The prevalence of childhood obesity has focused increased attention on food and beverage consumption among children, particularly of sugar-sweetened beverages. Nutrient-dense beverages, such as 100% orange juice, can be part of a healthful diet to promote nutrient adequacy and improved diet quality. In fact, the consumption of 100% orange juice has been associated with improved diet quality and nutrient adequacy in children. Unfortunately, media frequently reports misinformation about 100% orange juice and the sugar naturally present in orange juice, which can cause confusion and uncertainty among parents about the healthfulness of consuming 100% orange juice and its role as part of a healthy, well-balanced diet for children.

Overweight & Obesity

The majority of research shows that there is no association between consumption of 100% orange juice/100% fruit juice and overweight or obesity status, BMI, body fat percentage or waist circumference in children.

Systematic Reviews and Cross Sectional Studies

  • A systematic review of the association between 100% fruit juice intake and weight in children and adolescents reported that after assessing 21 studies, a majority reported no association between 100% juice intake and adiposity—even when juice was consumed in amounts exceeding current recommendations.1
  • In a study of beverage consumption among children ages 6 to 19 years, researchers report no significant association between BMI and the consumption of citrus juice.2
  • In a cross-sectional study using 24-hour diet recalls from NHANES 2003-2006, researchers reported no significant difference in BMI, waist circumference or percentage body fat in children and adolescents who consumed 100% orange juice compared to OJ nonconsumers.3
  • Researchers examined data from NHANES 2003-2006 of children two to 18 years and reported that those who
    consumed 100% orange juice had higher energy intakes than OJ nonconsumers; however, there were no differences in body weight or BMI between these two groups. There was also no significant difference in the risk of being overweight or obese for children who consumed 100% orange juice compared to OJ nonconsumers.4
  • Researchers analyzed data of adolescents aged 12 to 18 years from NHANES 1999-2002 to investigate the associations between 100% juice consumption, nutrient intake and body weight measures. Findings reported no differences in mean weight measures among adolescents consuming 100% juice compared to those not consuming 100% juice.5
  • In a cross-sectional study using data from NHANES 1999-2002 for children ages two to 11 years, researchers reported no association between 100% juice consumption and weight status or the likelihood of being overweight.6
  • Results of a study evaluating beverage intake in school children and adolescents ages seven to 15 years reported that intake of 100% fruit juices was not associated with obesity.7
  • Researchers evaluated beverage intake among preschool children ages two to five years from NHANES 1999-2002 and reported no association between higher 100% fruit juice consumption and BMI.8
  • A study examining 100% fruit juice consumption in children ages 12 to 59 months participating in WIC reported no statistically significant relationships between higher fruit juice intake (≥ 12 ounces/day) and obesity or short stature.9
  • A study of 319 Mexican-American children ages 8 to 10 years living in northern California reported no association between 100% fruit juice intake and obesity.10

Longitudinal Studies

  • Researchers assessed the association between growth parameters and fruit juice intake in preschool children ages 24 to 36 months and reported no statistically significant differences in children’s height, BMI or ponderal index related to fruit juice intake.11
  • A longitudinal study of 72 children ages 2 to 6 years reported no statistically significant associations between juice intake and children’s height, weight or BMI. Researchers also noted that as juice consumption decreased, intakes of less nutritious beverages increased.12
  • The association between the consumption of fruit juice, anthropometric indices and the overal diet was examined during a three-year period in a group of healthy preschool children participating in the Dortmund Nutritional Anthropometrical Longitudinally Designed (DONALD) Study. Growth velocity, BMI and height standard deviation scores were not correlated with fruit juice consumption.13
  • Based on food frequency questionnaires for a large sample (n=14,918) of children and adolescents in the United States from 1996 to 1999, researchers reported no association between intake of 100 percent juices and changes in BMI.14
  • In a longitudinal study using data from the National Heart, Lung and Blood Institute Growth and Health Study for girls ages nine to 19, researchers reported no association between 100% fruit juice consumption and BMI.15
  • In children ages two to five years participating in the North Dakota WIC program, researchers reported no association between fruit juice intake and changes in weight or BMI over a one year period.16

Nutrient Intake and Diet Quality

Scientific evidence supports that consumption of 100% orange juice/100% fruit juice contributes significantly to nutrient intake and can help children meet their fruit intake recommendations as a complement to whole fruit.

