Effect of Orange and Apple Juices on Iron Absorption in Children

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. Design: On 2 successive days, children consumed identical meals that included apple juice on one day and orange juice on the other, in random order. The meals were labeled with iron-57 on one day and iron-58 on the other. Iron absorption was measured from red blood cell incorporation of the iron stable isotopes 14 days later. Setting: Nutrition research institute in a major metropolitan medical center. 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. Intervention: Identical meals served with orange juice and apple juice were given on consecutive days, in a balanced randomized design. Main Outcome Measures: Iron absorption measured by established stable isotope methods. Results: Median iron absorption from the meal ingested with apple juice was 7.17% (mean±SD, 9.48%±9.68%). Median iron absorption from the meal ingested with orange juice was 7.78% (9.80%±6.66%; P=.44). Iron absorption from the meal that included apple juice was significantly correlated with serum ferritin concentration (P=.02); iron absorption from the meal that included orange juice tended to correlate with serum transferrin receptor concentration (P=.051). Conclusions: 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.