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New Study of White Grape Juice Could Change Feeding Recommendations for Infants and Toddlers by Pediatricians
NEW YORK, NY (March 8, 1995) – A new clinical study shows that infants and toddlers can digest white grape juice more easily than apple juice. The study, which may have a significant impact on how American parents view "baby’s first juice," showed that infants and toddlers exhibited significantly greater carbohydrate malabsorption when they drank apple juice than when they drank white grape juice.
"Apple juice can be very difficult on the digestive tracts of very young children, yet is more often than not the first juice children receive," says Dr. Fima Lifshitz, author of the study and Chairman of the Department of Pediatrics at Maimonides Medical Center in Brooklyn, New York. "White grape juice, on the other hand, because of its balance of sugars and lack of sorbitol, is more easily digested and a better choice as a ‘first juice’. As children get older and their digestive tracts mature, other types of fruit juice become logical additions to their diet."
The study, published in the March 1995 issue of Pediatrics, the scientific publication of the American Academy of Pediatrics, showed signs of carbohydrate malabsorption in 54 percent of the children who were given age-appropriate servings of apple juice. Conversely, only 19 percent of the infants and toddlers given white grape juice showed signs of carbohydrate malabsorption. Carbohydrate malabsorption has been identified in previous studies as contributing to chronic nonspecific diarrhea (CNSD) in healthy infants and young children.
Study Methodology
Participants were recruited from the Ambulatory Health Center of the Maimonides Medical Center and its affiliated Women, Infants and Children (WIC) program. They included only healthy, non-symtomatic children. Prior to testing, participants fasted for periods of four hours for 6-month old infants and 8 hours for 18-month old toddlers.
Initially, each child was given either apple juice or white grape juice in a double-blinded protocol. The tests were then repeated with the alternate juice between three and fourteen days after the initial test. For breath hydrogen testing, breath samples were obtained at baseline and at 30-minute intervals for 2.5 hours after each juice was ingested. The collected air samples were analyzed for hydrogen content within four to eight hours of collection.
Both collectively and in individual study subjects, breath hydrogen response was lower after white grape juice consumption than after apple juice consumption. This suggests that white grape juice is better absorbed in infants and toddlers, as compared to apple juice.
Sugar Variations in Popular Juices Important
The investigators noted that the observed patterns of white grape and apple juice absorption are consistent with the body of research findings concerning carbohydrate absorption in young children. These data indicate that sorbitol, a sugar alcohol that is naturally present in certain fruits and juices, is poorly absorbed in a young child’s immature gut and can interfere with fructose absorption. White grape juice contains no sorbitol while apple juice contains significant amounts of sorbitol. In addition, fructose absorption is improved when equivalent amounts of glucose are present. Apple juice contains twice as much fructose as glucose, while white grape juice contains more evenly balanced amounts of fructose and glucose. The disproportionate amount of fructose in apple juice is believed to contribute to the incomplete absorption of apple juice observed in the current study. In contrast, the more even balance of fructose and glucose in white grape juice appears to make it much easier for infants and young children to digest and absorb.
Author Concludes White Grape Juice is Preferable
"The differences in the balance of sugars in white grape juice and apple juice is enormous," said Dr. Lifshitz. "White grape juice has a balance of sugars that appears to facilitate absorption, and our data clearly show that the digestion and absorption of white grape juice is more complete than that of apple juice in young children. Given this, I would recommend white grape juice over apple juice as the introductory juice in most infants’ diets."