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Ingestion of soil and dust is a pathway of children's exposure to several environmental contaminants, including lead, pesticides, and fecal contamination. Empirically based estimates of central tendency for soil consumption by children in high-income countries range from 9 to 135 dry mg/day. Using a Monte Carlo simulation, we modeled the mass of soildirectly and indirectly ingested per day by rural Bangladeshi children and identified the parameters that influence the mass ingested. We combined data from observations of direct and indirect ingestion among children with measurements of soil mass on the children's hands, mother's hands, and objects to quantify soil ingestion/day. Estimated geometric mean soil ingestion was 162 dry mg/day for children 3-5 months, 224 dry mg/day for children 6-11 months, 234 dry mg/day for children 12-23 months, 168 dry mg/day for children 24-35 months, and 178 dry mg/day for children 36-47 months old. Across all age groups, children placing their hands in their mouths accounted for 46-78% of total ingestion and mouthing objects contributed 8-12%. Direct ingestion of soil accounted for nearly 40% of soil ingested among children 6-23 months old. Sensitivity analyses identified that the parameters most affecting the estimates were the load of soil on the child's hand, the frequency of hand-to-mouth contacts while not eating, and, for children 6-23 months old, the frequency of direct soil ingestion. In a rural, low-income setting, children's soil consumption was substantially more than the estimates for children in high-income countries. Further characterizing soil ingestion of children in low-income contexts would improve assessments of the risks they face from soil-associated contaminants.

Objective To describe and determine the association between the occurrence of pica and eating attitudes in women with high-risk pregnancies and to determine the prevalence of pica during pregnancy. Methods A cross-sectional and prospective 24-month study was conducted with 913 women with high-risk pregnancies. Structured interviews were carried out and the Eating Attitudes Test was applied. Results Pica was diagnosed in 5.7 % of the pregnant women, and its most commonly practiced type was geophagia (57.7 %). The association between pica and signs related to the eating attitudes: “to be considered too thin by others” (p

Geophagy among orangutans is the most poorly documented in contrast to the knowledge of soil-eating practices of other great ape species. Observations of soil consumption by orangutans in the Sungai Wain Forest Preserve (Wanariset) of Borneo are presented, along with physico-mineral-chemical analyses of the ingested soil in an effort to understand what might stimulate the activity. The consumed soils are: light colored, not excessively weathered by normal standards, higher in the clay size fraction relative to controls, and are comprised of a mix of clay minerals without any specificity of 1:1, 2:1 and/or 2:1:1 (Si:Al) species. The geophagic soils contain chlorides below detection limits, effectively eliminating salt as a stimulus. Soil chemical and geochemical analyses confirm that orangutans prefer soils with pH levels near or above 4.0, while controls are consistently lower (pH = 3.5-4.0), a considerable difference in acidity for at least four out of six soils consumed. Geochemical analysis shows Al, Fe and K are high in the consumed vs control samples; higher Al follows from higher clay percentages in the consumed earth. Iron and K may play physiological roles, but Fe is mostly in the ferrous form (Fe(+2)) and may not be readily taken up by the animals. The preferential choice of consumed samples, with pH above 4.0 and higher clay contents, may promote a more beneficial intestinal environment.

The article focuses on the development of the reasons of the consumption by the wild herbivorous animals of the subsurface rocks in the apical part of Alous and Atamagu mountains, situated on the territory of the Caucasian State Biosphere Reserve. It was investigated the mineralogical and geochemical peculiarities of the eaten and not eaten rocks, the chemical composition of their water extracts and also the chemical composition of vegetation. It was determined that the consumed rocks mainly consist of the clay mineral illite, crystalline silica, hydrous micas and chlorites and are the derivatives of eolation of the Paleozoic granitoids in one case, and argillite–aleurolites of the Jurassic age in the second case. The chemical composition of the aqueous extracts demonstrated the relatively low contents of natrium and other macrocomponents in comparison with the non-consumed rocks, and also the increased content of lanthanides. The elicited facts are not compatible with the hypothesis that the pursuance for geophagia in animals at Caucasus can be connected with the peculiarities of elements change from lanthanide group in the organism.

