A study suggests that fruit juice is linked to some -- but not significant -- weight gain in early childhood
"It's very easy to drink a lot of calories. ... That's where the concern has historically been with juice," one expert says
Sugar can easily sneak into the diet, both for you and for your child, even through 100% fruit juices.
Many health experts have even expressed concerns that the content of naturally occurring sugars in such juices can have negative health effects on children, such as increasing the risk for obesity.
The relationship between 100% fruit juice consumption and weight gain has been analyzed in a study published in the journal Pediatrics on Thursday.
The study suggests that drinking 100% fruit juice is associated with a slight amount of weight gain in children 6 and younger who have one serving a day, but no association was found for children 7 and older who have one serving a day.
Yet the study has some limitations, and it recommends drinking 100% fruit juice only in moderation.
“I think caution is definitely in order and that when possible, parents should give whole fruit to kids, instead of fruit juice,” said Dr. Brandon Auerbach, a primary care physician and instructor at the University of Washington’s Division of General Internal Medicine in Seattle. “Water or low-fat unsweetened milk are other good alternatives to 100% fruit juice.”
Auerbach, lead author of the new study, said he is the parent of a 7-month-old boy who soon may be offered fruit juices in day care and at school.
“I share the concern that 100% fruit juices have a lot of sugar, even though it’s naturally occurring sugar,” he said. “There are other health concerns about drinking 100% fruit juice, besides weight gain, especially related to risk of cavities and risk of future metabolic syndrome or diabetes.”
Younger children may face weight gain risk
The analysis showed that consuming 100% fruit juice was slightly associated with weight gain in children 1 to 6 years old, but not enough to potentially harm health, Auerbach said.
The researchers found that in children ages 1 to 6, consumption of one daily serving was associated with a weight gain of 0.3 pounds or less over one year. In children 7 and older, 100% fruit juice was not independently associated with any weight gain.
“While the amount of annual weight gain may be small … two points should be made,” said Dr. Dean Schillinger, a professor of medicine at the University of California, San Francisco, who was not involved in the study.
“For a 5-year-old, 40-pound girl, consuming 4 to 8 ounces of 100% fruit juice daily for a year will be associated with her gaining an extra quarter-pound, compared to if she had not been drinking that juice,” he said, adding that “the effect of daily consumption appears to be amplified the longer a young child is exposed to daily fruit juice. Consuming fruit juice daily for two years was associated with a significantly greater amount of weight gain.”
In other words, the data did not show that gaining a quarter-pound due to drinking fruit juice over two years resulted in a half-pound weight gain. Rather, there appeared to be a risk of much greater weight gain with prolonged fruit juice drinking, Schillinger said of the study.
“This study determined that the individual effect on obesity was ‘clinically small.’ However, they acknowledge that, from a population health standpoint, such small changes may, in fact, have important public health implications with respect to the obesity and diabetes epidemics,” he said. “The evolving consensus is that children should not be exposed to fruit juices, especially in the first 6 years of life.”
The researchers also wrote that although the estimate of weight gain in younger children, 2 to 6, was not clinically significant, individual studies in the analysis showed clinically significant weight gain in children younger than 2.
Supporting national guidelines
Overall, the study results showed that one daily 6- to 8-ounce serving increment of 100% fruit juice was associated with a small .003 unit increase in body mass index over one year in children of all ages.
“I was somewhat surprised by the results, given that some types of 100% fruit juice have comparable amounts of sugar as regular soda,” Auerbach said.
He added, however, that the study certainly had some limitations.
“Although we combined evidence from the best available research, the studies were not randomized controlled trials,” Auerbach said. “We did not examine other important health outcomes besides weight gain, such as diabetes risk, because too few studies exist on this topic in children.”
Also, two studies included in the meta-analysis found significant amounts of weight gain in children ages 1 to 3 associated with drinking one serving of 100% fruit juice a day, Auerbach said.
“It may be possible that this age group is at higher risk for weight gain from drinking 100% fruit juice than older children,” he said.