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Consequences of incomplete carbohydrate absorption from fruit juice consumption in infants
C R Cole1, R Rising, F Lifshitz
1Research Institute, Miami Children's Hospital, Fla 33155, USA.
Insights
Fruit juices with sorbitol, like pear juice, can cause carbohydrate malabsorption in infants, leading to increased physical activity and metabolic rate. White grape juice is a better alternative for infant nutrition.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Infant Metabolism
Background:
- Many infants consume fruit juices early, posing potential risks.
- Sorbitol in fruit juices may lead to asymptomatic carbohydrate malabsorption.
- Increased physical activity and metabolic rate are hypothesized to link with carbohydrate malabsorption.
Purpose of the Study:
- To investigate the association between carbohydrate malabsorption and physical activity/metabolic rate in infants.
- To compare the effects of pear juice (sorbitol, high fructose-glucose) and white grape juice (sorbitol-free, low fructose-glucose).
Main Methods:
- 14 healthy infants (5.1 months avg. age) underwent a 3-hour respiratory chamber study.
- Infants were fed either pear juice or white grape juice after a 2-hour fast.
- Carbohydrate absorption assessed via breath hydrogen analysis; study was double-blinded.
Main Results:
- Carbohydrate malabsorption occurred in 5/7 infants fed pear juice and 2/7 fed white grape juice (P < .01).
- Malabsorption linked to increased physical activity (P < .001) and metabolic rate (P < .05).
- Only pear juice consumption correlated with increased physical activity (P < .01).
Conclusions:
- Infant carbohydrate malabsorption is linked to higher physical activity and metabolic rates.
- Pear juice, containing sorbitol and high fructose, was associated with malabsorption in most infants.
- Fruit juices with sorbitol and high fructose may not be optimal for young infants.
Background:
Most infants consume fruit juices by 6 months of age. However, fruit juices containing sorbitol may be associated with carbohydrate malabsorption without clinical symptoms. We hypothesized that increased physical activity and metabolic rate may be associated with carbohydrate malabsorption.
Methods:
Physical activity and metabolic rate were determined in 14 healthy infants ([mean +/- SD] age, 5.1 +/- 0.8 months; weight, 7.8 +/- 1.1 kg; length, 67 +/- 4.2 cm; and body fat, 26% +/- 5%) for 3 hours in a respiratory chamber. Seven were fed pear juice, and the other 7 were fed white grape juice (120 mL) after a 2-hour fast. Pear juice contains sorbitol and a high fructose-glucose ratio, whereas white grape juice is sorbitol free and has a low fructose-glucose ratio. Carbohydrate absorption was determined by breath hydrogen gas analysis. The study was double-blinded.
Results:
When compared with the infants without carbohydrate malabsorption (peak breath hydrogen level < 20 ppm above baseline), 5 of the 7 infants fed pear juice and 2 of the 7 infants fed white grape juice exhibited carbohydrate malabsorption (peak breath hydrogen level > or = 20 ppm above baseline; P < .01). These infants also exhibited both increased physical activity (P < .001) and metabolic rate (P < .05) after juice consumption in comparison with infants with normal carbohydrate absorption. When grouped according to the type of juice consumed, only infants fed pear juice exhibited increases in physical activity (P < .01).
Conclusions:
Carbohydrate malabsorption is associated with increased physical activity and metabolic rate in infants. Most of the infants who had carbohydrate malabsorption consumed pear juice. Therefore, fruit juices containing sorbitol and high levels of fructose may not be optimal for young infants.