People may be surprised to hear that 100% fruit juice is another type of sugary drink with the same potential harmful effects as soft drinks.
We know that juice drinks contain a lot of sugar and our tendency was to instead recommend only 100% fruit juice for infants and young children. However a study published in the journal Pediatric Obesity in 2015, concluded that the regular consumption of 100% fruit juice at 2 years of age was associated with a higher risk of becoming overweight by 4 years of age as compared to those who infrequently drink or do not drink 100% fruit juice. This is very relevant as we also now recognize that overweight children tend to become overweight adults. So the old assumption that 100% fruit juice is better than soft drinks is now in question.
Intuitively, we may think that 100% fruit juice is healthy and just as good as eating the solid fruit when it comes to counting the daily servings of fruits/vegetables. However eating the solid fruit is actually better than drinking fruit juice. Here are some other relevant facts:
- Fruit juice contains less fiber than the solid fruit so children may not feel as satisfied after drinking juice and still be hungry.
- In fruit juice, sugar is the only source of calories which may still leave a child hungry as compared to ingesting foods with protein and fat.
- Obesity risks may be higher when drinking fruit juice with snacks; after drinking juice children may still be hungry and tend to eat more snacks increasing their overcall calorie intake.
- Fruit juice typically does not include the skin that contains anti-oxidants thought to lower the risk of cancer.
More Facts About Fruit Juice
Fruit juices contain water (mainly), sugars such as sucrose, fructose, glucose, and sorbitol, and a small amount of protein and minerals. While some juices naturally contain high levels of minerals and vitamins, others are fortified with vitamin C. Although drinking juice may have some benefits, there are some potential problems. These include high sugar content that contributes to increased calorie intake and the risk of dental caries, as well as the lack of protein and fiber in juice. Here are some highlights from the latest American Academy of Pediatrics(AAP) policy statement:
- Fruit juice offers no nutritional benefits for infants younger than 1 year of age.
- Fruit juice offers no nutritional benefits over whole fruit and has no essential role in healthy, balanced diets of children.
- One hundred percent (100%) fresh or reconstituted fruit juice can be a healthy part of the diet in children older than 1 year as part of a well-balanced diet (provided that the daily consumption does not exceed the recommended amounts outlined below).
- Fruit drinks are not nutritionally equivalent to fruit juice and should be avoided.
- Juices should not be used to treat diarrhea or dehydration.
- Excessive juice consumption can cause over-nutrition or under-nutrition, diarrhea, flatulence (excessive gas), abdominal discomfort, and tooth decay.
- Provided in the appropriate amounts for a child’s age, fruit juices, are not likely to cause any significant problems.
A Practical Approach
I want to stress that not offering a baby fruit juice is not harmful, yet too much may be, in the long run. From a practical point of view, parents and child caretakers should track and limit fruit juice consumption and as much as possible, offer water and solid fruits instead. Starting this practice early in life can assure that this becomes a life-long healthy habit. Here are the latest AAP recommendations(MAY 2017):
- Juice should not be introduced infants before 12 months of age (note that this recommendation differs from the previous one).
- For children 1- 3 years old, juice intake should be limited to 4 ounces per day
- For children 4 – 6 years old, juice intake should be limited to 4 – 6 ounces per day
- For children 7 – 18 years old, juice intake should be limited to 8 ounces (1 cup) per day.
- Toddlers should not be given juice from bottles or easily transportable covered cups that allow them to consume juice easily throughout the day.
- Juice should not be given at bedtime to toddlers.
- Children should be encouraged to eat whole fruit to meet their recommended daily fruit intake.
- Unpasteurized juices should not be given to infants, children, and adolescents.
- Grapefruit juice should be avoided in any child taking certain medications including: ibuprofen, warfarin, phenytoin, fluvastatin, and amitriptyline. Please speak to your health care provider for more specific details if your child is taking any medication.
Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.