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.