“The role of 100% fruit juice in associate with childhood obesity”

 

Advances in Nutrition, Volume 6, Issue 2, 1 March 2015.

“Squeezing Fact from Fiction about 100% Fruit Juice”

By, Roger Clemens, Adam Drewnowski, Mario G Ferruzzi, Cheryl D Toner, Diane Welland.

 

Says, the preponderance of evidence supports the position that 100% fruit juice delivers essential nutrients and phytonutrients.

 

Comprehensive analyses of the evidence by the Academy of Nutrition and Dietetics in 2014, the US Dietary Guidelines Advisory Committee in 2010, and the Australian Dietary Guidelines of 2013 concluded that 100% fruit juice is not related to adiposity in children when consumed in appropriate amounts for age and energy needs.

 

International journal of obesity, London conclude in a research article (Int J Obes (Lond). 2005 Sep; 29 Suppl 2:S54-7) that there is an association between obesity and consumption of soft drinks. Initiatives focusing on reducing the consumption of these drinks may help to prevent a further increase in childhood obesity.

 

WHAT IS A SUGARY DRINK?

A sugary drink is defined as any beverage that has added calories from sweeteners — referred to as “added caloric sweeteners” or “added sugars.” All such sweeteners are considered to be sugar or sugars, regardless of manufacturers’ efforts to disguise them with complicated or atypical terms. Common sugary drinks are regular (non-diet) sodas, sports drinks, bottled teas, fruit-flavored drinks, juice cocktails, vitamin fortified juice drinks, vitamin waters and energy drinks. (Beverages labeled as “juice drink,” “juice beverage” or “juice cocktail” are not 100 percent fruit juice and typically contain added caloric sweeteners.)

 

Sugar drinks has many forms including carbonated beverage, cool drink, cold drink, fizzy drink, fizzy juice, lolly water, pop, seltzer, sweet soda, coke, soda pop, tonic, and mineral.

 

Sugary Drinks & Obesity in Young Children

Increasingly, the obesity epidemic in children is pointing to sugary drinks as a prime source of added calories. Young children are consuming far more calories from sugar-sweetened beverages now than they did 30 years ago and the consumption of these sugary drinks is strongly correlated with weight gain. These beverages are full of empty calories in the form of added sugars and provide little to no essential nutrients. They are linked not only to weight gain, but also to poor diets, poor health and tooth decay in children.

 

So, beverage choices matter from the childhood. For optimal health and growth of the children.

 

Sugary Drinks Are Bad for Children’s Health

There is ample evidence that when children consume sugary drinks, they are at greater risk for being overweight or obese and suffering from the consequences of this added weight. Sugary Drinks Increase Overweight and Obesity Preschoolers who are at risk of being overweight further increase their risk of obesity when they habitually consume sugary drinks. For each additional sugary drink a child consumes per day, his or her risk of obesity increases by an astonishing 60 percent. Children who are already overweight are more likely to remain overweight if they drink sugary drinks every day. The connection between drinking sugary drinks and gaining excess weight is amplified by the fact that liquid calories are not as satisfying as calories from solid food. Research has shown that when we intake calories from a sugary drink, we do not fully compensate for those calories by eating less at the next meal, as we would if those same calories had come from solid food. Consequently, calories from these beverages tend to be “extra” calories that lead to higher total caloric intake and therefore weight gain. Obesity Presents Numerous Health Risks to Children Childhood obesity is strongly associated with grave health risks. Like adults, obese children are more likely to have high cholesterol, high blood pressure and type 2 diabetes — all of which increase their risk for cardiovascular disease.

 

Obese children also suffer more often from sleep apnea, asthma, joint problems, fatty liver, gallstones and acid reflux (heartburn). Obese children are more likely to become obese adults, further increasing their risks for higher rates of type 2 diabetes, heart disease, and some cancers later in life. Profound mental health and quality of life impacts are seen in children with severe obesity. Childhood Obesity by the Numbers Nationwide, obesity rates have more than doubled in children ages 2 to 5 since the 1980s, when those rates were just 5 percent. Today, 10.4 percent of the young children are considered obese. In California, 10.5 percent of children ages 2 to 5 are overweight for their age. Lower-income children under 5 are even more likely to be overweight. Among these children, 17 percent are considered obese, up from 14.6 percent in 1995. Childhood Overweight and Obesity Defined Body mass index (BMI) is a measure calculated using a child’s weight and height to determine childhood overweight and obesity. BMI does not measure body fat directly, but it is a reasonable indicator of body fatness for most children. The 2000 CDC Growth Charts for children more than 2 two years old provide these definitions: Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex. Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex.

