Carbohydrate Absorption From Fruit Juice in Young Children

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 H sub 2 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. Pediatrics 1995;93:340-344; carbohydrate malabsorption, apple juice, white grape juice, fructose, sorbitol.