We sought to describe the impact of pica, the craving for and intentional ingestion of substances not defined as food, as a risk factor for lead poisoning in New York City (NYC) pregnant women. In order to describe pregnant women with elevated blood lead levels (BLLs) who report pica, NYC health department data from 491 cases of lead-poisoned pregnant women from January 2001 to June 2009 were reviewed. Descriptive frequencies were obtained for women reporting pica. Data were compared between women reporting and not reporting pica. In NYC, of the 43 (9%) lead-poisoned pregnant women reporting pica, 42 (97.7%) were immigrants and 28 (64.6%) had consumed soil. Compared to lead-poisoned pregnant women not reporting pica, women reporting pica had higher peak BLLs (29.5 vs. 23.8 μg/dL, P = 0.0001), were more likely to have had a BLL ≥ 45 μg/dL (OR = 3.3, 95% CI, 1.25, 8.68) and receive chelation (OR = 10.88, 95% CI, 1.49, 79.25), more likely to have emigrated from Mexico (OR = 3.05, 95% CI, 1.38–6.72), and less likely to have completed high school (OR = indeterminate; 0 vs. 34%; P = 0.003). Among NYC lead-poisoned pregnant women, pica was associated with higher peak BLLs. Providers in NYC, and possibly other urban settings, should be vigilant and question pregnant women, especially immigrants, about pica and strongly consider testing this at-risk population for lead poisoning.

Geophagia has been commonly reported for bighorn sheep (Ovis canadensis) and other ungulates worldwide. The phenomenon is often attributed to the need to supplement animal diets with minerals available in the soil at mineral lick locations. Sodium is the mineral most frequently cited as being the specific component sought, although this has not been found universally. In this study area, bighorn sheep left normal summer-range to make bimonthly 26-km, 2,000-m-elevation round-trip migrations, the apparent purpose of which was to visit mineral licks on normal winter-range. Lick soil and normal summer-range soil were sampled for their available mineral content and summer-range forage was sampled for total mineral content, and comparisons were made to determine the specific components sought at the lick by bighorn sheep consuming soil. It was concluded that bighorn sheep were attracted to the lick by a desire for sodium but that geophagia also supplemented a diet deficient in the trace element selenium. Where sheep are denied access to licks, populations may be limited by mineral deficiency.

We previously reported on a study of 4 soils that chimpanzees of the Kanyawara community in the Kibale National Park, Uganda consumed on a near-daily basis. We suggested that iron was a possible chemical stimulus in association with high quantities of Si:Al = 1:1-dominated clay minerals in the consumed material. To test our initial findings, we analyzed 18 samples from the same general area including 7 samples that the chimpanzees did not eat. Among the chemical elements, As, Au, Br, Ca, Cl, Dy, Mg, Ni, Sb, Sr, and I are below detection limits. Only Fe stands out as a potentially important nutritional element present in sufficient quantity to provide a physiological stimulus for chimpanzees living at high elevations near the flanks of the Ruwenzori Mountains. Along with Fe, metahalloysite is present in high amounts in these soils. In its pure crystalline form as a pharmaceutical grade clay mineral metahalloysite may well counteract the debilitating effects of diarrhea, with an effect similar to what is achieved with kaolinite (cf. Kaopectate TM ). An unexpected result, the relatively high nitrogen and carbon in the eaten samples relative to the uneaten group, indicates the chimpanzees may have a higher threshold for organic-rich material than previously believed. Contrarily, the color of the ingested material, depicts a material with less humus than in the uneaten group, a finding that is compatible with previous work reported at other geophagy sites in Africa. Of all the choices of soil available to them, the chimpanzees appear to be selecting highly homogeneous chemical natural earths with well-leached and uniform mineralogical material similar to the uneaten group, but with higher relative amounts of clay size material.

Geophagy is the deliberate consumption of soil and clay deposits by animals, including man. Various hypotheses have been advanced to explain geophagic behavior, the main ones being: detoxification of noxious or unpalatable compounds present in the diet, alleviation of gastrointestinal upsets such as diarrhea, supplementation of mineral nutrients, and as a means of dealing with excess acidity in the digestive tract. This review focuses on the mineralogical and chemical nature of the materials consumed, and considers whether this has been adequately characterized, particularly in the contexts of the above hypotheses. In many cases, the information provided is fragmentary and a number of inconsistencies and anomalies are identified. In particular, it is suggested that for these materials further information on their mineral constituents is required, particularly with respect to the kaolin minerals, interstratified kaolinite/smectite, the smectitic minerals and iron oxide and aluminous minerals. It is suggested that total chemical analyses of these materials are of little relevance unless supported by a physiologically based extraction test, this approach being essential in any study seeking to confirm the nutrient supplementation hypothesis.

