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WHITE GRAPE JUICE LESS LIKELY TO CAUSE RECURRENCE OF DIARRHEA IN INFANTS AND TODDLERS THAN APPLE OR PEAR JUICE

First-of-its-kind study in The Journal of Pediatrics shows better tolerance; less relapse with white grape juice

Miami, FL—Young children tolerate white grape juice significantly better after a bout with diarrhea than either apple or pear juice, according to a study published in this month's issue of The Journal of Pediatrics. The researchers found that during the recovery phase following diarrhea, infants and toddlers who drank one serving of white grape juice produced a third the stool output of those fed the apple juice and a quarter of the output of the pear juice group. Additionally, the apple and pear juice groups experienced a recurrence of loose stools while the grape juice group did not.

"Consuming fluids after acute diarrhea is an important part of the recovery process for young children, and juice is used throughout the world as an excellent adjunct to water for this purpose," explains Fima Lifshitz, M.D., Chief of Nutrition Sciences and Professor of Pediatrics, Miami Children's Hospital. "We carried out a double-blind, randomized study of 60 children with acute diarrhea to determine their ability to tolerate commonly consumed fruit juices and guide our subsequent recommendations to our patients’ parents."

The results were attributed to the juices' different carbohydrate profiles. White grape juice contains no sorbitol, a carbohydrate that is not digested, whereas both apple and pear juice contain significant amounts. White grape juice also has an even balance of fructose and glucose whereas the fructose to glucose ratios of apple and pear are both more than 2:1. This is significant, explain the researchers, because fructose that is not balanced by glucose is also difficult for young children to digest.

"Previous research has shown us that these undigested carbohydrates can cause gas, bloating and discomfort in healthy children at doses they are accustomed to drinking," explains Dr. Lifshitz. "With children whose GI tracts are particularly sensitive—like those recovering from diarrhea—these carbohydrates create even more problems. The undigested carbohydrates in the apple and pear juice groups led to more loose stools and a recurrence of the diarrhea."

The researchers also noted that the study was conducted by giving the children a single serving of juice during the recovery period. The children ranged in age from four to 20 months, with an average age of twelve months. The serving of juice given was one ounce for every four and a half pounds of body weight; for example, a one year old child weighing 22 pounds was given 5 ounces of juice.

"This is the first prospective study that measures the tolerance of children to common juices during the recovery phase," adds Dr. Lifshitz. "We know from previous research that continuous feeding of apple juice in the recovery phase can lead to chronic diarrhea. This study shows that a juice with an even balance of fructose and glucose, and no sorbitol, likely will not have the same effect, making it a good choice for children and babies who are coming off an episode of diarrhea."

Dr. Lifshitz offers the following advice for managing children with acute diarrhea:

1. Bring the diarrhea under control and rehydrate in consultation with the family pediatrician.

2. During the recovery period, water and certain foods can be supplemented with juice that contains no sorbitol and has an even fructose/glucose ratio, such as white grape juice.

3. If diarrhea returns, consult your pediatrician.

The study was supported in part by a grant from Welch Foods, Inc.

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