By SUSAN CALLAHAN, Associate Editor and Featured Columnist
Have you heard about the addiction some people have to eating ice? I have seen it first hand but I didn't know what I was seeing. My sister-in-law has a pattern: she finishes work, comes home, drops her bag and heads straight for the freezer. She pops in her mouth the first of a dozen ice cubes which she crunches as she tidies up her kitchen. Later, she may pop in a few more as she watches TV. Then a few more before dinner. All told, she may eat 24 to 30 ice cubes a day.
I never thought much of this habit of hers because she is always been a picky eater and extremely cautious about losing weight. I never thought much about it that is, until she came down with strange dark blotches on her skin. The blotches looked like she had been hit all over her body, which she had not. After seeing a doctor, she was told that her hemoglobin levels were off. She was severely anemic.
My sister-in-law has what scientists call "pica", a condition in which people eat non-food items for more than a month. Scientists disagree as to whether pica is an addiction or an eating disorder or something else.
The Ice-Eating Addiction Is Pagophagia
The particular form of pica that involves eating ice is called "pagophagia". Pica in general and pagophagia in particular has often been described as an eating disorder that has "appeared" with the last 30 years or so in the US.
That's not accurate. Pica and pagophagia are not new phenomenon. Hippocrates, the Greek physician who is the father of Modern Medicine, and Aristotle both referred to cases in which people inappropriately eat ice or drank cold water, according to a 1992 study from University of Glasgow.
Causes of and Natural Remedies for Ice-eating
1. You're Low on Iron. Anemia ---low-iron levels or iron deficiency--- is the most common culprit. Several studies have linked anemia to pagophagia. In fact, the link between anemia and pagophagia is so strong that pagophagia is sometimes defined as ice pica that is relieved by iron supplementation.
A study from Japan's Daijukai Kaisei General Hospital in 2014 found that, among those with anemia, 16% are ice-eaters.
Other studies, such as a 2014 study from the University of Pennsylvania surveyed anemics and found that 56% of them were ice-eaters.
2. You're Stressed Out. A 2014 study from India's University College of Medical Sciences & Guru TegBahadur Hospital in Delhi reported the case of a 42-year old woman whose ice-eating was triggered by stress.
The patient was not anemic either before the ice-eating began nor was she anemic after she started ice-eating. What triggered the ice-eating was her distress over her son's mediocre performance on his school exams. The patient had been the child's only tutor for the exams.
Because the ice-eating was not triggered by low levels of iron, iron supplementation would not have been effective in stopping the pagophagia.
What worked to stop the ice-eating? Treatment with fluoxetine 20 mg daily for three weeks. After three weeks, the dose was scaled up to 30 mg per day. The doctors also gave the patient suggestions to distract her from her distress and made her aware of her symptoms so she could better understand why they appeared.
Any form of stress can trigger eating disorders. The biggest asset you have against this stress turning into pagophagia is awareness. When you are under stress, you should try to first simply acknowledge that your body and mind are under attack. It's natural to reach for something --anything -- to help relieve the stress.
If you are prone to reaching for the ice trays, try substituting sugar free gum. Try also adding foods rich in omega-3 fatty acids such as salmon, which have been associated with lowering release of stress hormones such as cortisol.
3. You're Consuming Too Much Calcium. Just as iron deficiency can cause pagophagia, so can excess calcium. Calcium blocks your body's ability to absorb iron. Eating or drinking too much calcium , therefore, can lead to anemia, which in turn can lead to ice-eating.
4. You're Not Getting Enough Zinc. Some scientists believe that pagophagia is triggered by zinc deficiency.
Zinc is a trace mineral which is found in nuts and seafoods such as oysters. Because zinc is found in only a few foods, it's fairly easy to become deficient in this mineral unless you take a daily multi-vitamin. The World Health Organization estimates that, worldwide, 31% of people have zinc deficiency.
5. Elevate Your Legs to Remedy Ice-Eating? In the association between anemia and pagophagia, it's not clear whether the anemia is a cause of the pagophagia or is it a symptom of the pagophagia. Those scientists who think anemia is the cause believe that people are seeking out ice because the brain receives more oxygen when people chew ice, and as a result the brain gets more of the iron it is missing, a mechanism called the "mammalian diving reflex".
You experience the mammalian diving reflex whenever you are exposed to cold temperatures. Your body prioritizes keeping your vital organs warm and blood rushes from your outer extremities -- leaving your hands and feet cold -- toward your core and your brain.
This is the working thesis of the much-publicized 2014 study from the University of Pennsylvania led by Melissa Hunt.
Another way you can increase the amount of blood flow to your brain is by moving. Exercise increases blood flow generally and certain exercises can differentially increase blood flow to your brain. Doing downward dog yoga poses increases blood flow to your brain. Elevating your legs on two or three pillows will cause your blood to flow away from your legs and toward your core and your brain.
6. You're Short on Stimulation. People who eat ice have reported that the practice makes them more alert, like "drinking a cup of coffee". The University of Pennsylvania study demonstrated that ice-eating does appear to stimulate the brain to become more alert.
One strategy, then, you might consider is substituting a moderate amount of coffee for the ice-eating. Coffee contains the stimulant caffeine, so of course, you have to keep the total amount of caffeine you consume in mind. One or two cups per day have not been associated with negative health effects.
7. Distract Yourself with Planned Fun. Anxiety and other underlying psychological issues can lead to eating disorders. Adding regular opportunities to let off steam and inject some fun into your life can help to stave off turning to destructive eating habits such as pagophagia.