The article discusses geophagia, which is the practice of eating dirt. The authors note that geophagia is classified in the fourth edition of the "Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)" as an eating disorder subtype, called pica, in which individuals consume things that are not food. Topics include the prevalence of geophagia among animals, such as parrots, deer, and elephants, evolution research investigating whether geophagia is abnormal of adaptive behavior, and the idea that eating dirt may be a way to detoxify the body.

Geophagia, the deliberate ingestion of soil, is a complex eating behaviour with obscure aetiology and numerous health/medical problems. It is conventionally assumed that geophagia may help supplement mineral nutrients in individuals with limited intake of trace elements such as Fe and Zn. This view, however, has largely been based on the bulk nutrient composition of geophagic materials and the assumption that these nutrients are potentially available for absorption in the body. We have tested this assumption by equilibrating five geophagic materials collected from Uganda, Tanzania, Turkey and India with mineral nutrient concentrations and conditions similar to the gastrointestinal tract. The results showed that all five geophagic materials, regardless of their composition, sorbed large amounts of Fe and Zn across a range of dietary intake scenarios, even under acidic conditions (pH 2) similar to the stomach. However, significant amounts of Ca desorption were observed from calcareous soil samples. The findings show that while calcareous geophagic materials may supplement Ca, geophagia can potentially cause Fe- and Zn-deficiency. This is consistent with mineral nutrient deficiency problems observed in clinical nutrition studies conducted amongst geophagic populations.

A specific enzootic form of geophagia (the deliberate ingestion of soil) occurs in young cattle and sheep in restricted areas of the Barkley-West, Postmasburg and Vryburg Districts of the Northern Cape- and North West Provinces of the Republic of South Africa. It results in severe, subacute to chronic hepatitis and jaundice, with a high mortality rate in untreated cases. An association between the disease and high concentrations of manganese in soils was shown since all the affected farms are situated on outcrops of the Reivilo Formation of the Campbell Rand Subgroup, which consists mainly of manganiferous dolomite. Furthermore high concentrations of manganese were found in the analysis of liver specimens from affected calves and the characteristic microscopic pathological changes in the liver could be induced experimentally in a calf and lamb by oral administration of manganese sulphate. The highest incidence of geophagia occurs at 7 to 14 days, whereas calves older than about 2 months are rarely affected. The symptoms usually start with intermittent, progressive geophagia, followed by constipation, dehydration and death within ca. 7–10 days in untreated cases. Young calves and lambs display an insatiable appetite for soil and sometimes lick iron poles. The treatment of calves by the parenteral injection of commercial iron-dextran- and vitamin B12 preparations at 1 to 2 days after birth, and at 14 days of age, at the registered therapeutic doses, appeared to have a marked preventative effect on the occurrence of geophagia and its complications. Regional geochemical maps show a northeast–southwest trending anomaly in MnO, Zn and Pb, visually correlating with the distribution of the affected farms. Anomalously high distributions of Pb and Zn are also spatially related to the Pering (Pb,Zn) Mine. In this study, two farms were selected for comparative purposes. Gam, a farm situated on the Reivilo Formation of the Campbellrand Subgroup was chosen where a high incidence of geophagia occurred, as well as the farm Holpan on the Lyttelton Formation of the Malmani Subgroup where the problem was not known to be present. The farm Holpan was chosen as a control area, and is situated close to an old manganese mine on dolomite with a high MnO content. Geographically, Holpan is situated in an area with a high rainfall, with leaching and the formation of deep red soils on the dolomite, together with a hilly relief and low soil pHH2O. Gam is situated in an area with lower rainfall, where precipitation would be less than evapotranspiration. The dolomite of the Malmani Subgroup and the Reivilo Formation are significantly different in their soil geochemistry. The MnO, Fe2O3T and Co contents are significantly higher in the soils of the Malmani Subgroup than in the Reivilo Formation. The MnO, Zn and Pb contents on Gam are higher than on Holpan, whereas the Fe2O3T and Co contents are lower. Soil on Holpan contains iron-minerals such as haematite, while no iron minerals were detected in the soils of Gam. The concretions, found in the soils on both farms, differs remarkably in iron-contents. Concretions on both farms have similar high concentrations of MnO, whereas the FeO content are low for the concretions on Gam and high for Holpan. Preliminary comparative analytical results of the colostrum, sampled from cows with new born calves within three days of birth, do not entirely reflect the soil geochemistry of the different farms. Whereas the soils on Gam have higher MnO, Zn and Pb, and lower Fe2O3T and Co than Holpan, the colostrum produced on Gam has lower Mn, Fe and Co than on Holpan. The Pb and Zn concentrations in the colostrum on both farms do not differ significantly. The comparative regional geochemical soil data, together with the colostrum data, suggest that young calves on the farm Gam probably suffer from Fe and Co deficiency. Conversely, it was illustrated that the Fe and Co content in the soils are high and the Fe is abundant in the concretions on the farm Holpan. These findings, together with the apparent absence of geophagia at Holpan, as well as the observed effect of iron and cobalt supplementation in the prevention of geophagia on the farm Gam, suggests an association of geophagia with iron and cobalt deficiencies on the farm Gam.

