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Association between infantile colic and carbohydrate malabsorption from fruit juices in infancy
Debora Duro1, Russell Rising, Maribel Cedillo
1Research Institute, Miami Children's Hospital, Miami, Florida 33155, USA.
Insights
Infantile colic (IC) is linked to carbohydrate malabsorption from fruit juices high in sorbitol and fructose. Infants with colic fed apple juice showed malabsorption, leading to increased crying and reduced sleep.
Area of Science:
- Pediatric Gastroenterology
- Infant Nutrition
- Digestive Health
Background:
- Infantile colic (IC) affects a significant number of infants, causing distress to both infants and parents.
- The etiology of IC is multifactorial, with dietary factors being a potential contributor.
- Carbohydrate malabsorption has been implicated in digestive discomfort in infants.
Purpose of the Study:
- To investigate the association between infantile colic (IC) and carbohydrate malabsorption from fruit juices.
- To determine if specific fruit juice compositions exacerbate symptoms in colicky infants.
- To assess the impact of carbohydrate malabsorption on infant behavior and energy expenditure.
Main Methods:
- A double-blind study involving 30 infants (divided into those with and without IC) was conducted.
- Infants were fed either white grape juice (sorbitol-free) or apple juice (containing sorbitol and a high fructose-to-glucose ratio).
- Carbohydrate malabsorption was assessed via breath hydrogen (BH(2)) analysis, with physical activity (PA), energy expenditure (EE), crying, and sleeping times monitored.
Main Results:
- Infants with IC fed apple juice demonstrated carbohydrate malabsorption (increased BH(2) excretion).
- This malabsorption correlated with increased crying, reduced sleep, and elevated PA and EE in infants with IC.
- White grape juice did not induce malabsorption, nor did it affect behavior or energy expenditure in any infant group.
Conclusions:
- Infantile colic is associated with carbohydrate malabsorption, particularly from fruit juices containing sorbitol and a high fructose-to-glucose ratio.
- The findings suggest that specific juice components may trigger or worsen colic symptoms due to malabsorption.
- Dietary modifications, avoiding juices with high sorbitol and fructose content, may benefit infants experiencing colic.
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 (BH(2)) 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 BH(2) 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 BH(2) 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.