Carbohydrate Absorption From Fruit Juice in Young Children

Abstract

Objective. To compare carbohydrate absorption following ingestion of apple juice and white grape juice in 28 healthy children. Design. Randomized, double-blind crossover study. Setting. Outpatient pediatric clinic at Maimonides Medical Center. Participants. A total of 18 healthy infants (mean age 6.3 months) and 10 toddlers (mean age 18.0 months), representing those ages when juice is first introduced (6 months) and when juice comprises a large portion of the diet (18 months). Methods. Breath hydrogen (H2) testing was performed after age-specific servings of white grape juice or apple juice, 4 and 8 ounces respectively, were consumed. These portions provided approximately 1 g of fructose per kg of body weight. Breath H2 responses of >20 ppm were considered positive, indicating incomplete absorption of fruit juice carbohydrates. Results. In the combined age groups, carbohydrate malabsorption occurred more frequently after apple juice consumption (54%) than after white grape juice (19%; P < .001). Significant differences in area under the breath H2 curve (AUC) were also found between the two juices in both age groups. Among toddlers, the differences between the mean peak breath H2 responses were significant (48 ppm after apple juice consumption compared with 12 ppm after white grape juice; P < .001). These differences were not significant in the infant group. Significant differences (P < .05) were seen between the two age groups after consumption of apple juice; the toddlers exhibited a greater number of positive breath H2 responses and higher peak responses compared with the infants. Data from the children who drank both juices showed significant differences in peak breath H2 responses after consumption of apple juice compared with white grape juice (P < .005). Conclusions. The study demonstrated less carbohydrate malabsorption following ingestion of white grape juice compared with apple juice in healthy 6- and 18- month-old children.