Association Between Infantile Colic and Carbohydrate Malabsorption From Fruit Juices in Infancy

Abstract

Objective. To determine whether infantile colic (IC) is associated with malabsorption of carbohydrates present in fruit juices.

Methods. In this double-blind study, parents of 30 healthy infants (5.1 ± 0.7 months, 7.4 ± 1.0 kg, 64 ± 4 cm) were administered a questionnaire to quantitatively assess IC. Thereafter, they were divided into 2 groups, 16 infants with and 14 without IC. Within each treatment group infants were fed 120 mL (16.3 ± 2.0 mL/kg) of either white grape (sorbitol-free; 1:1 fructose-to-glucose ratio) or apple (sorbitol 0.5 g/dL; 2.6:1 fructose-to-glucose ratio) juice. Physical activity (PA), energy expenditure (EE), crying, and sleeping times were measured for 0.5 and 3.0 hours before and after juice feeding, respectively, using the Enhanced Metabolic Testing Activity Chamber. Carbohydrate malabsorption was determined by breath hydrogen (BH₂) gas analysis after juice feedings. Statistical differences between groups were determined by 2-way analysis of variance with the Tukey procedure.

Results. Infants with IC fed apple juice exhibited carbohydrate malabsorption as shown by increased BH₂ excretion, whereas those without IC absorbed carbohydrates normally when fed this juice. Infants fed apple juice with carbohydrate malabsorption cried more and consequently slept less during the last 1.5 hours of the study. This was associated with increased PA and EE as compared with infants without IC fed apple juice. In contrast, infants fed white grape juice, regardless of IC, showed no increase in BH₂ excretion, PA, and EE. Furthermore, crying and sleeping times were unchanged in infants fed white grape juice regardless of the presence or absence of IC.

Conclusions. IC was associated with carbohydrate malabsorption from fruit juices containing sorbitol and a high fructose-to-glucose ratio.