled basmati rice (the most popular rice in Karachi and her usual rice in the USA), drying cement, and dirt. She often developed abdominal pain after eating large amounts of uncooked basmati rice. She was a vegetarian. Physical examination revealed moderate pallor and chipped and abraded teeth due to eating her pica substances. Iron deficiency and microcytic anemia (Table 1) were attributed to menorrhagia and multiparity. She was intolerant of oral iron supplements and thus was treated with intravenous iron (1000 mg total) [18]. Pica resolved after the first infusion of 500 mg of iron [18]. Other manifestations (except tooth damage) resolved after completion of iron dextran therapy.

We performed a computerized search of the National Library of Medicine (http://www.pubmed.gov) and other internet sites to identify reports of ryzophagia (rizophagia). In some studies, pica for uncooked rice (ryzophagia) is categorized as a subtype of starch pica (amylophagia, amylophagy) [21, 22]. Thus, we used amylophagia as an additional search term. We also performed a manual search of many reports of iron deficiency, pregnancy, pica, and amylophagia to identify other cases of ryzophagia.

4. Discussion

The present women had iron deficiency complicated by microcytic anemia, fatigue, hair and nail symptoms, and pica for uncooked milled basmati rice. These observations are consistent with previous reports of ryzophagia in men and nonpregnant women. In 16 adolescent girls with anemia or iron deficiency on Réunion Island (La Réunion), 81% had pica for uncooked rice [20]. In 79 European and non-European patients (92% women) with iron deficiency in France, 4% had pica for uncooked rice [19]. None of 79 control subjects reported ryzophagia [19].

Pica for uncooked basmati rice was more intense during pregnancy in Patient 1. In 2,367 pregnant women on Pemba Island, Zanzibar, Tanzania, 897 had pica [21]. Of those 897, 86% had pica for uncooked rice alone and 4% had pica for both uncooked rice and earth [21]. In comparison with pregnant women without pica, women who routinely ate uncooked rice had mean hemoglobin concentrations that were 0.6 g/dL lower () and those who consumed uncooked rice and earth had mean Hb concentrations that were 1.1 g/dL lower (). A pregnant woman in India without report of iron measures also had pica for uncooked rice and wheat [23].

Abdominal discomfort or pain occurred in the present patients after they ate large quantities of uncooked basmati rice. In pregnant women on Pemba Island, the prevalence of nausea and abdominal pain was significantly greater among those who had consumed uncooked rice during pregnancy (mean daily consumption 34.5 g (range 7.7–77.9 g) or ~1/3 cup, on average) than those who had not consumed uncooked rice () [21]. Abdominal discomfort or pain was also reported by another pregnant woman with ryzophagia [23] and by other patients with iron deficiency who had either arabositophagia [24] or geophagia [25]. Tooth damage occurred in both of the present women, in another woman who ate uncooked rice [23], and in other persons with iron deficiency and pagophagia [5]. Both of the present women reported hair loss. Iron deficiency was significantly associated with hair loss in three studies [2628] but not in another report [29].

Mean corpuscular volume (MCV), a surrogate measure of tissue iron stores [30], is inversely associated with pica in persons with iron depletion or deficiency [6, 8]. This is consistent with the present observations and with pretreatment laboratory test results in nine adolescent females with pica for uncooked rice and iron deficiency on Réunion Island (mean MCV (SD) fL) [20]. Iron deficiency and its severity were independent predictors of pica in adults in regression analyses [6, 19]. Pica in the present women resolved after they were treated for iron deficiency, in agreement with other reports [6, 19, 20]. Recurrence of pica is often a harbinger of recurrent iron deficiency [5, 6]. These observations infer that iron depletion or deficiency is causally related to pica in some adults, although the biochemical mechanism(s) by which iron depletion or deficiency induces pica remains obscure.