Howler monkeys, Alouatta spp., are the most folivorous of neotropical primates (Platyrrhini), although Amazonian red-handed howlers (Alouatta belzebul) are relatively frugivorous. The feeding ecology of a free-ranging group of A. belzebul was monitored at a site in eastern Brazilian Amazonia over a ten-month period (November 1997 to August 1998). The first half of the study period encompassed the peak of the wet season, during which the study group's diet was predominantly frugivorous (scan sample records: 53.5% fruit, 40.8% leaves), and the second half, the transition from wet to dry season, characterized by a marked shift to folivory (18.9% fruit, 77.9% leaves). This shift was accompanied by a marked increase in mature, as opposed to flush leaves, which are relatively rich in secondary compounds. Ingestion of soil from termitaria was recorded on a total of 26 occasions, all of which occurred during the second half of the study period. Soil from termitaria was relatively rich in elements such as Ca and Na and in organic carbon, in comparison with that from the forest floor. The extent to which the monkeys ingested soil for their mineral supplements, or as an aid for the digestion of leaves, in particular the absorption of secondary compounds, remains unclear. The marked correlation with the observed patterns of folivory suggests that the latter function may have been the primary motive for geophagy in this species.

We gathered data on the amount, composition, and rate of ingestion of foods and soils by the provisioned Japanese macaques (Macaca fuscata fuscata) at Arashiyama, Japan. Behavioral observations spanned one year on 8 adult females, using focal animal sampling. We analyzed a subsample of their foods for nutritional and toxic secondary compound content. We also analyzed soils eaten by the macaques for several physical-chemical properties and tested their adsorption affinity to tannins and alkaloids. Geophagy occurred at a high rate of 2.97 g/indiv./day with an elevated frequency in the afternoon. About two-thirds of their foods (by fresh weight) were provisioned items, which are extremely rich in proteins and soluble carbohydrates. The soils that they ingested were generally poor in mineral elements, the bio-availability of which was low. The soils had a high adsorption capacity for plant alkaloids but were poorly absorptive for tannins. They were rich in clay minerals of proven buffering capacity. Geophagy at Arashiyama may improve the health of macaques via buffering gastric upset. We discuss the results from the viewpoint of several hypotheses on geophagy.

Termite mound soils eaten by chimpanzees of the Mahale Mountains and Gombe National Parks, Tanzania, have mineralogical and geochemical compositions similar to many soils eaten by higher primates, but release very low levels of either toxic or nutritional inorganic elements to solution at acid pH. Comparison with control (uneaten) soils from the same areas showed lower levels of carbon and nitrogen in the eaten soils, a relationship confirmed by surface analysis. Surface analysis also revealed lower levels of iron on particle surfaces versus interiors, and higher levels of iron on ingested versus control soil particle surfaces. The soils can adsorb dietary toxins, present in the plant diet or those produced by microorganisms. Taking the toxic alkaloids quinine, atropine, sparteine, and lupanine as examples, it is evident that soils from Mahale have a very good adsorptive capacity. A new adaptive advantage of geophagy is proposed, based on the prevention of iron uptake. The behavior of the soils in vitro is consistent with the theory that geophagy has a therapeutic value for these chimpanzees.

