wow carbohydrte malabsorbtion associated with increasd physical activity and met

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Consequences of Incomplete Carbohydrate Absorption From Fruit Juice

Consumption in Infants

Conrad R. Cole, MD; Rising, MS, PhD; Fima Lifshitz, MD

Arch Pediatr Adolesc Med. 1999;153:1098-1102.

Background Most infants consume fruit juices by 6 months of age.

However, fruit juices containing sorbitol may be associated with

carbohydrate malabsorption without clinical symptoms. We hypothesized

that increased physical activity and metabolic rate may be associated

with carbohydrate malabsorption.

Methods Physical activity and metabolic rate were determined in 14

healthy infants ([mean±SD] age, 5.1±0.8 months; weight, 7.8±1.1 kg;

length, 67±4.2 cm; and body fat, 26%±5%) for 3 hours in a respiratory

chamber. Seven were fed pear juice, and the other 7 were fed white

grape juice (120 mL) after a 2-hour fast. Pear juice contains

sorbitol and a high fructose–glucose ratio, whereas white grape juice

is sorbitol free and has a low fructose–glucose ratio. Carbohydrate

absorption was determined by breath hydrogen gas analysis. The study

was double-blinded.

Results When compared with the infants without carbohydrate

malabsorption (peak breath hydrogen level <20 ppm above baseline), 5

of the 7 infants fed pear juice and 2 of the 7 infants fed white

grape juice exhibited carbohydrate malabsorption (peak breath

hydrogen level 20 ppm above baseline; P<.01). These infants also

exhibited both increased physical activity (P<.001) and metabolic

rate (P<.05) after juice consumption in comparison with infants with

normal carbohydrate absorption. When grouped according to the type of

juice consumed, only infants fed pear juice exhibited increases in

physical activity (P<.01).

Conclusions Carbohydrate malabsorption is associated with increased

physical activity and metabolic rate in infants. Most of the infants

who had carbohydrate malabsorption consumed pear juice. Therefore,

fruit juices containing sorbitol and high levels of fructose may not

be optimal for young infants.

From the Research Institute, Miami Children's Hospital, Miami, Fla.

http://archpedi.ama-assn.org/cgi/content/abstract/153/10/1098