The Association Between Sugar-Sweetened Beverage Consumption and Toddler's Diarrhea: A Systematic Review
Notice bibliographique
Résumé
Introduction: Toddler's diarrhea, or Chronic Nonspecific Diarrhea of Childhood (CNSD), is a common functional gastrointestinal disorder in children aged 6 months to 5 years. It is characterized by chronic, loose stools in otherwise healthy, thriving children. While dietary factors are implicated, particularly fruit juice, a comprehensive synthesis of the evidence across all types of sugar-sweetened beverages (SSBs) is lacking. This systematic review aims to evaluate the association between SSB consumption and toddler's diarrhea. Methods: A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for studies published in English. Randomized controlled trials (RCTs), controlled trials, cohort studies, case-control studies, and case series (N≥5) evaluating the association between SSB (including fruit juices, sodas, and other sweetened drinks) consumption and diarrheal outcomes in children aged 6 months to 5 years were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Findings were synthesized narratively. Results: Seventeen studies, comprising six RCTs/controlled trials, six observational studies, and five case series, met the inclusion criteria. The evidence consistently demonstrated a strong association between the consumption of SSBs and toddler's diarrhea. An RCT found that infants consuming apple juice or white grape juice had significantly higher fecal output (3.94 g/kg/h and 3.59 g/kg/h, respectively) and longer diarrhea duration (49.4 hours and 47.5 hours, respectively) compared to those consuming water (2.19 g/kg/h and 26.5 hours) (Valdovinos et al., 2005). Observational studies linked excessive fluid intake, particularly from juice, to increased stool frequency (4-10 stools/day) (Greene and Ghishan, 1983). Breath hydrogen tests confirmed carbohydrate malabsorption (fructose and sorbitol) as a key mechanism (Hyams and Leichtner, 1985; Smith and Lifshitz, 1995). Dietary intervention studies showed that restricting or eliminating SSBs was curative or led to significant symptom resolution in most cases (Hyams and Leichtner, 1985). Beverages with a high fructose-to-glucose ratio and sorbitol content, such as apple and pear juice, were most frequently implicated (Gormally et al., 1997). Discussion: The findings support a multifactorial pathophysiological model where the high osmotic load from poorly absorbed sugars (fructose, sorbitol) in SSBs exceeds the absorptive capacity of a toddler's immature gut. This effect is often compounded by rapid intestinal transit from low-fat diets and high overall fluid volume. The mechanistic principles derived from studies on fruit juice can be logically extended to other SSBs sweetened with high-fructose corn syrup. While some evidence supports dilute juice for rehydration in mild acute gastroenteritis due to palatability, its role is distinct from its causal contribution to chronic functional diarrhea (Freedman et al., 2016). Conclusion: There is strong evidence to support a causal association between the consumption of SSBs and the etiology of toddler's diarrhea. A detailed dietary history focusing on SSB intake is the cornerstone of diagnosis, and dietary modification is the primary, most effective management strategy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,065 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».