Putting a Lid on Juice Drinking

CHICAGO TRIBUNE

If you know about the kids-and-juice controversy among dietitians, pediatricians, parents and producers, then you realize it is one debate getting milked for all it's worth. If you don't know about the juice controversy, chances are you will benefit from understanding it.

That goes for the perspectives of both kids and adults who drink juice. In 1997, research was published in the medical journal Pediatrics showing that excess fruit juice consumption is associated with obesity and short stature in preschool-age children. The study resulted in widespread publicity and media reports about "reducing the juice" for young kids.

No one type of juice was singled out in the 1997 study, conducted by Dr. Barbara Dennison, a pediatrician with the Mary Imogene Bassett Research Institute in Cooperstown, N.Y. Thirty-nine percent drank mixed juice, mostly a vitamin-fortified brand called Juicy Juice; 30% consumed apple juice; 23% favored orange juice; and 7% were grape juice drinkers.

Dennison acknowledged that more research would be necessary to make a stronger link between juice consumption and overweight children. Dennison's study did not analyze and control for the children's entire diets or their physical activity.

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Now come two new salvos in the juice battle. In April, a longitudinal study published in the Journal of the American Dietetic Assn. concludes that consumption of "100% juice" by 2- to 6-year-olds does not directly affect a child's weight or height. It is the only study with long-term juice intake, which allows for a more accurate correlation between juices consumed and children's growth patterns.

Last month, in its Pediatrics medical journal, the American Academy of Pediatrics released its newest policy statement about fruit juice and kids. It recommends limiting juice intake to 4 to 6 ounces per day for 1- to 6-year-olds. For children 7 to 18, the academy suggests limiting intake to 8 to 12 ounces. Previous recommendations were no juice at all for children 6 months or younger 4 ounces daily between 6 and 18 months, 8 ounces up to 2 years old, then about 12 ounces for older kids.

At the heart of the pediatric group's guidelines is concern that "excessive juice consumption is associated with malnutrition, diarrhea, stomach problems and tooth decay." The academy found it necessary this time around to instruct parents not to give juice to infants or toddlers in bottles or cups that allow them to consume easily throughout the day.

The Pediatrics report bothered Jean Skinner, lead author of the study in the Journal of the American Dietetic Assn. and nutrition professor at the University of Tennessee. "Juice is a perfectly nutritious food," Skinner said. "It gets parents asking questions like, 'Should I not give my child juice?' That gets dangerous, especially if the juice is being replaced with other beverages such as carbonated [soft] drinks and other nonnutritious drinks."

Skinner said that if parents choose to limit juice consumption to the pediatricians' standards, they should be just as ardent about replacing the reduced juice with more milk or water. "I would limit carbonated drinks to maybe one a week," she said.

What's helpful is seeing where Skinner agrees with the pediatricians' policy statement. No one is suggesting that kids--or even adults--should be regularly consuming "juice" drinks that are not 100% juice (a detail now required on packaging by the U.S. Food and Drug Administration). Lots of products are available that tout juice concentrations between 5% and 15%; experts say that in most cases, 5% to 15% concentration provides little more nutritional benefit than sugar water or sodas.

"Most people still don't realize the difference between 100% juice products and those with a small percentage of juice," Skinner said. "The nutrition community has a lot of educating to do."

One indicator is whether the drink provides any minimum daily requirement of 2% or greater for any nutritional value. Many pseudo-juice beverages are fortified with vitamin C to meet 100% of the federal dietary guideline, but that is typically the only nutritional claim.

For nutritionist JoAnn Hattner, the juice controversy hinges on one fundamental point. "Don't use juice as a way to quench thirst," said Hattner, a researcher at Stanford University. "That should be water's job for kids and adults." Hattner said juice has too many hidden calories to be consumed in any large amounts.

"People have the misconception that juice doesn't have many calories," she said. 'Very few people drink just 4 ounces of juice," she explained. "That much juice is 60 calories. A small orange is the same number of calories, but you will fill up faster by eating the orange."

Though some studies indicate that certain juices can protect against, say, heart disease or cancer, be careful that juice doesn't add pounds to the same body you are trying to help. Every nutritionist agrees that the whole fruit is superior to juice.

"Only active people with normal weights can afford to drink a lot of juice," Hattner said. "When I see skateboarders having an extra-large drink at the local juice and smoothie bar, I figure they will burn it off. But when I see an overweight mother and overweight child having the same extra-large drinks [on the premise of health], I wish they would split it."

Hattner said the best way to consume juice is to regard it as a sweet treat. She laments that few people use the tiny juice glasses that were staples in the cupboards of our parents and grandparents. She dilutes her own fruit juices with at least as much water and always looks at the nutritional charts available at juice bars to pick the ones lowest in calories and unwanted sugars.

Beware of the juice and smoothie bars that don't use only pure juice or whole fruits. For instance, nonfat frozen yogurt sounds healthful until you discover it can be loaded with sugar.

Another issue, especially for exercisers drinking juice as a way to hydrate after workouts, is the blood sugar super-boost you might inadvertently receive from pure juice. Fruit juices are quickly metabolized in the body. Putting a few ounces of juice in your water bottle for flavor and carbohydrate reloading is a positive step. Guzzling the entire 16-ounce carton is not, Hattner said.

"I have seen it in the lab setting," Hattner added. "We give 8 ounces of juice to a pregnant woman and her baby will kick almost immediately."

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