Constant cravings

The compelling appetite for substances that are largely non nutritious such as clay, metal, chalk, glass, soil, sand or ice is well studied and known as pica.

JUDGING from my bodily stature, it doesn’t take a genius to work out that I have a passion for food. But many do not realise, that apart from eating; I also have an appetite for cooking.

Yes, I confess, I have a secret compelling desire to be a chef. In fact, some of my best friends will tell you that I was contemplating quitting medicine at one stage, to pursue my hunger to cook up a storm in the kitchen.

All right, I admit, my constant craving for a career as a chef did not really take off. But secretly, I am challenging myself to acquire that culinary magic that is possessed by many of the chefs whom I aspire to be like, such as Boulud, Bourdain and Samuelsson.

Of course, the life of a chef is by no mean easy. Marcus Samuelsson, the Ethiopian-born chef who was adopted in Sweden at the age of three, has explained what chefs really crave for after facing the heat of the kitchen like this: “Chef don’t eat at normal hours, so the only time you feel like you really need a meal is after service, when you are exhausted and just crave something to help you wind down.”

One of the most amazing experiences of being a chef is the thirst for new gastronomic discoveries. My other foodie idol, the American author and television personality, Anthony Bourdain talked about his discovery of Asian cuisine while filming on this side of the world. He explained: “Going to Southeast Asia for the first time and tasting that spectrum of flavours – that changed my whole palate, the kind of food I crave. A lot of dishes I used to love became boring.”

My favourite chef and restaurateur Daniel Boulud, who started his career at Le Cirque in New York once said: “I think at Le Cirque I learned how to make real food, which is what people crave, not just gimmicky things on a plate.”

The question then is: In real life, how much of what we crave is real and what is gimmicky? That what we will try to answer with regard to the unexplained cravings of this reader’s wife.

Dear Dr. G,

My name is Vincent and I have a very strange problem.

I am 28 and my wife is 26. We have been married for two years and my wife gave birth to a baby boy last year.

As you know, towards the end of her pregnancy, it is “pantang” to have sexual intercourse and we avoided sex completely. My wife had a bit of a traumatic birth and had to enter the operating theatre after the delivery due to bleeding. Thank goodness everything is okay now.

I must confess, my wife and I have not had any intimacy for nearly a year. I am not a “self-indulgence” kind of guy and have also not engaged in “extra-curricular activities”. I am really craving sexual activity. But there is nothing I can do about it, as my wife does not seem to be ready.

Don’t get me wrong, I fully understand she may not be ready for sex yet, since she is breast-feeding and especially as she is recovering from the bleeding trauma. The thing is, after the delivery, she is now craving for all sorts of things, but sex.

Since the birth of my boy, my wife has this craving for chewing ice. Yes, she has been chewing ice cube like an addict. Surely, this is very abnormal.

I really don’t know what to do, I wonder if you can help?

Vincent

The compelling appetite for substances that are largely non nutritious such as clay, metal, chalk, glass, soil, sand or ice is well studied and known as pica. For such cravings to be considered pica, the sufferer must be age and developmentally appropriate and the cravings are not part of a culturally sanctioned practice.

Although pica has been linked to mental disorders, such as stress or obsessive-compulsive disorder, abnormal cravings for non-food items such as soap, have been well observed in pregnant women. Of course, the consumption of the materials can occasionally lead to intoxication or even bowel obstructions.

Pagophagia is a form of pica involving the compulsive consumption of ice or ice chewing. Although such a compulsion may sound psychotic, the craving is generally associated with iron deficiency, anaemia or nutritional deficiencies. In extreme cases, people with undiagnosed anaemia have been known to go through multiple packets of ice cubes in a day. Apart from causing concern, the ice chewing may also induce dental damage. Such cravings usually resolve with iron supplements or treatment for anaemia.

The true mechanism of pagophagia is unknown. One study demonstrated that ice chewing might increase alertness of the fatigued anaemic individuals. Others postulate the compulsive chewing of ice can relieve the inflammation in the mouth brought on by iron deficiency anaemia.

For Vincent’s wife, the craving for ice after a traumatic birth can be due to anaemia, malnutrition or even postpartum depression. A visit to the doctor for a simple blood tests and thorough examination is crucial. I guess for “non self indulging” Vincent, the craving for sex after one year of deprivation is completely expected. The avoidance of “extra-curricular” activities is also highly praiseworthy.

Iron-rich food such as spinach may not only give Vincent’s wife Popeye’s superhuman strength, it may also resolve the ice-chewing craving if the pica is caused by iron deficiency. Food such as liver, mussels and oysters, believed to be aphrodisiacs, are also good sources of heme iron. So, Vince, Dr. G’s advice is to cook up a storm in the kitchen and hopefully, the bedroom.