  • Researchers evaluated data from NHANES 2003-2006, including children and adolescents ages 4 to 18 years, and reported that fruit servings consumed were positively associated with 100% orange juice consumption, and contributed to helping children and adolescents meet calorie-specific USDA MyPyramid recommendations for fruit. Increased 100% orange juice consumption was also correlated with increased daily intakes of certain micronutrients, antioxidants and phytochemicals.17
  • Researchers examined data from NHANES 2003-2006 of children ages two to 18 years and reported that consumers of 100% orange juice had a higher percentage of the population meeting the EAR for certain nutrients (vitamins A and C, folate and magnesium) and higher intakes of total fruit, fruit juice and whole fruit compared with nonconsumers. One hundred percent orange juice consumers had significantly higher HEI-2005 scores compared to nonconsumers. Researchers concluded that moderate consumption of 100% orange juice should be encouraged in children as a component of a healthy diet.4
  • In a cross-sectional study using data from NHANES 1999-2002, children and adolescents who consumed 100% fruit juice had significantly higher intakes of carbohydrates, vitamins C and B6, folate, potassium, magnesium, and iron and significantly lower intakes of total fat and saturated fatty acids compared to nonconsumers. Children ages two to 11 years who consumed 100% fruit juice also had lower intakes of added sugars and discretionary fat, while adolescents ages 12 to 18 years had higher intakes of fiber compared to nonconsumers. 100% fruit juice consumers in all age groups had higher intakes of whole fruit compared to nonconsumers.5,6
  • Data reporting 100% fruit juice consumption for children and adolescents ages two to 18 years from NHANES 2003-2006 revealed a significantly higher percentage of nonconsumers of 100% fruit juice had intakes below the EAR for vitamins A and C, folate, phosphorus and magnesium, while a greater percentages of children and adolescents who consumed 100% fruit juice exceeded the Adequate Intake (AI) for potassium compared with OJ nonconsumers.18 100% fruit juice consumers also had higher intakes of total and whole fruit, lower intakes of added sugars, and higher total HEI-2005 scores in all age groups.18
  • The CDC analyzed adolescent beverage habits using data from the 2010 National Youth Physical Activity and Nutrition
    Study (NYPANS) and noted that along with water, milk and 100% fruit juices are healthful beverage selections and sources of key nutrients.20

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References

  1. O’Neil CE, Nicklas TA. A review of the relationship between 100% fruit juice consumption and weight in children and adolescents. Am J Lifestyle Med. 2008; 2(4):315-354.
  2. Forshee RA, Storey ML. Total beverage consumption and beverage choices among children and adolescents. Int J Food Sci Nutr. 2003; 54:297-307.
  3. Wang Y, Lloyd B, Yang M, et al. Impact of orange juice consumption on macronutrient and energy intakes and body composition in the US population. Public Health Nutr. 2012; 15(2):2220-2227.
  4. O’Neil CE, Nicklas TA, Rampersaud GC, Fulgoni III VL. One hundred percent orange juice consumption is associated with better diet quality, improved nutrient adequacy and no increased risk for overweight/obesity in children. Nutr Res. 2011; 31(9):673-682.
  5. O’Neil CE, Nicklas TA, Kleinman R. Relationship between 100% juice consumption and nutrient intake and weight of adolescents. Am J Health Promot. 2010; 24(4): 231-237
  6. Nicklas TA, O’Neil CE and Kleinman R. Association between 100% juice consumption and nutrient intake and weight of children aged 2 to 11 years. Arch Pediatr Adolesc Med. 2008; 162(6):557-565.
  7. Papandreou D, Andreou E, Heraclides A, Rousso I. Is beverage intake related to overweight and obesity in school children? Hippokratia. 2013: 17(1):42-46.
  8. O’Connor M, Yang S and Nicklas T. Beverage intake among preschool children and its effect on weight status. Pediatrics. 2006; 11(4):e1010-e1018.
  9. Kloeblen-Tarver AS. Fruit juice consumption not related to growth among preschool aged children enrolled in the WIC program. J Am Diet Assoc. 2001;101:996.
  10. 10. Beck AL, Tschann J, Butte NF, Penilla C, Greenspan LC. Association of beverage consumption with obesity in Mexican American children. Public Health Nutrition. 2014;17(2):338-344.
  11. Skinner JD, Carruth BR, Moran J III, et al. Fruit juice intake is not related to children’s growth. Pediatrics. 1999; 103:58-64.
  12. Skinner JD, Carruth BR. A longitudinal study of children’s juice intake and growth: the juice controversy revisited. J Am Diet Assoc. 2001; 101:432-437.
  13. Alexy U, Sichert-Hellert W, Kersting M, Manz F, Schoch G. Fruit juice consumption and the prevalence of obesity and short stature in German preschool children: results of the DONALD Study. Dortmund Nutritional and Anthropometrical Longitudinally Designed. J Pediatr Gastroenterol Nutr. 1999; 29:343-349.
  14. Field A, Gillman MW, Rosner B, Rockett HR, Colditz GA. Association between fruit and vegetable intake and change in body mass index among a large sample of children and adolescents in the US. Int J Obes Relat Metab Disord. 2003; 27(7):821-826.
  15. Striegel-Moore RH, Thompson D, Affenito SG et al. Correlates of beverage intake in adolescent girls: the National Heart, Lunch and Blood Institute Growth and Health Study. J Pediatr. 2006; 148:183-187.
  16. Newby PK, Peterson KE, Berkey CS, Leppert J, Willett WC, Colditz GA. Beverage consumption is not associated with changes in weight and body mass index among low-income preschool children in North Dakota. J Am Diet Assoc. 2004; 104:1086-1094.
  17. Yang M, Lee SG, Wang Y, et al. Orange juice, a marker of diet quality, contributes to essential micronutrient and antioxidant intakes in the United States population. J Nutr Educ Behav. 2013; 45(4):340-348.
  18. O’Neil CE, Nicklas TA, Zanovec M, Kleinman RE and Fulgoni, III VL. Fruit juice consumption is associated with improved nutrient adequacy in children and adolescents: the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Public Health Nutr. 2012; 12(10):1871-1878.
  19. O’Neil CE, Nicklas TA, Zanovec M, Fulgoni VL 3rd. Diet quality is positively associated with 100% fruit juice consumption in children and adults in the United States: NHANES 2003-2006. Nutr J. 2011; 10:17.
  20. 20. Centers for Disease Control and Prevention. Beverage consumption among high school students – United States, 2010. Morbidity and Mortality Weekly Report (MMWR). 2011; 60(23):778-780.