Can Consuming Apples or Apple Juice Cause Diarrhea?

Does a link exist between apple juice and diarrhea? Harvard Health Publishing reports that drinking too much of the beverage can result in intestinal complaints. Moreover, the Food and Drug Administration (FDA) warns that drinking unpasteurized fruit juice, including apple juice, can cause symptoms of food poisoning, such as diarrhea.

Apples can cause intestinal problems. (Image: mediaphotos/iStock/GettyImages)

Tip

Drinking excessive amounts of apple juice can cause diarrhea, especially in children.

Apple Juice Sugars and Diarrhea

Harvard Health Publishing explains that natural sugars within food stimulate the intestinal tract to put out electrolytes and water, which loosens the stools. When you consume too much of these sugars, diarrhea can result.

One of the main sugar culprits in apple juice is fructose. In fact, according to gastroenterologist Norton Greenberger, M.D., a professor at Harvard Medical School, "Seventy-five percent of people who ingest more than 40 to 80 grams of fructose per day get diarrhea."

A small April 1989 study of 17 toddlers, published in the European Journal of Pediatrics, isn't a recent investigation; yet, it's worth mentioning because it illustrates how the fructose in apples can lead to diarrhea.

The study states that the sugars sorbitol and fructose in apples aren't completely absorbed in most people, a problem that sometimes culminates in loose stools. When apple juice was removed from the diet of all nine toddlers who had nonspecific diarrhea, the frequency and consistency of their stools became normal.

Boston Children's Hospital agrees that diarrhea in children can arise from an excessive intake of apple juice and other fruit juices with a high content of sorbitol. If a toddler gets diarrhea at the same time table food is introduced into the diet, it indicates the child has difficulty with sugar and starch digestion.

Unpasteurized Apple Juice and Diarrhea

The FDA reports receiving notifications of food poisoning that stem from drinking raw fruit juice and cider that haven't undergone a pasteurization process to kill bacteria. While most people's immunity protects them from becoming ill when they ingest foodborne bacteria, certain segments of the population with weakened immunity are at risk. These include seniors, children, pregnant women and individuals with cancer, diabetes or HIV.

Although most apple juice sold in U.S. supermarkets is pasteurized, some grocers, farmers' markets, juice bars and health food stores sell the unpasteurized variety. The FDA requires these untreated products to carry a warning on the label stating that they're unpasteurized and may cause illness in some people. In contrast, the agency doesn't require labels on juices and cider sold by the glass.

To avoid contracting food poisoning from unpasteurized apple juice, look for the warning label when shopping, recommends the FDA. If you prepare apple juice at home, wash the fruit and your hands thoroughly before juicing.

Aside from diarrhea, foodborne illnesses can cause vomiting, fever and abdominal pain. If you suspect that you or a family member has such an illness, contact your health care practitioner immediately. It's also a good idea to familiarize yourself with food poisoning culprits other than apples.

Apples and Gas

Cleveland Clinic lists apples as one of the foods that can cause gas, which manifests in belching, burping or flatulence. One of the factors leading to gas is the shortage of enzymes that digest sugars, fiber and starches. The sugars of fructose and sorbitol in apples that sometimes produce diarrhea may also cause gas.

Because the fiber in apples and other fruits produces gas, the International Foundation for Gastrointestinal Disorders recommends gradually increasing dietary fiber intake to reduce symptoms.

Be aware that responses to fiber among individuals will vary and that too much fiber may worsen symptoms in some people. Unquestionably, fiber is beneficial for health, but it's best to increase your intake slowly, starting with a small amount.

Apples cause gas because they contain a large amount of substances called fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). Therefore, they're considered "high-FODMAP" fruits.

Doctors in Australia developed the low-FODMAP diet to promote the relief of symptoms associated with gut disorders, says Harvard Health Publishing. If you experience intestinal discomfort from apples, you may want to switch to low-FODMAP fruits such as blueberries, bananas, strawberries, oranges and cantaloupes.

Whole Apples Versus Apple Juice

Apples, like any fruit, are very nutritious, but is apple juice equally healthy? A small study published in the European Journal of Nutrition in December 2013 compared the effects of apples with apple juice in 23 participants.

It concluded that, because the juice is free of fiber, it doesn't have the health benefits of whole apples. Although apple juice is considered a serving in the five-fruits-per-day recommendation, it may not be a suitable substitute for the whole fruit.

The Harvard T.H. Chan School of Public Health agrees with the authors of the European Journal of Nutrition study, stating that fresh, whole apples offer the most nutrients. The pasteurization and filtering process removes most of the fiber and other healthful constituents called flavonoids.

Uses of Apples

Apples stored at room temperature on the counter will last one to two weeks, but the texture may change. If stored in the crisper in the refrigerator, apples will stay good for two months.

The Academy of Nutrition and Dietetics provides tips on how to include more apples in the diet. Add the fruit to your oatmeal or yogurt in the morning. Slice them, and include them in sandwiches to impart pizzazz. Puree apples in a blender to make a sauce to pour over pancakes or grilled meat. Additional healthy apple snacks include pairing apple slices with peanut butter, almond butter or thin slices of cheddar cheese.

Apples are also delicious when featured in salads. Slice apples, fennel and endives and make a vinaigrette with olive oil, vinegar and lemon juice to pour over it. Alternatively, create a Waldorf salad with apples, celery, walnuts and raisins and mix a dressing of lemon zest, mayonnaise and plain yogurt.

USDA's ChooseMyPlate offers still more suggestions. Make a fresh fruit salad by combining apples with other fruit varieties. Whip up a low-calorie dip to make an apple-slice snack more appealing.

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