Excess Fruit Juice Consumption as a Contributing Factor in Nonorganic Failure to Thrive

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Abstract
Objective. To determine whether excessive consumption of fruit juice is a contributing factor in nonorganic failure to thrive in early childhood. Methods. Eight patients, aged 14 to 27 months, referred for failure to thrive were evaluated by medical history, physical examination, and biochemical assessment. Growth patterns were reviewed and anthropometric measurements including skinfold thickness and midarm circumference were obtained. Diet history included 3-day food records and 24-hour diet recalls. An open-ended interview explored factors associated with fruit juice consumption. Breath hydrogen testing of fructose, sorbitol, or fruit juice was performed in three children who had a history of diarrhea or gastrointestinal complaints. Nutritional intervention focused on reducing fruit juice consumption and increasing the energy and nutrient density of the children's diets. Results. In each case, deterioration of weight and linear growth progression coincided with excessive juice consumption. All children exhibited weights Conclusions. These findings indicate that large intakes of fruit juices may displace more calorie- and nutrient-dense foods. Additionally, fructose and sorbitol malabsorption may occur. Excess fruit juice consumption may present a contributing factor in nonorganic failure to thrive.

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