ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720471

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or“toddler's”diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed>or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720475

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

As consumption of dietary fructose and sorbitol increases, the association between consumption of these sugars and gastrointestinal symptoms has been recognized. As a result, studies of fructose and sorbitol absorption and malabsorption have emerged with investigations relying largely on the use of breath hydrogen (H2) measurements. Since these sugars are prevalent in fruit juices, a major dietary staple in the first 5 years of life, an understanding of fructose and sorbitol absorption is particularly important to pediatric health care providers. This review examines fructose and sorbitol absorption in humans, reviewing as well the breath H2 method upon which studies of fructose and sorbitol absorption largely depend.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720469

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

The stomach stores food and starts digesting protein and fat. Lipids, sugars, certain amino acids, and nutrients of high osmolality trigger sensory mechanisms from the intestine which inhibit gastric emptying. Food rich in carbohydrates leaves the stomach slower than protein-rich food, and emptying is slowest after a meal containing lipid. For carbohydrate beverages, the gastric emptying rate is primarily determined by the volume, caloric content, and osmolality of fluid ingested. Gastric emptying rates vary among isocaloric beverages of different type (e.g., sucrose, fructose, galactose) or forms (e.g., maltodextrins, starches) of carbohydrate. For instance, gastric emptying is faster for a fructose solution compared with isocaloric glucose and galactose solutions. A maltodextrin or a sucrose solution empties faster than a glucose solution. This is possibly due to the greater inhibitory feedback associated with the introduction of glucose in the duodenum. In addition, fruit juices contain soluble fibers which further modulate the gastric emptying. Noninvasive methods to study gastric emptying have recently been developed. The pattern of the myoelectric activity of the gastric contraction and the effect of meals on this pattern can now be recorded by cutaneous electrodes. In healthy children ingesting different juices, the myoelectric pattern of the stomach (indicator of the gastric emptying) correlates with the carbohydrate absorption (measured by breath hydrogen excretion). Fast gastric emptying was associated with greater production of breath hydrogen. The malabsorption of juice carbohydrates may in part be related to their effect on gastric motility.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720470

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

Ingestion of fruit juices in which there is an imbalance between glucose and fructose (apple, pear nectar) and the presence of sorbitol is one of the major causes of the syndrome of chronic, nonspecific diarrhea of infancy and childhood. Stools in the condition at time of symptoms are acidic with a pH<5.5, Clinitest positive, but free of blood and white cells. Lactose and sucrose breath hydrogen tests are normal but breath hydrogen is elevated if measured between 60-120 minutes after the offending juice is taken in sufficient quantity to elicit symptoms. Elimination of the offending juices immediately stopped the diarrhea in all of the cases. Three cases are presented documenting the variability of symptoms including one adolescent who became symptomatic while on a fruit and juice diet.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720472

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

The role of the colonic bacterial flora as scavenger of carbohydrate (CHO) in general and that of fruit juice in particular is reviewed. In the large bowel, CHO is fermented to short chain fatty acids (SCFA) and gas. SCFA are not produced in the immediate neonatal period when the fecal flora is still at the first stage of its development. Studies have demonstrated that mature animals have a compensatory response to diarrhea by increasing six times the capacity to absorb fluids in the large bowel compared to the younger animals; furthermore, CHO that arrives in the colon is completely fermented to SCFA while in the younger pigs CHO passes through the colon unchanged. As in the young pigs, a similar situation can occur in young children when a relatively large amount of CHO arrives in the large bowel.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720473

出版商:Routledge    

年代:1996

数据来源: Taylor

摘要:

This paper reviews the history and character of these research requirements, with special emphasis on questions concerning the role of industry in sponsored research. This discussion is becoming more vigorous with each passing year as private investment in research assumes greater importance in the scientific enterprise. I concentrate on issues of industry-supported human use that are on the“cutting edge”of contemporary biomedical ethics. Of special interest are questions about the disclosure of financial arrangements between industry and investigators, such as the nature and amount of capitated remuneration.

ISSN:0731-5724    

DOI:10.1080/07315724.1996.10720474

出版商:Routledge    

年代:1996

数据来源: Taylor