Nutrition vs. Obesity? How to Give Your Child Fruit Juice Wisely

Based on the results of six studies for children aged 2 and above, there are pros and cons to giving children fruit juice.

(1) It provides nutrients: In general, the reviewed papers support that fruit juice can provide the various nutrients which are beneficial for children.

(2) Relation to obesity: limit the amount to below 12 fl oz per day and avoid giving apple juice. (One study found that the consumption of more than 12 fl oz per day of juice is associated with obesity and being short. The consumption of apple juice is related to obesity, but not other types of juice.)

(3) Think twice about giving children apple juice and grape juice:  It was found that apple juice is associated with obesity, and both apple and grape juice are associated with being short.

(4) Don’t feed your child juice in a baby bottle as it may result in caries. Feeding in a cup may reduce this risk.

(5) Fruit juice is not associated with diarrhea in toddlers and is not associated with less consumption of milk.

Created on November 21 2015 at 08: 00 AM


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Details of Scientific Answers: Click on each bullet to Read References

Pros

References:

1: "Fruit Juice Consumption By Infants And Children: A Review.," Journal Of The American College Of Nutrition, 1996, by BA Dennison. (Citations: 133).

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or “toddler's” diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed > or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.


2: "Association Between 100% Juice Consumption And Nutrient Intake And Weight Of Children Aged 2 To 11 Years," Archives Of Pediatrics, 2008, by TA Nicklas, CE O'Neil. (Citations: 74).

Objective To investigate the associations between 4 categories of daily 100% juice consumption (0 fl oz, > 0 to ≤ 6 fl oz; > 6 to < 12 fl oz; and ≥ 12 fl oz) and nutrient and food group intake and weight in children. Design Cross-sectional study. Setting Secondary analysis of the 1999-2002 National Health and Nutrition Examination Survey data. Participants Children 2 to 11 years of age (N = 3618). Main Exposure Juice consumption. Outcome Measures The association between juice consumption, nutrient intake, food group consumption, and weight status was determined as was the likelihood of overweight with juice consumption. Results Mean daily juice consumption was 4.1 fl oz, which contributed a mean intake of 58 kcal (3.3% of total energy intake). Compared with nonconsumers, the overall nutritional profile of those consuming 100% juice had significantly higher intakes of energy, carbohydrates, vitamins C and B6, potassium, riboflavin, magnesium, iron, and folate and significantly lower intakes of total fat, saturated fatty acids, discretionary fat, and added sugar. Children consuming 100% juice also consumed significantly more servings of total whole fruit than nonconsumers. No significant differences were found in weight status and the amounts of 100% juice consumed. There was no difference in the likelihood of being overweight between juice consumers and nonconsumers. Conclusions On average, children consumed less than the maximum amounts of 100% juice recommended by the American Academy of Pediatrics. One hundred percent juice consumption was associated with better nutrient intake than in the nonconsumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age.


3: "Pacifier Sucking Habit And Associated Dental Changes. Importance Of Early Diagnosis.," Anales De Pediatria (Barcelona, Spain: 2003), 2012, by VV Franco, GB Gorritxo. (Citations: 9).

INTRODUCTION: The non-nutritive sucking habits are a physiological activity during the first months of life of a child, but if they persist afterwards, these habits can affect the development of dental occlusion.The aim of this study was to determine the frequency of past pacifier-sucking habits in a sample of school children and its role in the genesis of dental malocclusion in primary dentition, as well as to follow up these alterations until the next phase of the dentition (mixed dentition). MATERIAL AND METHODS: We performed a longitudinal epidemiological study on a sample of 225 children from age 2 to 10 years in the Basque Autonomous Region.Data were obtained by means of a questionnaire of children habits, filled in by parents, and clinical tests carried out on the children, recording the presence of alterations in dental occlusion, such as anterior open bite and posterior crossbite. RESULTS: We found a significant increase of malocclusion in the primary dentition of children who prolonged the pacifier-sucking habit. If this habit was abandoned early, anterior open bites improved, while posterior crossbites clutch remained or even got worse. CONCLUSIONS: The pacifier sucking habit influences the development of the teeth, thus, it is necessary to detect early changes in order to prevent the establishment of dental malocclusion.


4: "Is Fruit Juice A Nono In Children'S Diets?," Nutrition Reviews, 2000, by RE Doucette, JT Dwyer. (Citations: 7).

In addition to milk and other beverages, juices in reasonable quantities (12 fl oz/day or less) provide nutrients infants need while keeping sugar and food energy intakes adequate.


