CARBOHYDRATE-ABSORPTION FROM ONE SERVING OF FRUIT JUICE IN YOUNG-CHILDREN - AGE AND CARBOHYDRATE-COMPOSITION EFFECTS

Objectives: To test the hypotheses that: the efficiency of carbohydrat e absorption in childhood increases with age; and decreased carbohydra te absorption occurs more frequently with juices containing more fruct ose than glucose and/or sorbitol than with juices which contain equal amounts of fructose and glucose and are sorbitol-free. Methods: One hu ndred and four healthy children were recruited from the Ambulatory Cen ter at Maimonides Children's Center. They were assigned to one of thre e age groups: approximately 1, 3 and 5 years of age. Each child receiv ed one age-specific dose (by randomization) of one of four juices: a) pear juice which contains fructose in excess to glucose and a large am ount of sorbitol; b) apple juice which is similar to pear juice in its fructose to glucose ratio but contains four times less sorbitol than pear juice; c) white grape juice or d) purple grape juice both of whic h contain equal amounts of fructose and glucose and are sorbitol-free. Breath hydrogen excretion (BH2) was utilized as the index of carbohyd rate absorption. It was measured in fasting children and at 30-minute intervals for 3 hours after drinking the single serving of juice, Mult iple breath hydrogen related parameters were quantified and results we re expressed as: BH2 peak, area under the curve, and degree of carbohy drate malabsorption. After the test, parents completed a questionnaire and recorded signs and symptoms of intestinal malabsorption for 24 ho urs. Results: Pear juice related BH2 levels were significantly higher among children 1 and 3 years of age as compared to the levels achieved after the other juices. Apple juice related BH, levels were significa ntly higher only among the youngest age group of children. There was n o significant difference in carbohydrate absorption among the 5 year o ld children regardless of the juice consumed. Incomplete carbohydrate absorption (BH2 peak above 20 ppm) occurred more frequently after pear juice consumption (84%) than after apple juice (41%) or grape juice ( white 20%, purple 24%) [p<0.05]. Further outcome measures of BH2 excre tion did not elicit differences beyond those detected by the above-men tioned parameters. Parents reported diarrhea in six children after pea r juice, two after apple juice and two after purple grape juice and th ese children had the highest BH2 levels in their respective groups. No other symptoms were reported. Conclusions: The data show that the eff iciency of carbohydrate absorption of one age-specific serving of juic e increases with advancing age of children. Decreased carbohydrate abs orption occurs more often after ingestion of juices that contain more sorbitol, a nonabsorbable sugar and higher concentrations of fructose over glucose than after ingestion of juices which lack sorbitol and co ntain equal amounts of fructose and glucose.