 

Little Kids Are Drinking Too Many Sugary Drinks

Children are consuming nearly twice as many calories from sugary drinks today than they did 30 years ago. Sugary drinks now represent the biggest source of added sugar in children’s diets. Of particular concern are consumption patterns for the youngest children — toddlers to preschoolers. A national random sample found that 44 percent of toddlers 1 ½ to 2 years old consume a sugary drink on any given day. Alarmingly, that proportion grows to 70 percent of 2- to 5-year-olds consuming a sugary drink on a typical day. Fewer than half of the sugary drinks consumed by toddlers are carbonated, indicating that caregivers may be unaware that carbonated sugary drinks and non-carbonated sugary drinks are similarly detrimental to children’s health because of their high added sugar content. The L.A. County Health Survey found that 28.6 percent of children 5 and under consumed one or more sodas or sweetened drinks (such as Gatorade, Red Bull or Sunny Delight) per day. This percent grows to roughly 50 percent for African American and Latino children of the same age.

 

TURNING THE TIDE: WE MUST START EARLY!

Learned habits start early and are difficult to undo as children grow. Habits that contribute to excess weight gain, such as consuming sugary drinks, can set a child up for a potential lifelong struggle with excess body weight and the health problems that can come with it. The benefits of reducing sugary drink consumption in childhood are significant. They include lowering BMI, reducing the risk of obesity and improving dietary intake — all of which reduce the risk of diabetes and other health effects of overweight and obesity.

 

100% Fruit Juices

 

100% Fruit Juice: Complementing Whole Fruit in a Healthy Diet

Fruit provides important nutrients for overall health, yet most people fall short of meeting their daily recommended goals of 1-2 cups. As a complement to whole fruit, 100% fruit juice can be a convenient, delicious and nutritious way to squeeze more fruit into the day. And, 100% fruit juice makes it easier to try a variety of colorful fruit as part of a balanced diet throughout the year. So, your favorite fruit is always “in season” when enjoyed as 100% juice!

 

Yet, myths persist that 100% fruit juice is a source of “empty calories.” This tool shares the latest science to provide the whole truth behind the role of 100% fruit juice in a healthy diet.

 

Daily Fruit Recommendations MyPlate.gov fruit recommendations vary by age, gender and physical activity level. Any fruit or 100% fruit juice counts as part of the Fruit Group

 

Children	2-3 years 4-8 years	1 cup 1-1 ½ cups
Girls	9-13 years 14-18 years	1 ½ cups 1 ½ cups
Boys	9-13 years 14-18 years	1 ½ cups 2 cups
Women	19-30 years 31-50 years 51+ years	2 cups 1 ½ cups 1 ½ cups
Men	19-30 years 31-50 years 51+ years	2 cups 2 cups 2 cups

 

Unlike sugar-sweetened beverages, 100% juice has no added sugar. The grams of sugar listed on the Nutrition Facts panels of 100% fruit juice products refer to the naturally occurring sugars found in the fruit from which the juice was squeezed. 100% fruit juice contains those natural fruit sugars along with vitamins, minerals and plant nutrients. As the DGA state: “sugars found naturally in foods are part of the food’s total package of nutrients and other healthful components.

 

Key Message:

100% fruit juice provides nutrition squeezed from whole fruit without added sugars.

It’s important to remind clients to check the label and look for 100% fruit juice to ensure no sugar has been added and to get the most nutrients in every calorie.

 

100% Fruit Juice: Delivering Benefits of Whole Fruit

Like whole fruit, 100% fruit juice contains important vitamins, minerals and plant nutrients, such as polyphenols. And, in some cases, drinking 100% fruit juice may actually provide more of these beneficial polyphenols than eating the fruit. For example, the same polyphenols in Concord grapes are found in 100% grape juice – but the polyphenols in whole Concord grapes are found in the grape’s thick skin as well as its seeds, both of which are generally discarded and left uneaten. To make 100% grape juice, Concord grapes are crushed – skin, seeds and all – and heated to release plant nutrients straight from the grape into the juice. So, drinking 100% grape juice made with Concord grapes makes it easier to enjoy the benefits of these plant nutrients. The implication is not that 100% fruit juice should be consumed exclusively, but rather that both whole fruit and 100% juice contribute to a healthy lifestyle. While eating whole fruit provides fiber – a nutrient lacking in many Americans’ diets – there are benefits to enjoying both whole fruit and 100% juice in a balanced diet to get the most nutrient benefits from fruit.

 

Polyphenols and Health:

Juicy New Research Emerging research is now underway to understand the effect of polyphenols on glucose absorption and carbohydrate metabolism. A review by Haniheva et al explored the effect of certain polyphenols (flavonoids) on carbohydrate metabolism and glucose absorption and found that polyphenols may limit the rate of sugar absorption in the gut. This could mean experiencing less of a “sugar spike” and more sustained energy after consuming certain 100% fruit juices rich in flavonoids versus other sugar-containing beverages. However, science in this area is very preliminary, and more research is needed to understand the impact of 100% fruit juice consumption on carbohydrate digestion, absorption and metabolism in humans.

 

Key Message:

To enjoy all the benefits fruit offers, consume whole fruit and moderate amounts of 100% fruit juice as part of a healthy diet. 100% juice delivers convenient, concentrated nutrients including polyphenols, while whole fruit can be a better source of fiber.

