Chewing Ice A Sign Of Anaemia?

By Norhidayyu Zainal

KUALA LUMPUR, July 1 (Bernama) — For some individuals, ice is not just a beverage companion, but a daily ‘snack’ that must be chewed for its crunchy and cooling sensation.

However, behind this seemingly trivial habit lies the question: is it merely a quirky preference or an early sign of an underlying health issue?

Deputy Dean of Academics (Health Sciences) at the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Prof Dr Barakatun Nisak Mohd Yusof, said that the habit of frequently chewing ice is known as pagophagia, a type of pica, which is a compulsive craving to consume non-food substances such as ice cubes.

“Globally, a systematic review of 89 studies from 33 countries found that 22.5 per cent of pica cases involved the habit of chewing ice. The same study also reported that 81 per cent of pica cases occurred alongside anaemia, indicating a strong correlation between the two conditions,” she told Bernama.

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Dr Barakatun Nisak, who is also a dietetics expert at UPM, said many individuals with iron deficiency or anaemia develop an unusual craving for chewing ice, a habit that typically disappears once iron levels are restored.

“What may seem like a harmless habit could actually be a sign of a nutritional disorder. While ice itself does not affect the digestive system, its link to pica reflects a more serious underlying health concern,” she said.

Dr Barakatun Nisak explained that pagophagia is one of the indirect symptoms of anaemia, which occurs when the body lacks sufficient haemoglobin, the substance in red blood cells that carries oxygen.

“Symptoms of anaemia include fatigue, paleness, shortness of breath, headaches, and in some cases, a strong craving to chew ice,” she added.

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Therefore, she recommends that individuals with a fondness for chewing ice undergo blood tests to check haemoglobin levels, serum ferritin, serum iron, and Total Iron Binding Capacity (TIBC) to assess iron absorption levels.

“Although there are no official statistics in Malaysia, chewing ice should not be dismissed as a simple habit. It may be an early sign of nutrient deficiency, especially iron, and should be screened or referred for further examination.

“The most important step is to treat the root cause, not just to substitute the ice. Whether it stems from nutritional deficiency, emotional stress, or compulsive behaviour, the treatment must be holistic,” she emphasised.

Associate Professor Dr Nor Azlida Mohd Nor, a Public Health Dentistry expert from the Faculty of Dentistry, Universiti Malaya, said persistent pagophagia can pose risks to dental health.

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“If chewing ice is only done occasionally, it does not have serious effects on the teeth. But if it becomes habitual, it can cause tooth sensitivity, wear, and micro-cracks or fractures in the teeth or existing fillings,” she said.

More worryingly, she said, prolonged chewing of hard objects can lead to major cracks or fractures in the teeth that affect the nerves and roots, potentially requiring more complex dental treatment.

“In some cases, it may also affect the jaw joints and surrounding muscles, leading to pain, clicking sounds, or difficulty moving the jaw,” she added, noting that pagophagia is also linked to eating disorders and anaemia.

For Nur Nadhirah Ali Imran, 26, plain ice used to be her must-have during meals — to the point she would order a glass of ice just to chew and satisfy her craving.

“If I couldn’t chew ice, I’d feel stressed and unsatisfied. But I’m grateful that I haven’t experienced any serious health issues so far,” said Nadhirah, who eventually decided to quit the habit entirely after realising the potential health risks.

— BERNAMA