Cons

References:

1: "Fruit Juice Consumption By Infants And Children: A Review.," Journal Of The American College Of Nutrition, 1996, by BA Dennison. (Citations: 133).

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or “toddler's” diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed > or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.


References:

1: "Excess Fruit Juice Consumption By Preschool-Aged Children Is Associated With Short Stature And Obesity," Pediatrics, 1997, by BA Dennison, HL Rockwell, SL Baker. (Citations: 338).

Background. In a referral population of young children, excessive fruit juice consumption has been reported to be a contributing factor in nonorganic failure to thrive. Objective. To evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood. Design. Cross-sectional study. Setting. General primary care health center in upstate New York. Participants. One hundred sixteen 2-year-old children and one hundred seven 5-year-old children, who were scheduled for a nonacute visit, and their primary care taker/parent were recruited over a 2-year period. Measurements. For 168 children (ninety-four 2-year-old children and seventy-four 5-year-old children), mean dietary intake was calculated from 7 days of written dietary records, entered, and analyzed using the Minnesota Nutrition Data System. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale. Results. The 2-year-old and 5-year-old children consumed, on average, 5.9 and 5.0 fl oz/day of fruit juice and 9.8 and 11.0 fl oz/day of milk, respectively. Nineteen children (11%) consumed ≥12 fl oz/day of juice. Forty-two percent of children consuming ≥12 fl oz/day of juice had short stature (height less than 20th sex-specific percentile for age) vs 14% of children drinking less than 12 fl oz/day of juice. Obesity was more common among children drinking ≥12 fl oz/day of juice compared with those drinking less juice: 53% vs 32% had a body mass index ≥75th age- and sex-specific percentile; 32% vs 9% had a body mass index ≥90th age- and sex-specific percentile; and 32% vs 5% had a ponderal index ≥90th age-specific percentile. After adjustment for maternal height, child age, child sex, and child age-sex interaction, children consuming ≥12 fl oz/day of juice, compared with those drinking less than 12 fl oz/day of juice, were shorter (86.5 vs 89.3 cm and 106.5 vs 111.2 cm for the 2-year-old and 5-year-old children, respectively) and more overweight (body mass index = 17.2 vs 16.3 kg/m2 and ponderal index = 18.4 vs 16.8 kg/m3). Conclusions. Consumption of ≥12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day.


2: "Fruit Juice Intake Is Not Related To Children'S Growth," Pediatrics, 1999, by JD Skinner, BR Carruth, J Moran, K Houck. (Citations: 118).

Background. Excessive fruit juice intake (>12 ounces/day) has been reported to be associated with short stature and obesity in preschool children. Objective. To confirm whether excess fruit juice intake was associated with short stature and obesity in preschool children, we assessed growth parameters and fruit juice intake in 105 white children, ages 24 to 36 months. Methodology. Mothers were interviewed twice by a registered dietitian when children were age 24, 28, or 32 months (interview 1) and when children were age 28, 32, or 36 months (interview 2); interviews were assigned randomly. At each interview mothers provided 3 days of dietary data (one 24-hour recall and a 2-day food record) and the registered dietitian weighed the child and measured his/her height. Dietary data were analyzed using Nutritionist IV software. Each child's body mass index (wt/ht2) and ponderal index (wt/ht3) were calculated for each interview. Growth parameters of children consuming <12 ounces/day 100% fruit juice were compared with those consuming ≥12 ounces/day using the Student's t test, χ2, Fisher's exact test, and mixed model repeated measures analyses (PROC MIXED). Results. Results consistently indicated no statistically significant differences in children's height, body mass index, or ponderal index related to fruit juice intake. Intakes of soda pop were negatively related to intakes of milk and fruit juice although intakes of milk and fruit juice were not related. Conclusions. The consistent lack of relationship between children's fruit juice intake and growth parameters in our study does not support previous recommendations to limit the intake of 100% fruit juice to <12 ounces/day.


3: "A Longitudinal Study Of Children'S Juice Intake And Growth: The Juice Controversy Revisited," Journal Of The Academy Of Nutrition, 2001, by JD Skinner, BR Carruth. (Citations: 101).

Abstract Skinner and Carruth determine associations between children's longitudinal juice intake and growth parameters at age 72 months and determine children's beverage intake patterns over time. The results indicate that children's longitudinal juice intake was not ...


4: "Association Between 100% Juice Consumption And Nutrient Intake And Weight Of Children Aged 2 To 11 Years," Archives Of Pediatrics, 2008, by TA Nicklas, CE O'Neil. (Citations: 74).