It is plausible that the predominant cause of pica associated with iron deficiency or depletion in adults is low tissue iron levels, possibly in the tongue, olfactory apparatus, or other locations in the brain [31, 32]. In iron-deficient rats, mean blood 59Fe levels after intranasal administration of the radioisotope as ferrous or ferric form were significantly higher than those of iron-sufficient control rats [33]. Divalent metal transporter-1 (DMT1) levels are significantly higher in the olfactory bulbs of iron-deficient rats [33]. Thus, the molecular mechanism of olfactory iron absorption and possibly of olfactory or gustatory function involves DMT1 and is influenced by body iron repletion. The transport of noniron divalent metal ions such as manganese via nasal mucosa is also increased in iron-deficient mice [34] and may contribute to pica. It has been suggested that the iron content of the hippocampus influences the expression of pica in humans [35]. Hunt et al. demonstrated that chewing ice (pagophagia) significantly improved response time on a neuropsychological test among persons with iron-deficiency anemia but not in control subjects [36]. Potential explanations for these observations include activation of the dive reflex, which would lead to peripheral vasoconstriction and preferential perfusion of the brain or, alternatively, sympathetic nervous system activation, which would also increase blood-flow to the brain [36]. Other factors driving pica in adults with iron deficiency are related to geographic location, race/ethnicity, cultural attributes, available pica items, age, and gender [6, 37]. Gross epithelial manifestations of iron deficiency or depletion such as glossitis or cheilosis or common alleles of the TMPRSS6 gene that encodes matriptase-2, a serine protease that represses hepcidin, probably do not cause or influence pica [6, 38].

The iron content of rice grains, estimated using chemical analyses or Prussian blue staining [39, 40], varies according to cultivar, region of cultivation, and other factors, including genetic manipulation [3941]. Milling removes much of the iron from rice grains [40]. In previous reports of ryzophagia, it was inferred but not explicitly stated that the rice was milled [1921, 23]. No study has assessed the bioavailability of micronutrients in uncooked rice, but it is unlikely that more nutrients would be available in uncooked than cooked rice [21]. The “white” rice consumed in Zanzibar is not enriched and has low levels of most micronutrients [42]. Bioavailability of iron in meals that contain cooked rice may be reduced by the phytate content of the rice grains [43, 44].

Basmati ryzophagia in the two present women may have been triggered in part by the aromatic properties of the rice. The predominant aromatic compound in basmati rice, 2-acetyl-1-pyrroline, accounts for its popcorn-like smell [45, 46]. Brown and milled basmati rice retain this key aroma and flavor compound [46, 47]. 2-Acetyl-1-pyrroline is also an important aroma and flavor compound in popcorn [45, 48], pica for which (arabositophagia) has been reported in patients of European descent with iron deficiency [6, 24]. The type(s) of uncooked rice consumed by patients in previous reports [1921, 23] was not specified. In Malagasy people, smell motivated geophagia in 5% of study subjects and consumption of other pica items in 4% [22]. In response to craving, some pregnant women smell particular substances alone or with pica [31, 32]. Rats with iron deficiency had longer exploratory times for attractive odorants than control rats [33].

Both of the present women were vegetarians and non-Europeans. Kettaneh et al. performed a case-control study of 79 Europeans and non-Europeans with iron deficiency and 79 controls, all of whom resided in France [19]. In a univariable comparison, 33% (7/21) of vegetarians had pica, whereas only 7% (4/58) of nonvegetarians had pica () [19]. In a logistic regression, iron-deficiency anemia and being non-European were significant independent predictors of pica [19]. Ryzophagia was reported by 4% of the patients with iron deficiency, although whether patients with ryzophagia were Europeans or non-Europeans was not reported [19].

Six of 13 iron-deficient adolescent females on Réunion Island who reported pica for uncooked rice also had pagophagia (46%) [20]. Two (15%) also had geophagia, like Patient 2. Polypica is relatively common in large case series of persons with iron depletion or deficiency [5, 6, 19]. Ice is a common or the predominant pica item in case series of whites of European descent, South African blacks, and African Americans with iron deficiency [5, 18, 19, 4951]. In a study of pregnant women on Pemba Island, Young et al. excluded ice from pica analyses because the study subjects had infrequent access to ice [21]. Geophagia was the predominant pica item in one study of black patients with iron deficiency in South Africa [5]. Pregnant Saudi women with iron deficiency craved milk, salty and sour foods, sweets, and dates [17]. These observations substantiate that no pica item is specific for iron deficiency or depletion. The items vary according to personal choice, race/ethnicity, culture, availability and convenience, and geographic origin of patients [1519].

