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Children Rate Flavoring Agents Used With Activated Charcoal

Elisabeth Guenther Skokan, MD, MPH; Edward P. Junkins, Jr, MD; Howard M. Corneli, MD; Jeff E. Schunk, MD

Arch Pediatr Adolesc Med. 2001;155:683-686.

Objective  To compare flavoring agents added to activated charcoal (AC) to determine which mixture is most palatable to children.

Design  Healthy volunteers between the ages of 3 and 17 years participated in a prospective masked trial. Five identical pitchers were prepared containing AC alone, AC with chocolate milk, AC with Coca-Cola (Coca-Cola Corp, Atlanta, Ga), AC with cherry-flavored syrup, and AC with sorbitol. Subjects tasted all 5 substances in random order. Children younger than 8 years rated taste on a 10-point Faces Scale. Children 8 years and older used a 100-point visual analog scale to rate taste and, separately, ease of swallowing. All children were asked which mixture was best. Ratings were compared using 1-way analysis of variance, and comparisons for all pairs were made using the Tukey test. P<.05 was considered significant.

Results  Mean age among the 53 children enrolled was 8.3 years; 23 children were younger than 8 years. Girls made up 52% of the group. Taste scores for chocolate milk, Coca-Cola, and cherry-flavored syrup were significantly better than those for no flavoring agent. The scores for ease of swallowing for Coca-Cola, chocolate milk, and cherry-flavored syrup were significantly better than those for either no flavoring agent or sorbitol. When asked to choose a single best flavoring agent, 39% chose chocolate milk, 23% picked Coca-Cola, and 23% chose cherry-flavored syrup.

Conclusion  The addition of chocolate milk, Coca-Cola, or cherry-flavored syrup to AC improves palatability for children and is favored over no flavoring agent or sorbitol.

From the Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine and Primary Children's Medical Center, Salt Lake City.

Corresponding author and reprints: Elisabeth Guenther Skokan, MD, MPH, Division of Pediatric Emergency Medicine, Department of Pediatrics, Primary Children's Medical Center, University of Utah School of Medicine, 100 N Medical Dr, Salt Lake City, UT 84113 (e-mail: eskokan{at}hsc.utah.edu).