Objective To investigate the associations between 4 categories of daily 100% juice consumption (0 fl oz, > 0 to ≤ 6 fl oz; > 6 to < 12 fl oz; and ≥ 12 fl oz) and nutrient and food group intake and weight in children. Design Cross-sectional study. Setting Secondary analysis of the 1999-2002 National Health and Nutrition Examination Survey data. Participants Children 2 to 11 years of age (N = 3618). Main Exposure Juice consumption. Outcome Measures The association between juice consumption, nutrient intake, food group consumption, and weight status was determined as was the likelihood of overweight with juice consumption. Results Mean daily juice consumption was 4.1 fl oz, which contributed a mean intake of 58 kcal (3.3% of total energy intake). Compared with nonconsumers, the overall nutritional profile of those consuming 100% juice had significantly higher intakes of energy, carbohydrates, vitamins C and B6, potassium, riboflavin, magnesium, iron, and folate and significantly lower intakes of total fat, saturated fatty acids, discretionary fat, and added sugar. Children consuming 100% juice also consumed significantly more servings of total whole fruit than nonconsumers. No significant differences were found in weight status and the amounts of 100% juice consumed. There was no difference in the likelihood of being overweight between juice consumers and nonconsumers. Conclusions On average, children consumed less than the maximum amounts of 100% juice recommended by the American Academy of Pediatrics. One hundred percent juice consumption was associated with better nutrient intake than in the nonconsumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age.


References:

1: "Fruit Juice Intake Is Not Related To Children'S Growth," Pediatrics, 1999, by JD Skinner, BR Carruth, J Moran, K Houck. (Citations: 118).

Background. Excessive fruit juice intake (>12 ounces/day) has been reported to be associated with short stature and obesity in preschool children. Objective. To confirm whether excess fruit juice intake was associated with short stature and obesity in preschool children, we assessed growth parameters and fruit juice intake in 105 white children, ages 24 to 36 months. Methodology. Mothers were interviewed twice by a registered dietitian when children were age 24, 28, or 32 months (interview 1) and when children were age 28, 32, or 36 months (interview 2); interviews were assigned randomly. At each interview mothers provided 3 days of dietary data (one 24-hour recall and a 2-day food record) and the registered dietitian weighed the child and measured his/her height. Dietary data were analyzed using Nutritionist IV software. Each child's body mass index (wt/ht2) and ponderal index (wt/ht3) were calculated for each interview. Growth parameters of children consuming <12 ounces/day 100% fruit juice were compared with those consuming ≥12 ounces/day using the Student's t test, χ2, Fisher's exact test, and mixed model repeated measures analyses (PROC MIXED). Results. Results consistently indicated no statistically significant differences in children's height, body mass index, or ponderal index related to fruit juice intake. Intakes of soda pop were negatively related to intakes of milk and fruit juice although intakes of milk and fruit juice were not related. Conclusions. The consistent lack of relationship between children's fruit juice intake and growth parameters in our study does not support previous recommendations to limit the intake of 100% fruit juice to <12 ounces/day.


References:

1: "Fruit Juice Consumption By Infants And Children: A Review.," Journal Of The American College Of Nutrition, 1996, by BA Dennison. (Citations: 133).

The pattern of fruit juice consumption has changed over time. Fifty years ago, orange juice was the major juice produced and it was consumed primarily to prevent scurvy. Now, apple juice is the juice of choice for the under 5 age group. While fruit juice is a healthy, low-fat, nutritious beverage, there have been some health concerns regarding juice consumption. Nursing bottle caries have long been recognized as a consequence of feeding juice in bottles, using the bottle as a pacifier, and prolonged bottle feeding. Non-specific chronic diarrhea or “toddler's” diarrhea has been associated with juice consumption, especially juices high in sorbitol and those with a high fructose to glucose ratio. This relates to carbohydrate malabsorption, which varies by the type, concentration, and mixture of sugars present in different fruit juices. Fruit juice consumption by preschoolers has recently increased from 3.2 to about 5.5 fl oz/day. Consumption of fruit juice helps fulfill the recommendation to eat more fruits and vegetables, with fruit juice accounting for 50% of all fruit servings consumed by children, aged 2 through 18 years, and 1/3 of all fruits and vegetables consumed by preschoolers. Concomitant with the increase in fruit juice consumption has been a decline in milk intake. This is concerning as milk is the major source of calcium in the diet, and at present, only 50% of children, aged 1 through 5 years, meet the RDA for calcium. Studies of newborn infants and preschool-aged children have demonstrated a preference for sweet-tasting foods and beverages. Thus, it is not surprising that some children, if given the opportunity, might consume more fruit juice than is considered optimal. Eleven percent of healthy preschoolers consumed > or = 12 fl oz/day of fruit juice, which is considered excessive. Excess fruit juice consumption has been reported as a contributing factor in some children with nonorganic failure to thrive and in some children with decreased stature. In other children, excessive fruit juice consumption has been associated with an increased caloric intake and obesity. This paper reviews the role of fruit juice in the diets of infants and children and outlines areas for future research. Recommendations regarding fruit juice consumption based on current data are also given.


