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Updated: Aug 29, 2026

The Caco-2 Cell Bioassay for Measurement of Food Iron Bioavailability
Published on: April 28, 2022
Effect of orange and apple juices on iron absorption in children
Malika Shah1, Ian J Griffin, Carlos H Lifschitz
1Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Insights
Children absorb iron effectively from meals with either apple or orange juice. A preference for apple juice does not increase the risk of iron-deficiency anemia in children.
Area of Science:
- Pediatric Nutrition
- Mineral Metabolism
- Dietary Interventions
Background:
- Iron-deficiency anemia is a significant public health concern in the United States, particularly among children.
- Ascorbic acid (vitamin C) in juices can enhance iron absorption.
- Orange juice has a higher ascorbic acid content than apple juice, which is a preferred beverage among US children.
Purpose of the Study:
- To compare iron absorption in children when consumed with apple juice versus orange juice.
- To determine if the higher ascorbic acid content of orange juice leads to greater iron absorption compared to apple juice.
Main Methods:
- A randomized, crossover study involving 21 healthy children aged 3-6 years.
- Children consumed identical meals with either apple juice or orange juice on consecutive days.
- Iron absorption was quantified using stable iron isotopes (iron-57 and iron-58) and measured via red blood cell incorporation 14 days later.
Main Results:
- Median iron absorption was similar between meals with apple juice (7.17%) and orange juice (7.78%).
- No statistically significant difference was found in iron absorption between the two juices (P =.44).
- Iron absorption from apple juice correlated with serum ferritin, while absorption from orange juice showed a trend correlating with serum transferrin receptor.
Conclusions:
- Children absorb iron adequately from meals accompanied by either apple juice or orange juice.
- A preference for apple juice over orange juice does not appear to negatively impact iron absorption.
- These findings suggest that children's beverage preferences do not pose a significant risk for iron-deficiency anemia in the context of these juices.
Objective:
To measure iron absorption in children from meals containing apple juice or orange juice so as to determine if iron absorption will be greater with orange juice because of its higher ascorbic acid content than apple juice, a noncitrus fruit juice that US children reportedly prefer.
Design:
On 2 successive days, children consumed identical meals that included apple juice on one day and orange juice on the other, in random order. The meals were labeled with iron-57 on one day and iron-58 on the other. Iron absorption was measured from red blood cell incorporation of the iron stable isotopes 14 days later.
Setting:
Nutrition research institute in a major metropolitan medical center.
Patients:
A total of 25 healthy children, 3 to 6 years of age, were recruited, of whom 21 (11 male and 10 female) completed the study. Intervention Identical meals served with orange juice and apple juice were given on consecutive days, in a balanced randomized design.
Main Outcome Measures:
Iron absorption measured by established stable isotope methods.
Results:
Median iron absorption from the meal ingested with apple juice was 7.17% (mean +/- SD, 9.48% +/- 9.68%). Median iron absorption from the meal ingested with orange juice was 7.78% (9.80% +/- 6.66%; P =.44). Iron absorption from the meal that included apple juice was significantly correlated with serum ferritin concentration (P =.02); iron absorption from the meal that included orange juice tended to correlate with serum transferrin receptor concentration (P =.051).
Conclusions:
As children absorb iron well from a meal that includes either orange or apple juice, a preference for apple juice does not pose a concern with regard to the prospect of iron-deficiency anemia, which remains a significant health problem in the United States.
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