Abstract
Apple juice (AJ) is a popular drink in toddlers. Due to the wide-spread belief that it has an anti-diarrhoeal effect, it frequently is advocated in case of chronic diarrhoea. Recently, however, it has been suggested that AJ promotes diarrhoea in toddlers either due to fructose (F) or to sorbitol (S). AJ contains about 60g/l of F, 20g/l of glucose, and possibly up to 10g/l of S. Aim of this study was to investigate the incidence of incomplete absorption of AJ carbohydrates and to identify the responsible carbohydrate, using breath hydrogen (BH) tests. Methods. We studied 10 children, 7 without and 3 with chronic nonspecific diarrhoea (CNSD), all AJ consumers, ages l-4½y. BH tests were done with 150-250ml of AJ. In 7 (2 CNSD), tests were repeated with F (10g); in 4/7 (1 CNSD) also with S (5g). BH increase >10ppm indicated positive (+ve) tests. Results. AJ tests were +ve in 5/7 controls (20-55ppra) and in all 3 CNSD patients (42-69ppm). In addition, 2/5 controls and 2/2 CUSD patients had +ve F tests (16-55ppm). The 3 controls with negative F tests had +ve S tests (16-29ppm); one CNSD patient had a negative S test. Actual S content of AJ (assessed by GLC) was 4.3g/l. In the CNSD patients, stools became normal after AJ elimination. Conclusions. These results indicate that AJ absorption frequently is incomplete in toddlers and may result in CNSD, and that neither F nor S can be held solely responsible for this phenomenon.
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Kneepkens, C., Douwes, A., Van Der Klei-Van Moorsel, J. et al. APPLE JUICE: INCOMPLETE ABSORPTION, BUT OF WHICH CARBO HYDRATE?. Pediatr Res 20, 697 (1986). https://doi.org/10.1203/00006450-198607000-00074
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DOI: https://doi.org/10.1203/00006450-198607000-00074