References:

1: "Excess Fruit Juice Consumption By Preschool-Aged Children Is Associated With Short Stature And Obesity," Pediatrics, 1997, by BA Dennison, HL Rockwell, SL Baker. (Citations: 338).

Background. In a referral population of young children, excessive fruit juice consumption has been reported to be a contributing factor in nonorganic failure to thrive. Objective. To evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood. Design. Cross-sectional study. Setting. General primary care health center in upstate New York. Participants. One hundred sixteen 2-year-old children and one hundred seven 5-year-old children, who were scheduled for a nonacute visit, and their primary care taker/parent were recruited over a 2-year period. Measurements. For 168 children (ninety-four 2-year-old children and seventy-four 5-year-old children), mean dietary intake was calculated from 7 days of written dietary records, entered, and analyzed using the Minnesota Nutrition Data System. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale. Results. The 2-year-old and 5-year-old children consumed, on average, 5.9 and 5.0 fl oz/day of fruit juice and 9.8 and 11.0 fl oz/day of milk, respectively. Nineteen children (11%) consumed ≥12 fl oz/day of juice. Forty-two percent of children consuming ≥12 fl oz/day of juice had short stature (height less than 20th sex-specific percentile for age) vs 14% of children drinking less than 12 fl oz/day of juice. Obesity was more common among children drinking ≥12 fl oz/day of juice compared with those drinking less juice: 53% vs 32% had a body mass index ≥75th age- and sex-specific percentile; 32% vs 9% had a body mass index ≥90th age- and sex-specific percentile; and 32% vs 5% had a ponderal index ≥90th age-specific percentile. After adjustment for maternal height, child age, child sex, and child age-sex interaction, children consuming ≥12 fl oz/day of juice, compared with those drinking less than 12 fl oz/day of juice, were shorter (86.5 vs 89.3 cm and 106.5 vs 111.2 cm for the 2-year-old and 5-year-old children, respectively) and more overweight (body mass index = 17.2 vs 16.3 kg/m2 and ponderal index = 18.4 vs 16.8 kg/m3). Conclusions. Consumption of ≥12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day.


2: "Fruit Juice Intake Is Not Related To Children'S Growth," Pediatrics, 1999, by JD Skinner, BR Carruth, J Moran, K Houck. (Citations: 118).

Background. Excessive fruit juice intake (>12 ounces/day) has been reported to be associated with short stature and obesity in preschool children. Objective. To confirm whether excess fruit juice intake was associated with short stature and obesity in preschool children, we assessed growth parameters and fruit juice intake in 105 white children, ages 24 to 36 months. Methodology. Mothers were interviewed twice by a registered dietitian when children were age 24, 28, or 32 months (interview 1) and when children were age 28, 32, or 36 months (interview 2); interviews were assigned randomly. At each interview mothers provided 3 days of dietary data (one 24-hour recall and a 2-day food record) and the registered dietitian weighed the child and measured his/her height. Dietary data were analyzed using Nutritionist IV software. Each child's body mass index (wt/ht2) and ponderal index (wt/ht3) were calculated for each interview. Growth parameters of children consuming <12 ounces/day 100% fruit juice were compared with those consuming ≥12 ounces/day using the Student's t test, χ2, Fisher's exact test, and mixed model repeated measures analyses (PROC MIXED). Results. Results consistently indicated no statistically significant differences in children's height, body mass index, or ponderal index related to fruit juice intake. Intakes of soda pop were negatively related to intakes of milk and fruit juice although intakes of milk and fruit juice were not related. Conclusions. The consistent lack of relationship between children's fruit juice intake and growth parameters in our study does not support previous recommendations to limit the intake of 100% fruit juice to <12 ounces/day.


3: "A Longitudinal Study Of Children'S Juice Intake And Growth: The Juice Controversy Revisited," Journal Of The Academy Of Nutrition, 2001, by JD Skinner, BR Carruth. (Citations: 101).

Abstract Skinner and Carruth determine associations between children's longitudinal juice intake and growth parameters at age 72 months and determine children's beverage intake patterns over time. The results indicate that children's longitudinal juice intake was not ...