The aetiology of geophagia in periurban dairy cattle in Nigeria was assessed in relation to the mineral status of the serum, the herbage consumed, and the soil from where the herbage was consumed. The study was carried out using nine herds in the derived savannah zone during both the wet and dry seasons. Generally, the Na, Ca, Fe, Zn and Cu levels in the samples were adequate. However, the forages were low in Ca and the serum was deficient in P. Forage, soil and termite hill samples were also deficient in P. The low levels of P in the soil and termite hill samples showed that the consumption of sand by the cattle did not have any positive impact on their P intake. A seasonal effect was apparent (p 0.05) the concentration of P in the serum, the reported cause of geophagia. Geophagia is probably caused by a marginal level of P in the serum and low levels in the forage and soil. Experimental trials will be required to confirm these observations.

This study tests hypotheses on the biochemical functions of geophagy in parrots: mechanical enhancement of digestion, acid buffering capacity, mineral supplementation, adsorption of dietary toxins, and gastrointestinal cytoprotection. Parrots showed clear preferences for specific soil horizons. Comparisons of preferred and nonpreferred soils from several sites suggest that soils have little ability to enhance grinding and no measurable ability to buffer gastric pH. Soils offered insignificant mineral supplementation since most minerals occurred at similar levels in samples regardless of preference, and the minerals were generally more plentiful in the birds' diets. Sodium was available in moderate levels at some sites (>1000 ppm), but was well below sodium detection thresholds of parrots. X-ray diffraction, cation exchange capacity, and in vitro adsorptive trials showed that the preferred soils are capable of exchanging substantial quantities of cations and are capable of adsorbing low-molecular-weight secondary compounds. In captive Amazona parrots, orally administered clay reduced the bioavailability of the alkaloid quinidine by roughly 60%, demonstrating that in vivo adsorption of potentially toxic compounds may be a biologically important function of geophagy. Labeled clay remained in the lower gastrointestinal tract of captive parrots for >12 hr, which along with high adsorptive capacities, further suggests a potential role in protecting the gastrointestinal lining from various biological and chemical insults. Detoxification and cytoprotection are the most likely functions of geophagy for parrots and herbivores with similar ecologies. Given the variety of chemically defended seeds consumed by these herbivores, geophagy likely protects consumers from dietary toxins, allowing increased diet breadth and/or enhancing digestibility.

Geophagy, the deliberate act of eating soil, has been observed in various primate species, although the reasons for this behavior are poorly understood. The present study supports the general hypothesis that the physical and/or chemical nature of the soil is a likely reason for geophagy in hybrid macaque monkeys of Kowloon, Hong Kong. Samples were taken from areas where macaques were seen to be eating soil and from areas where there was no evidence of geophagy. Samples that were refused by the macaques were also obtained. Soils were analyzed for the following chemical and physical properties: soil pH, cation exchange capacity, organically bound and inorganic crystalline and poorly crystalline Fe and Al, organic carbon, acid extractable elements, particle size, and soil mineralogy. The study supports a hypothesis that the monkeys are using visual cues to choose preferentially soils for ingestion. More frequently they chose fine-textured soils that were higher in Fe and Al oxides. We speculate that these properties are sought to aid in digestive processes.

The Zanzibar red colobus monkey is the only primate, aside from humans, known to eat charcoal in the wild. All age classes and both sexes eat charcoal, but only those groups living in perennial gardens or near human dwellings do so. The habit appears to be transmitted from mother to offspring by imitation, but how it developed in the first place is unknown. Sources of charcoal include charred stumps, logs, and branches, as well as that produced in kilns by humans. These charcoals adsorb organic materials, such as phenolics, particularly well and, as a consequence, remove these compounds, which have the potential to be toxic or interfere with digestion or both. The extreme inertness of charcoal makes it an unlikely source of minerals to the colobus. We conclude that, by eating charcoal, monkeys living in gardens with a high density of food species dominated by exotic trees — Indian almond and mango — are able to exploit this abundant food resource that is high in total phenolic content much more effectively than in the absence of charcoal. The young leaves of these exotic tree species are also very high in protein and highly digestible. The benefits of charcoal eating are most likely due to the fact that charcoal adsorbs phenolics better than proteins. This may explain in large part why the birth rates and population densities of the colobus living in the Indian almond and mango habitat adjacent to the Jozani Forest are significantly higher than those in the ground-water forest. The population density of colobus in this small area is the highest ever recorded for a nonhuman anthropoid (≥700/km 2 ). It may not, however, be a stable situation, as there are indications of higher levels of aggression, lower recruitment into the medium-juvenile size class, and overbrowsing.