Regular consumption of uncooked rice was not regarded as pica in one study [22]. In a population-based interview study of persons >5 years of age in 16 villages in the Makira Protected Area of Madagascar, the prevalence of geophagia was 53%, of consumption of raw starchy items was 85%, and of other unusual substances was 19% [22]. The starchy items were raw cassava, raw sweet potato, uncooked rice, and ambaradedin-ambazaha (genus Hedychium, a wild root vegetable which is consumed raw) [22]. The proportion of men who consumed these items was high (>90%). The proportion of women who consumed these items was not higher during pregnancy, although observations on only 4 pregnant women were reported [22]. Pulverized rice husks were consumed by 6% of the 760 study subjects [22]. Golden et al. concluded that all of these substances were consumed as self-medication or food, especially the starchy items, but not as pica [22]. On the other hand, these 760 subjects were not evaluated for anemia or iron status. In a study of food cravings (not defined as pica) reported by 185 female undergraduate students in Japan, cooked rice was the most popular item [52]. Komatsu concluded that “rice craving” may be characteristic of Asian rice-consuming countries and that craving for some foods is influenced by traditions of food products and cultures [52].

Uncertainties of our literature review include the possibility that we did not identify some reports of ryzophagia in our computerized searches because the reports were not indexed with search terms we used. We may have overlooked reports of ryzophagia in manual searches because it was not feasible to review all published reports of pica.

5. Conclusions

We conclude that adults with ryzophagia in European and derivative countries are likely to be non-Europeans. It is plausible but unproven that ryzophagia in adults is a common but infrequently reported manifestation of iron deficiency or pregnancy in large regions of Asia and sub-Saharan Africa where rice is a major dietary staple [53, 54], vegetarianism is common [5557], and the prevalence of iron deficiency in the general population is high [58, 59]. Physicians should inquire about pica at diagnosis of iron deficiency or depletion in all adults. The prevalence of ryzophagia may be greater in non-Europeans, especially women. Evaluation to identify causes of iron deficiency or depletion, possible dental trauma, and complaints of abdominal discomfort may also be appropriate in such patients.

Conflict of Interests

The authors declare that they have no competing interests.

Authors’ Contribution

James C. Barton conceived the project, evaluated both patients, and drafted the paper. J. Clayborn Barton reviewed the literature and compiled references. Luigi F. Bertoli evaluated both patients. All authors contributed to composition of the paper and agree with its final form.

Acknowledgment

This work was supported in part by the Southern Iron Disorders Center.

