Young children who drank one daily serving of 100% fruit juice gained a small but clinically insignificant amount of weight, according to a new meta-analysis.
In older children and teens, there was no association between fruit juice and weight gain, researchers said in the study “Fruit Juice and Change in Body Mass Index: A Meta-Analysis” (Auerbach B, et al. Pediatrics. March 23, 2017, https://doi.org/10.1542/peds.2016-2454).
The nutritional implications of 100% fruit juice have been a source of debate due to the presence of naturally occurring sugars, which are absorbed as glucose and fructose, authors wrote.
The Academy recommends no fruit juice for children under 6 months of age and limiting 100% fruit juice intake to 4-6 ounces per day for children ages 1-6 years and 8-12 ounces per day for those ages 7-18 years. Those recommendations were included in the 2015-2020 Dietary Guidelines for Americans.
Actual mean daily consumption is about 10.6 ounces for children age 2-18 years and 9.9 ounces for children 2-8 years, according to the study.
Researchers aimed to analyze the impact of 100% fruit juice on body mass index (BMI) through a systematic review and meta-analysis of eight prospective cohort studies. They considered 6-8 ounces of 100% fruit juice to be one serving.
Over the course of a year, one daily serving of fruit juice was associated with a 0.003 unit increase in BMI z scores. For children 6 years and under, there was a 0.087 unit increase in BMI z scores, which authors called a “statistically significant association” but “not clinically meaningful.” They said more research is needed to determine if there is a significant impact at the population level.
Some individual studies found a clinically significant weight gain for children under 2 years, which the authors said was “biologically plausible” considering one serving would make up a larger proportion of their caloric intake than for older children.
For children ages 7-18 years, there was no association between fruit juice and BMI z scores. The difference for younger and older children potentially could be linked to the types of juice they drank, according to the study. Younger children tend to drink apple juice while older children tend to drink orange juice, which has a lower glycemic load.
The authors called for randomized, controlled trials to further study the impact of fruit juice on young children. In the meantime, they recommended following the Academy’s guidelines.
The AAP recommendations are being updated but still will include limits on fruit juice intake, according to a related commentary co-written by Stephen R. Daniels, M.D., Ph.D., FAAP, chair of the AAP Committee on Nutrition.
Fruit juice is easy to transport and store, has a long shelf life and is palatable, potentially helping some older children reach their daily fruit intake goals, the authors wrote. However, more research is needed on the impact of different types of juice on weight and dental caries.