Soil mining and eating (geophagy) behavior of rhesus macaques (Macaca mulatta) on Cayo Santiago, Puerto Rico, is described and assessed with respect to the chemical, geochemical, and mineralogical composition of the ingested materials. The samples forming the uneaten (control) and eaten (matrix and blocky) groups of soils come from the top and flanks of a marine terrace underlain with volcanic tuff on Cayo Santiago, off the east shore of Puerto Rico. Both the uneaten and geophagy samples were analyzed to determine particle size distributions, clay and primary mineralogy, and soil chemical and geochemical compositions. Primary minerals such as orthoclase and plagioclase feldspar in the clay fraction is higher in the control group than in the ingested samples. Both the control and matrix plus blocky samples have moderate to abundant amounts of kaolinite and halloysite (both silicon:aluminum = 1:1 type clay minerals) that may be important as a stimulus to geophagy behavior. The pH, total salts, and phosphorus levels in both the control and geophagy samples show considerable overlap with little clear indication of causal factors. Analysis of the geochemical data showed no clear cut elemental differences to suggest elemental supplementation as a possible explanation for mining and eating of tropical soil. It is possible that rhesus macaques ingest clay to obtain kaolinite/halloysite minerals which may alter the taste of their provided food, and may act as pharmaceutical agents to alleviate intestinal ailments such as diarrhea.

Geophageous Rwandan mountain gorillas excavate and eat weathered leucite-rich regolith (subsoil C horizons) from the slopes of Mount Visoke in the Virunga Mountains. In the months of the dry season, the gorillas reportedly ingest a halloysitic natural earth having a chemical composition similar to that of Kaopectate, a pharmaceutical used by humans to treat gastrointestinal upsets. Several plants known to contain potential toxins are consumed more heavily by gorillas in these months. New information from geochemical and mineral analyses suggests that geophagy may alleviate intestinal problems associated with changes in their diet because the ingested weathered regolith,containing halloysitic clay minerals, may act as a pharmaceutical agent that helps to adsorb toxins and to control dehydration in the dry season.

Chemical markers for use as indicators of geophagia in Jamaica is reported. Five volunteers each ingested 10 g of each of three common soils of Jamaica to which carmine (an inert gastrointestinal dye) had been added. A pre-ingestion faecal sample and all post-ingestion faecal samples were collected until no more carmine was seen. The faecal and soil samples were analysed by instrumental neutron activation analysis. Of the 14 elements quantified, Dy, Eu, Ce, Hf, and Th were consistently detected in the post-ingestion but not in the pre-ingestion faecals. These elements should therefore be excellent markers of geophagia as they are present in insignificant levels in food compared to soils. Because of high sensitivity and short throughput times, Dy and Eu appear to be the most promising elements for the detection of the occurrence of geophagia.

Three groups of soils from two Japanese monkey parks at Arashiyama (Honshu) and Takasakiyama (Kyushu) were analyzed for their geochemistry and clay and primary mineral content. Two groups (Y and T) of soils are regularly eaten by Japanese macaques; a third group (N) is not eaten. Of the elements analyzed, soil group N (not eaten) is within the range of all elements in the Y group, and is very different from the T group. These preliminary data suggest there is no chemical stimulus in soil eating behaviour. We also analyzed the mineralogy of the clay fraction (

Mountain gorillas (Gorilla gorilla beringei) occasionally eat material from weathered regolith (subsoil) sediments in the Virunga Mountains of northwestern Rwanda. The possible nutritional significance of this behaviour has been investigated by analyzing the geochemistry, primary mineral composition, and clay content of several regolith and surface soil (paleosol) samples. Iron, Na, and Br content may be important in geophagy, and clay present in the soil may also have nutritional importance.

A West African folk illness called Pobouh Lang, characterized by compulsive geophagia, pallor, weakness, edema, depression, anxiety, and social isolation, has been examined in cultural context and with reference to pertinent biological, ethnographic, and historical literature on geophagia. Some features of the illness are probably related to iron lack and other nutritional deficiencies, Other features are related to the ambiguous cultural definition of, and negative response to, the manifest behavior. — The determinants of the cultural response are unclear, but they may involve a relatively recent increase in the prevalence of the syndrome or unidentified features of the ethos that make it hard to assimilate geophagic habits. — In many cultures geophagia is accepted behavior with either medicinal, hedonistic or religious overtones. In such contexts the psychiatric elements of the syndrome seem not to occur, even where an element of malnutrition is present, as in the present day rural American South or during pregnancy among the Serer.