References

  1. M. Cooper, Pica, Charles C. Thomas, Springfield, Ill, USA, 1957.
  2. J. A. Halsted, “Geophagia in man: its nature and nutritional effects,” American Journal of Clinical Nutrition, vol. 21, no. 12, pp. 1384–1393, 1968. View at: Google Scholar
  3. D. E. Danford, “Pica and nutrition,” Annual Review of Nutrition, vol. 2, pp. 303–322, 1982. View at: Publisher Site | Google Scholar
  4. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-5), vol. 5, American Psychiatric Association, Arlington, Va, USA, 2013.
  5. V. J. Louw, P. Du Perez, A. Malan, L. Van Deventer, D. Van Wyk, and G. Joubert, “Pica and food craving in adult patients with iron deficiency in Bloemfontein, South Africa,” South African Medical Journal, vol. 97, no. 11, pp. 1069–1071, 2007. View at: Google Scholar
  6. J. C. Barton, J. C. Barton, and L. F. Bertoli, “Pica associated with iron deficiency or depletion: clinical and laboratory correlates in 262 non-pregnant adult outpatients,” BMC Blood Disorders, vol. 10, article 9, 2010. View at: Publisher Site | Google Scholar
  7. M. Tobiasson, B. Alyass, S. Söderlund, and G. Birgegård, “High prevalence of restless legs syndrome among patients with polycytemia vera treated with venesection,” Medical Oncology, vol. 27, no. 1, pp. 105–107, 2010. View at: Publisher Site | Google Scholar
  8. B. J. Bryant, Y. Y. Yau, S. M. Arceo, J. A. Hopkins, and S. F. Leitman, “Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome,” Transfusion, vol. 53, no. 8, pp. 1637–1644, 2013. View at: Publisher Site | Google Scholar
  9. T. Uchida and Y. Kawati, “Pagophagia in iron deficiency anemia,” Rinsho Ketsueki, vol. 55, no. 4, pp. 436–439, 2014. View at: Google Scholar
  10. R. D. Horner, C. J. Lackey, K. Kolasa, and K. Warren, “Pica practices of pregnant women,” Journal of the American Dietetic Association, vol. 91, no. 1, pp. 34–38, 1991. View at: Google Scholar
  11. P. W. Geissler, C. E. Shulman, R. J. Prince et al., “Geophagy, iron status and anaemia among pregnant women on the coast of Kenya,” Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 92, no. 5, pp. 549–553, 1998. View at: Publisher Site | Google Scholar
  12. L. Karaoglu, E. Pehlivan, M. Egri et al., “The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey,” BMC Public Health, vol. 10:329, no. 1, pp. 1–12, 2010. View at: Publisher Site | Google Scholar
  13. S. L. Young, “Pica in pregnancy: new ideas about an old condition,” Annual Review of Nutrition, vol. 30, pp. 403–422, 2010. View at: Publisher Site | Google Scholar
  14. R. A. Lumish, S. L. Young, S. Lee et al., “Gestational iron deficiency is associated with pica behaviors in adolescents,” Journal of Nutrition, vol. 144, no. 10, pp. 1533–1539, 2014. View at: Publisher Site | Google Scholar
  15. B. Parry-Jones and W. L. Parry-Jones, “Pica: symptom or eating disorder? A historical assessment,” British Journal of Psychiatry, vol. 160, pp. 341–354, 1992. View at: Publisher Site | Google Scholar
  16. D. F. Moore Jr. and D. A. Sears, “Pica, iron deficiency, and the medical history,” American Journal of Medicine, vol. 97, no. 4, pp. 390–393, 1994. View at: Publisher Site | Google Scholar
  17. M. A. al-Kanhal and I. A. Bani, “Food habits during pregnancy among Saudi women,” International Journal for Vitamin and Nutrition Research, vol. 65, no. 3, pp. 206–210, 1995. View at: Google Scholar
  18. J. C. Barton, E. H. Barton, L. F. Bertoli, C. H. Gothard, and J. S. Sherrer, “Intravenous iron dextran therapy in patients with iron deficiency and normal renal function who failed to respond to or did not tolerate oral iron supplementation,” American Journal of Medicine, vol. 109, no. 1, pp. 27–32, 2000. View at: Publisher Site | Google Scholar
  19. A. Kettaneh, V. Eclache, O. Fain et al., “Pica and food craving in patients with iron-deficiency anemia: a case-control study in France,” American Journal of Medicine, vol. 118, no. 2, pp. 185–188, 2005. View at: Publisher Site | Google Scholar
  20. J. Giudicelli and J. C. Combes, “Pica and iron deficiency in adolescence,” Archives Françaises de Pédiatrie, vol. 49, no. 9, pp. 779–783, 1992. View at: Google Scholar
  21. S. L. Young, S. S. Khalfan, T. H. Farag et al., “Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania,” The American Journal of Tropical Medicine and Hygiene, vol. 83, no. 1, pp. 144–151, 2010. View at: Publisher Site | Google Scholar
