![]() ![]() ![]() The children were then discharged home and required to fast for an additional 2 hours. Once this portion was consumed, a further 60 mL of the same juice was used to rinse the glass, and the children were encouraged to consume as much of this as possible. They were given a meal of toast with jelly or butter, a choice of a noncitrus fruit, and 60 mL of low-pulp, non–calcium-fortified orange juice (Tropicana Products, Inc, Bradenton, Fla ascorbic acid content, 39 mg/100 mL) or apple juice (Tree Top, Inc, Selah, Wash ascorbic acid content, 1 mg/100 mL), to which 5 mg of aqueous ferrous sulfate enriched in either iron-57 ( 57Fe) or iron-58 ( 58Fe) had been added 12 to 18 hours earlier. Height and weight were measured by standard clinical methods. On the morning of the study, fasted subjects were admitted to the Metabolic Research Unit of the Children's Nutrition Research Center in Houston. As apple juice naturally contains less ascorbic acid, we hypothesized that iron absorption would be higher with orange juice. In this study, we compared the effect of apple juice, vs that of orange juice, on iron absorption in children consuming a meal. Although one study in adults has suggested that iron absorption is lower when apple juice, vs orange juice, accompanies a meal, 16 there are few data available on this important nutrition issue in children. ![]() Substitution of one for the other does not, therefore, change solely ascorbic acid intake. 15 However, apple and orange juices are complex beverages that differ in many ways. Previous studies in children have suggested that ascorbic acid can increase iron absorption from a school breakfast in Peruvian children 14 and from a chocolate-flavored milk drink in Jamaican children. 13 Apple juice contains far less ascorbic acid than orange juice, so this raises the question of whether such a preference adversely affects iron absorption and iron nutrition. A recent US Department of Agriculture study found that children are more likely to consume apple juice than orange juice. 9 - 12Īs children mature, their intake of foods and fruit juices becomes more diversified. Ascorbic acid can significantly increase iron absorption, 6 - 9 while phytate and calcium may inhibit it. 5 In humans, iron absorption can be greatly influenced by the presence of enhancers and inhibitors of iron absorption in the rest of the diet. 3 Iron-deficiency anemia has been associated with lower scores on tests of mental and motor functioning in toddlers 4 and with worse school performance in adolescents. 2 In the United States, it is estimated that 8% of children aged 1 to 5 years are iron deficient. IRON-DEFICIENCY anemia remains the most prevalent nutritional deficiency in the world 1 and affects more than 2 billion people globally. 051).Ĭonclusions As children absorb iron well from a meal that includes either orange or apple juice, a preference for apple juice does not pose a concern with regard to the prospect of iron-deficiency anemia, which remains a significant health problem in the United States. 02) iron absorption from the meal that included orange juice tended to correlate with serum transferrin receptor concentration ( P =. Iron absorption from the meal that included apple juice was significantly correlated with serum ferritin concentration ( P =. Median iron absorption from the meal ingested with orange juice was 7.78% (9.80% ± 6.66% P =. Results Median iron absorption from the meal ingested with apple juice was 7.17% (mean ± SD, 9.48% ± 9.68%). Main Outcome Measures Iron absorption measured by established stable isotope methods. Intervention Identical meals served with orange juice and apple juice were given on consecutive days, in a balanced randomized design. Patients A total of 25 healthy children, 3 to 6 years of age, were recruited, of whom 21 (11 male and 10 female) completed the study. Setting Nutrition research institute in a major metropolitan medical center. Iron absorption was measured from red blood cell incorporation of the iron stable isotopes 14 days later. ![]() The meals were labeled with iron-57 on one day and iron-58 on the other. Objective To measure iron absorption in children from meals containing apple juice or orange juice so as to determine if iron absorption will be greater with orange juice because of its higher ascorbic acid content than apple juice, a noncitrus fruit juice that US children reportedly prefer.ĭesign On 2 successive days, children consumed identical meals that included apple juice on one day and orange juice on the other, in random order.
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