Too Much Juice?

It is a common request from young children--they want juice, not milk, not water, juice! While juice can be refreshing and tasty, drinking too much is not a good idea. Juice can displace healthier foods in a child's diet, cause diarrhea and tooth decay, and may contribute to childhood obesity. However, with a little knowledge, juice can be made a part of a healthy diet.

Problems Associated with Too Much Juice

Obesity The link between juice intake and obesity is somewhat controversial. There have been research studies linking increased juice consumption by children (more than 12 ounces a day) with obesity. Other studies have failed to show this association. Research on adults reveals that our bodies adjust to increases in calories from solid foods, but not from liquid foods. For example, when adults were fed jelly beans in one study, they made up for the extra calories by eating less later in the day. But when they were fed the same number of calories in liquid form, they did not make up for it by eating less later.

Whether or not an association between juice and obesity exists, excess calories add up to weight gain, and calories from juice add up quickly. An eight-ounce glass of orange juice contains approximately 120 calories, while a whole orange has about 60 calories and contains fiber. The whole orange takes longer to eat and is more filling than the orange juice and has half the calories. In addition, you may "guzzle" a glass of juice and fill it right back up, or pour more than eight ounces in the first place, further increasing the calories from juice.

Displacement of More Nutritious Foods

Another problem with significant juice intake is that it often displaces other, more nutritious foods and beverages. Children who fill up on juice may not be hungry for protein or calcium-rich foods, namely milk. Milk consumption is important, since many children do not meet their recommended calcium needs during the critical years of bone growth and development.

Children described as picky eaters should have their juice intake evaluated. Often, the cure to getting a picky eater to eat more is simply cutting back her juice consumption so she is hungry for other foods.

The 5-A-Day campaign, which encourages all Americans to increase their fruit and vegetable consumption, recommends children consume at least two servings of fruit a day. Unfortunately, it has been estimated that more than 50 percent of the fruit young children consume is in the form of juice. When compared to fresh fruit, juice lags far behind nutritionally. While 100 percent fruit juice does contain some vitamins and minerals, it has far less than whole fruit; and juice contains none of the beneficial fiber of whole or fresh fruit.

A Cause of Diarrhea

Juice is mostly sugar. It takes roughly eight apples (and their naturally occurring sugar) to make one glass of apple juice. Young children often are unable to completely absorb this amount of sugar, making it a leading cause of diarrhea. This problem decreases with age, so one-year-olds are more likely to get diarrhea from juice than three- to five-year-olds.

Tooth decay The high sugar content of juice also places infants and children at risk for tooth decay. Babies who are permitted to take a bottle of juice to bed are at the greatest risk because of the increased time the juice is in contact with the enamel of their teeth.

Incorporating Juice into a Healthy Diet

When juice is offered to a child, it is important to make sure it is 100 percent fruit juice. While still inferior to fresh fruit, 100 percent fruit juice has more vitamins and minerals that fruit drinks made with only small amounts of fruit juice. Many parents and caregivers confuse 100 percent fruit juice with "fruit drinks," so read labels carefully and look for the words "100 percent fruit juice." Avoid beverages referred to as fruit drink, punch, or juice blends. Keep in mind that a juice drink that contains 10 percent fruit juice has less than two tablespoons of juice per cup.

It also is important to select juice that has been pasteurized. Raw apple juice or cider, sometimes referred to as "fresh" apple juice or "fresh" cider, has been identified as a source of bacterial contamination. Because children are the main consumers of apple juice and are at high risk of developing infections from contaminated juice, raw apple cider/juice should be avoided. The government as well as many orchards have taken steps to assure the safety of raw cider/juice that is offered to the public, but the best prevention is to avoid it all together. Parents and caregivers should only offer children juice that has been pasteurized. Again, reading labels is essential. Look for the word "pasteurized" on any juice being offered to a child.

Juice Guidelines

Use these guidelines to help you incorporate juice into a healthy diet:

• There is no need to hurry to introduce juice to infants; wait at least until they can drink from a sippy cup (around nine months). In fact, recent research indicates that an infant who eats strained baby foods does not need juice for the first year of life.
• Avoid giving juice in a bottle at any time.
• Keep portion control in mind; limit juice to three ounces a day for babies, and four-eight ounces a day for children. Buy small juice boxes to help keep portion sizes small.
• Always make fresh fruit available as an alternative to juice. Fruit is a great thirst quencher and packed with nutrients.
• Be sure children are drinking adequate amounts of milk.
• When offering juice, make sure it is 100 percent fruit juice; read the label and avoid juice "drinks," "punch," or "blends."
• Offer pasteurized juice only; look for the word "pasteurized" on the label.
• Consider diluting juice; mix it with regular or sparkling water. This is a great way to reduce juice intake gradually and get children accustomed to unsweetened drinks. Simply mix more water with less juice each time.
• Be a positive role model; if children see you quenching your thirst with water or a piece of fresh fruit, they are likely to do the same!

Mollie Aby-Valestrino, RD, Pediatric Dietitian,
Miller Children's Hospital, Long Beach, CA

Resources

The Dole Nutrition Program offers a free How'd You Do Your 5 A Day? chart (with quantities available for each child) by faxing or writing (on your letterhead including your program's name, your name, and telephone number) to:

Internet Resources

About.com, pediatrics.about.com/cs/nutrition/a/fruit_juice.htm

Baylor College of Medicine, www.kidsnutrition.org/consumer/archives/sorbitol.htm

Centers for Disease Control and Prevention, www.cdc.gov/nccdphp/dnpa/5aday

National Cancer Institute, www.5aday.gov

Produce for Better Health Foundation, www.5aday.com