  22. C. D. Golden, B. J. R. Rasolofoniaina, R. Benjamin, and S. L. Young, “Pica and amylophagy are common among Malagasy men, women and children,” PLoS ONE, vol. 7, no. 10, Article ID e47129, 2012. View at: Publisher Site | Google Scholar
  23. S. K. Upadhyaya and A. Sharma, “Onset of obsessive compulsive disorder in pregnancy with pica as the sole manifestation,” Indian Journal of Psychological Medicine, vol. 34, no. 3, pp. 276–278, 2012. View at: Publisher Site | Google Scholar
  24. R. E. Hoyt, “Popcorn, pica, and impaction,” American Journal of Medicine, vol. 103, no. 1, p. 70, 1997. View at: Google Scholar
  25. N. E. D. Hawass, M. M. Alnozha, and T. Kolawole, “Adult geophagia—report of three cases with review of the literature,” Tropical and Geographical Medicine, vol. 39, no. 2, pp. 191–195, 1987. View at: Google Scholar
  26. M. Moeinvaziri, P. Mansoori, K. Holakooee, Z. S. Naraghi, and A. Abbasi, “Iron status in diffuse telogen hair loss among women,” Acta Dermatovenerologica Croatica, vol. 17, no. 4, pp. 279–284, 2009. View at: Google Scholar
  27. E. A. Olsen, K. B. Reed, P. B. Cacchio, and L. Caudill, “Iron deficiency in female pattern hair loss, chronic telogen effluvium, and control groups,” Journal of the American Academy of Dermatology, vol. 63, no. 6, pp. 991–999, 2010. View at: Publisher Site | Google Scholar
  28. C. Pittori, A. Buser, U. E. Gasser et al., “A pilot iron substitution programme in female blood donors with iron deficiency without anaemia,” Vox Sanguinis, vol. 100, no. 3, pp. 303–311, 2011. View at: Publisher Site | Google Scholar
  29. A. Bregy and R. M. Trüeb, “No association between serum ferritin levels >10 μg/l and hair loss activity in women,” Dermatology, vol. 217, no. 1, pp. 1–6, 2008. View at: Publisher Site | Google Scholar
  30. B. S. Skikne, C. H. Flowers, and J. D. Cook, “Serum transferrin receptor: a quantitative measure of tissue iron deficiency,” Blood, vol. 75, no. 9, pp. 1870–1876, 1990. View at: Google Scholar
  31. N. R. Cooksey, “Pica and olfactory craving of pregnancy: how deep are the secrets?” Birth, vol. 22, no. 3, pp. 129–137, 1995. View at: Publisher Site | Google Scholar
  32. S. Nordin, D. A. Broman, J. K. Olofsson, and M. Wulff, “A longitudinal descriptive study of self-reported abnormal smell and taste perception in pregnant women,” Chemical Senses, vol. 29, no. 5, pp. 391–402, 2004. View at: Publisher Site | Google Scholar
  33. V. M. Ruvin Kumara and M. Wessling-Resnick, “Influence of iron deficiency on olfactory behavior in weanling rats,” Journal of Behavioral and Brain Science, vol. 2, no. 2, pp. 167–175, 2012. View at: Publisher Site | Google Scholar
  34. J. Kim, Y. Li, P. D. Buckett et al., “Iron-responsive olfactory uptake of manganese improves motor function deficits associated with iron deficiency,” PLoS ONE, vol. 7, no. 3, Article ID e33533, 2012. View at: Publisher Site | Google Scholar
  35. B. von Bonsdorff, “Pica: a hypothesis,” British Journal of Haematology, vol. 35, no. 3, pp. 476–477, 1977. View at: Publisher Site | Google Scholar
  36. M. G. Hunt, S. Belfer, and B. Atuahene, “Pagophagia improves neuropsychological processing speed in iron-deficiency anemia,” Medical Hypotheses, vol. 83, no. 4, pp. 473–476, 2014. View at: Publisher Site | Google Scholar
  37. S. Frenk, M. A. Faure, S. Nieto, and Z. Olivares, “Pica,” Boletín Médico del Hospital Infantil de México, vol. 70, no. 1, pp. 55–61, 2013. View at: Google Scholar
  38. P. L. Lee, J. C. Barton, P. L. Khaw, S. Y. Bhattacharjee, and J. C. Barton, “Common TMPRSS6 mutations and iron, erythrocyte, and pica phenotypes in 48 women with iron deficiency or depletion,” Blood Cells, Molecules, and Diseases, vol. 48, no. 2, pp. 124–127, 2012. View at: Publisher Site | Google Scholar
  39. C. Prom-u-Thai, B. Dell, G. Thomson, and B. Rerkasem, “Easy and rapid detection of iron in rice grain,” ScienceAsia, vol. 29, pp. 203–207, 2003. View at: Google Scholar
  40. M. A. Shabbir, F. M. Anjum, T. Zahoor, and H. Nawaz, “Mineral and pasting characterization of Indica rice varieties with different milling fractions,” International Journal of Agriculture and Biology, vol. 10, no. 5, pp. 556–560, 2008. View at: Google Scholar
  41. K. R. Sivaprakash, S. Krishnan, S. K. Datta, and A. K. Parida, “Tissue-specific histochemical localization of iron and ferritin gene expression in transgenic indica rice Pusa Basmati (Oryza sativa L.),” Journal of Genetics, vol. 85, no. 2, pp. 157–160, 2006. View at: Publisher Site | Google Scholar
