ESPEYB21 15. Editors’ Choice New Concerns (4 abstracts)
15.6. Consumption of 100% fruit juice and body weight in children and adults: a systematic review and meta-analysis
Nguyen M , Jarvis SE , Chiavaroli L , Mejia SB , Zurbau A , Khan TA , Tobias DK , Willett WC , Hu FB , Hanley AJ , Birken CS , Sievenpiper JL & Malik VS.
JAMA Pediatr 178(3): 237–246 (2024). PubMed: 38227336
In Brief This systematic review collated evidence from prospective cohort studies (PCS) with at least 6 months follow-up and randomized clinical trials (RCTs) to assess the influence of 100% fruit juice on body weight in children and adults. 100% fruit juice intake was associated with higher BMI gain among children and with higher weight gain in adults.
In children, 17 PCS (total 45,851 children) and no RCTs were identified. Each additional serving per day of 100% fruit juice was associated with a 0.03 (95% CI, 0.01–0.05) higher BMI change.
In adults, there were 6 PCS and 19 RCTs (total 268 095). In PCS, each additional serving per day of 100% fruit juice was associated with a 0.21 kg (95% CI, 0.15–0.27) greater body weight gain. The association was significant only among analyses unadjusted for total energy, suggesting that the effect of fruit juice is explained by higher calorie intake. There was no effect on body weight in RCTs, but confidence intervals were wide (mean difference: −0.53 kg; 95% CI, −1.55 to 0.48 kg).
100% fruit juice is widely perceived by the public and even many health professionals as being a ‘healthy food’. Indeed it can count towards one of your recommended ‘5-a-day’ portions of fruit and vegetables. However, its content is high in free (simple) sugars – and other types of sweet drinks are robustly associated with higher weight gain and higher risk of Type 2 diabetes in both children and adults. Hence it has been debated whether there is anything especially healthy about the natural sugar (mostly fructose) released directly from fruit. For comparison, most added (or ‘table’) sugar is sucrose that is extracted from sugar cane or sugar beet, and then refined.
These findings support guidance to limit intakes of fruit juice. While the overall effect sizes on weight and BMI were small, they could add up in individuals with high fruit juice intakes, and contribute significantly to the burden of excess calories at the population level - and sweetened fruit juices are probably even worse. In addition to weight gain, 100% fruit juice may also have adverse effects on blood glucose levels, risk of dental carries, and may lower dietary fibre intake by replacing consumption of whole fruits.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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