How

References:

1: "Excess Fruit Juice Consumption By Preschool-Aged Children Is Associated With Short Stature And Obesity," Pediatrics, 1997, by BA Dennison, HL Rockwell, SL Baker. (Citations: 338).

Background. In a referral population of young children, excessive fruit juice consumption has been reported to be a contributing factor in nonorganic failure to thrive. Objective. To evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood. Design. Cross-sectional study. Setting. General primary care health center in upstate New York. Participants. One hundred sixteen 2-year-old children and one hundred seven 5-year-old children, who were scheduled for a nonacute visit, and their primary care taker/parent were recruited over a 2-year period. Measurements. For 168 children (ninety-four 2-year-old children and seventy-four 5-year-old children), mean dietary intake was calculated from 7 days of written dietary records, entered, and analyzed using the Minnesota Nutrition Data System. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale. Results. The 2-year-old and 5-year-old children consumed, on average, 5.9 and 5.0 fl oz/day of fruit juice and 9.8 and 11.0 fl oz/day of milk, respectively. Nineteen children (11%) consumed ≥12 fl oz/day of juice. Forty-two percent of children consuming ≥12 fl oz/day of juice had short stature (height less than 20th sex-specific percentile for age) vs 14% of children drinking less than 12 fl oz/day of juice. Obesity was more common among children drinking ≥12 fl oz/day of juice compared with those drinking less juice: 53% vs 32% had a body mass index ≥75th age- and sex-specific percentile; 32% vs 9% had a body mass index ≥90th age- and sex-specific percentile; and 32% vs 5% had a ponderal index ≥90th age-specific percentile. After adjustment for maternal height, child age, child sex, and child age-sex interaction, children consuming ≥12 fl oz/day of juice, compared with those drinking less than 12 fl oz/day of juice, were shorter (86.5 vs 89.3 cm and 106.5 vs 111.2 cm for the 2-year-old and 5-year-old children, respectively) and more overweight (body mass index = 17.2 vs 16.3 kg/m2 and ponderal index = 18.4 vs 16.8 kg/m3). Conclusions. Consumption of ≥12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day.


References:

1: "Excess Fruit Juice Consumption By Preschool-Aged Children Is Associated With Short Stature And Obesity," Pediatrics, 1997, by BA Dennison, HL Rockwell, SL Baker. (Citations: 338).

Background. In a referral population of young children, excessive fruit juice consumption has been reported to be a contributing factor in nonorganic failure to thrive. Objective. To evaluate, in a population-based sample of healthy children, fruit juice consumption and its effects on growth parameters during early childhood. Design. Cross-sectional study. Setting. General primary care health center in upstate New York. Participants. One hundred sixteen 2-year-old children and one hundred seven 5-year-old children, who were scheduled for a nonacute visit, and their primary care taker/parent were recruited over a 2-year period. Measurements. For 168 children (ninety-four 2-year-old children and seventy-four 5-year-old children), mean dietary intake was calculated from 7 days of written dietary records, entered, and analyzed using the Minnesota Nutrition Data System. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale. Results. The 2-year-old and 5-year-old children consumed, on average, 5.9 and 5.0 fl oz/day of fruit juice and 9.8 and 11.0 fl oz/day of milk, respectively. Nineteen children (11%) consumed ≥12 fl oz/day of juice. Forty-two percent of children consuming ≥12 fl oz/day of juice had short stature (height less than 20th sex-specific percentile for age) vs 14% of children drinking less than 12 fl oz/day of juice. Obesity was more common among children drinking ≥12 fl oz/day of juice compared with those drinking less juice: 53% vs 32% had a body mass index ≥75th age- and sex-specific percentile; 32% vs 9% had a body mass index ≥90th age- and sex-specific percentile; and 32% vs 5% had a ponderal index ≥90th age-specific percentile. After adjustment for maternal height, child age, child sex, and child age-sex interaction, children consuming ≥12 fl oz/day of juice, compared with those drinking less than 12 fl oz/day of juice, were shorter (86.5 vs 89.3 cm and 106.5 vs 111.2 cm for the 2-year-old and 5-year-old children, respectively) and more overweight (body mass index = 17.2 vs 16.3 kg/m2 and ponderal index = 18.4 vs 16.8 kg/m3). Conclusions. Consumption of ≥12 fl oz/day of fruit juice by young children was associated with short stature and with obesity. Parents and care takers should limit young children's consumption of fruit juice to less than 12 fl oz/day.



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