  42. Z. Lukmanji, E. Hertzmark, N. Mlingi et al., “Tanzania Food Composition Tables,” 2008, https://cdn1.sph.harvard.edu/wp-content/uploads/sites/30/2012/10/tanzania-food-composition-tables.pdf. View at: Google Scholar
  43. M. Tuntawiroon, N. Sritongkul, L. Rossander-Hulten et al., “Rice and iron absorption in man,” European Journal of Clinical Nutrition, vol. 44, no. 7, pp. 489–497, 1990. View at: Google Scholar
  44. P. Thankachan, S. Kalasuramath, A. L. Hill, T. Thomas, K. Bhat, and A. V. Kurpad, “A mathematical model for the hemoglobin response to iron intake, based on iron absorption measurements from habitually consumed Indian meals,” European Journal of Clinical Nutrition, vol. 66, no. 4, pp. 481–487, 2012. View at: Publisher Site | Google Scholar
  45. R. G. Buttery and L. C. Ling, “2-Acetyl-1-pyrroline: an important aroma component of cooked rice,” Chemistry & Industry, vol. 36, pp. 958–959, 1982. View at: Google Scholar
  46. E. T. Champagne, “Rice aroma and flavor: a literature review,” Cereal Chemistry, vol. 85, no. 4, pp. 445–454, 2008. View at: Publisher Site | Google Scholar
  47. A. B. Nadaf, S. Krishnan, and K. V. Wakte, “Histochemical and biochemical analysis of major aroma compound (2-acetyl-1-pyrroline) in basmati and other scented rice (Oryza sativa L.),” Current Science, vol. 91, no. 11, pp. 1533–1536, 2006. View at: Google Scholar
  48. P. Schieberle, “Quantitation of important roast-smelling odorants in popcorn by stable isotope dilution assays and model studies on flavor formation during popping,” Journal of Agricultural and Food Chemistry, vol. 43, no. 9, pp. 2442–2448, 1995. View at: Publisher Site | Google Scholar
  49. C. A. Coltman Jr., “Pagophagia,” Archives of Internal Medicine, vol. 128, no. 3, pp. 472–473, 1971. View at: Publisher Site | Google Scholar
  50. J. Speirs and R. Jacobson, “The consumption of ice as a symptom of iron deficiency,” South African Medical Journal, vol. 50, no. 43, p. 1742, 1976. View at: Google Scholar
  51. W. G. Rector Jr., “Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss,” Journal of General Internal Medicine, vol. 4, no. 6, pp. 512–513, 1989. View at: Publisher Site | Google Scholar
  52. S. Komatsu, “Rice and sushi cravings: a preliminary study of food craving among Japanese females,” Appetite, vol. 50, no. 2-3, pp. 353–358, 2008. View at: Publisher Site | Google Scholar
  53. Chapter 1—Rice in the world, 1998, http://www.fao.org/wairdocs/tac/x5801e/x5801e08.htm#chapter%201%20%20%20rice%20in%20the%20world.
  54. Global Rice Science Partnership (GRiSP), Rice Almanac, International Rice Research Institute, Los Baños, Philippines, 4th edition, 2013.
  55. T. J. Key, P. N. Appleby, and M. S. Rosell, “Health effects of vegetarian and vegan diets,” Proceedings of the Nutrition Society, vol. 65, no. 1, pp. 35–41, 2006. View at: Publisher Site | Google Scholar
  56. P. N. M. Bhat, F. Arnold, K. Gupta et al., “Nutrition in India National Family Health Survey (NHFS-3), 2005-2006,” Volume 1, 2007, https://dhsprogram.com/pubs/pdf/FRIND3/FRIND3-Vol1AndVol2.pdf. View at: Google Scholar
  57. K. Shridhar, P. K. Dhillon, L. Bowen et al., “Nutritional profile of Indian vegetarian diets—the Indian Migration Study (IMS),” Nutrition Journal, vol. 13:55, no. 1, pp. 1–9, 2014. View at: Publisher Site | Google Scholar
  58. World Health Organization/UNICEF/UNU, Iron Deficiency Anaemia: Assessment, Prevention, and Control. A Guide for Programme Managers, World Health Organization/UNICEF/UNU, 2001.
  59. S.-R. Pasricha, H. Drakesmith, J. Black, D. Hipgrave, and B.-A. Biggs, “Control of iron deficiency anemia in low- and middle-income countries,” Blood, vol. 121, no. 14, pp. 2607–2617, 2013. View at: Publisher Site | Google Scholar

Copyright © 2016 James C. Barton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


More related articles

34144 Views | 634 Downloads | 2 Citations
 PDF  Download Citation  Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

We are committed to sharing findings related to COVID-19 as quickly and safely as possible. Any author submitting a COVID-19 paper should notify us at help@hindawi.com to ensure their research is fast-tracked and made available on a preprint server as soon as possible. We will be providing unlimited waivers of publication charges for accepted articles related to COVID-19. Sign up here as a reviewer to help fast-track new submissions.