 

100% Fruit Juice: A Nutrient-Dense Beverage

Consuming a variety of fruits and vegetables is a recognized way to maximize the intake of vitamins, minerals and beneficial plant nutrients. 100% fruit juices are key sources of these essential nutrients, and a growing body of evidence suggests certain juices may be linked to specific health benefits. In fact, more than a decade’s worth of research suggests that, thanks to the Concord grape, 100% grape juice can help support a healthy heart.

 

Studies also show the consumption of 100% fruit juice is closely linked to better nutrient intake among children, particularly certain “nutrients of concern” as identified in the 2010 DGA.17-20 In one study of intake among children 2-18 years of age, 100% fruit juice consumption is associated with higher intakes of vitamins A and C, magnesium, folate, phosphorus, and potassium.

 

While 100% fruit juice typically does not contain as much fiber as whole fruit, research suggests drinking 100% fruit juice does not negatively impact dietary fiber intake. An analysis of the 2003-2006 National Health and Nutrition Examination Survey (NHANES) showed that fiber intake among 100% fruit juice drinkers was not lower than non-juice drinkers.

 

Key Message:

Sip your way to essential nutrients. For every calorie, 100% juice packs more nutrition than many other beverage options.

 

100% Fruit Juice and Healthy Weight

The Weight of the Research

You might be aware of increased attention on possible negative aspects of 100% juice. The evidence behind such concerns is scant; in fact, the majority of the scientific evidence suggests that moderate 100% fruit juice consumption is not associated with overweight or obesity in healthy adults and children. In one analysis of NHANES (1999-2002), children and adults who consumed 100% grape juice versus those who did not:

 

• Showed no differences in total energy (calorie) intake, weight, body mass index (BMI) or waist circumference

• Consumed more servings of fruit, and children had lower intakes of added sugar

• Had higher intakes of vitamin C and potassium

 

While a handful of studies has noted possible associations between juice consumption and overweight and obesity, there are challenges with interpreting the data and applying the results for public health. For example, some of the studies did not distinguish between 100% juice and other fruit drinks, or were done with a smaller, more regional scope.

 

Filling Facts on 100% Juice

The role of foods and beverages on satiety and their impact on weight management is an area of evolving research. While some research indicates beverages have less of an impact on satiety than eating solid foods, other data suggest that, as with solid foods, the satiety response is dependent on a number of factors such as the volume consumed, the proximity to other foods consumed and the composition of the beverage.

 

One study by Hollis, Mattes and colleagues found that consuming a polyphenol free, grape-flavored, sugar sweetened beverage resulted in a reported reduction in fullness, as well as moderate but significant weight gain, whereas drinking Concord grape juice was not associated with significant changes in appetite, weight or increased energy intake. In fact, in this research, drinking Concord grape juice was associated with reduced waist circumference.

While intake of nutrient-dense foods is an important part of a healthy diet, one mustn’t forget the critical need to balance calories. No matter how healthy the food, when energy (calorie) intake exceeds energy expenditure, the result is weight gain.

 

“The overwhelming volume of scientific evidence suggests that there is no systematic association between consumption of 100% fruit juice and obesity using a variety of study, populations and a variety of measures of adiposity.”

Carol E. O’Neil, PhD, MPH, RD, LDN

 

 

Key Message:

No single food or beverage is responsible for the obesity epidemic. People should feel good about drinking 100% fruit juice in moderation, as the weight of the evidence shows that 100% fruit juice is not associated with overweight or obesity in healthy adults and children.

 

100% Fruit Juice in a Healthy Diet: Voices from Leading Health Experts

Registered dietitians and other health professionals recognize the value of 100% fruit juice as part of an overall healthy diet. As the 2010 Dietary Guidelines Advisory Committee stated: “When consumed in moderation as part of a nutrient-rich, energy balanced diet, 100% juice can be a healthy part of a child’s diet.”

 

According to a national survey of registered dietitians, 100% fruit juice is among the top beverages they would recommend to their clients (adults and children), in addition to water, milk and vegetable juice, yet only 60% of Americans consume 100% fruit juice at least once in an average two-week period.

 

American Academy of Pediatrics Daily Recommendations for 100% Juice AAP states that moderate consumption of 100% fruit juice can be part of a healthy diet and can help people meet their daily goals for fruit intake

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Ages 0-6 months avoid 100% juice

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Ages 1-6 years limit to 4-6 ounces

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Ages 7-12 years up to 12 ounces

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“Drinking 100% fruit juice is an effective, convenient and delicious way to increase fruit intake. It also gives a nutrition and flavor boost to recipes, such as spritzers, salad dressings and even entrees.”

Wendy Jo Peterson, MS, RD, CSSD

 

“Enjoying a healthy lifestyle means balancing a variety of options. When whole fruit isn’t readily available or desired, 100% fruit juice is a convenient, delicious and nutritious way to get more fruit. And, whether you’re choosing whole fruit or fruit juice, serving size matters.”

Robyn Flipse, MS, MA, RDN