Consumption of 100% fruit juice remains controversial for its potential adverse impact on weight and displacement of essential foods in the diets of children. A systematic review of the literature published from 1995-2013 was conducted using the PubMed database to evaluate associations between intake of 100% fruit juice and weight/adiposity and nutrient intake/adequacy among children of 1 to 18 years of age. Weight status outcome measures included body mass index (BMI), BMI z-score, ponderal index, obesity, weight gain, adiposity measures, and body composition. Nutrient outcome measures included intake and adequacy of shortfall nutrients. Data extraction and analysis was conducted according to the Academy of Nutrition and Dietetics Evidence Analysis Process. Twenty-two studies on weight status provided evidence that did not support an association between 100% fruit juice consumption and weight/adiposity in children after controlling for energy intake. Limited evidence from eight studies suggests that children consuming 100% fruit juice have higher intake and adequacy of dietary fiber, vitamin C, magnesium, and potassium. Differences in methodology and study designs preclude causal determination of 100% fruit juice as sole influencer of weight status or nutrient intake/adequacy of shortfall nutrients. In context of a healthy dietary pattern, evidence suggests that consumption of 100% fruit juice may provide beneficial nutrients without contributing to pediatric obesity.

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Objective: Glycaemic index (GI) reflects the postprandial glucose response of carbohydrate-containing foods. A diet with lower GI may improve glycaemic control in people with diabetes. The purpose of the present study was to evaluate the change in outcomes following a behavioural intervention which promoted lower-GI foods among adults with diabetes. Design: A pre-test-post-test control group design was used with participants randomly assigned to an immediate (experimental) or delayed (control) treatment group. The intervention included a 9-week, group-based intervention about carbohydrate and the glycaemic index. Dietary, anthropometric and metabolic measures were obtained pre/post-intervention in both groups and at 18-week follow-up for the immediate group. Setting: The study was conducted in a rural community in the north-eastern USA. Subjects: Adults having type 2 diabetes mellitus for $1 year, aged 40-70 years and not requiring insulin therapy (n 109) were recruited. Results: Following the intervention, mean dietary GI (P , 0?001), percentage of energy from total fat (P , 0?01) and total dietary fibre (P , 0?01) improved in the immediate compared with the delayed group. Mean BMI (P , 0?0001), fasting plasma glucose (P 5 0?03), postprandial glucose (P 5 0?02), fructosamine (P 5 0?02) and insulin sensitivity factor (P 5 0?04) also improved in the immediate group compared with the delayed group. Mean waist circumference among males (P , 0?01) and body weight among males and females (P , 0?01) were significantly different between treatment groups. Conclusions: Educating clients about carbohydrate and the glycaemic index can improve dietary intake and health outcomes among adults with type 2 diabetes. Keywords Nutrition assessment Glycaemic index Glycaemic load Patient education Type 2 diabetes mellitus Randomized controlled trialDiabetes affects approximately 9?3 % of the US population (1) , and the number of people diagnosed with diabetes is projected to increase by 198 % in 2050 (2) . In people aged 35-64 years in the USA, excess mortality attributable to diabetes was 6-27 % in 2000 (3) . The need for effective strategies for managing diabetes and the subsequent sequelae are imperative.Glycaemic index (GI) classifies carbohydrate-containing foods according to their glucose-raising potential, while glycaemic load (GL) reflects the total glycaemic effect of the diet (4,5) . GL can be lowered by reducing the amount of carbohydrate consumed, by choosing foods with lower GI, or by a combination of approaches. A diet with lower GI or GL may improve outcomes among people with diabetes (6) . GI may play a role in preventing or treating type 2 diabetes by decreasing the risk for obesity or by altering metabolic endpoints (7,8) . Improvements in glycaemic control were observed in people with diabetes in a recent meta-analysis (9) . A lower-GI diet was shown to decrease

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Carbohydrate-restricted diets have been shown to enhance satiation- and other homeostatic-signaling pathways controlling food intake and energy balance, which may serve to reduce the incidence of obesity and metabolic syndrome. This study was designed as a correlational, observational investigation of the effects of a carbohydrate-restricted diet on weight loss and body fat reduction and associated changes in circulating leptin, insulin, ghrelin, and cholecystokinin (CCK) concentrations in overweight/obese patients (4 men and 16 women) with metabolic syndrome. Subjects received clinical instruction on the initiation and maintenance of the commercial South Beach Diet, consisting of 2 phases: Phase I (initial 2 wk of the study) and Phase II (remaining 10 wk). Participants showed a decrease (P < 0.05) in body weight (93.5 +/- 3.6 kg vs. 88.3 +/- 3.4 kg), BMI (33.9 +/- 1.3 kg/m(2) vs. 32.0 +/- 1.3 kg/m(2)), waist circumference (112.8 +/- 2.8 cm vs. 107.7 +/- 3.0 cm), and total percent body fat (40.2 +/- 1.5% vs. 39.2 +/- 1.5%) by study completion. Plasma fasting insulin and leptin concentrations decreased significantly from baseline concentrations (139.1 +/- 12.2 pmol/L and 44.1 +/- 4.5 microg/L, respectively) by the end of Phase I (98.6 +/- 2.6 pmol/L and 33.3 +/- 4.1 microg/L, respectively). Plasma fasting ghrelin concentrations significantly increased from baseline (836.7 +/- 66.7 ng/L) by Phase II (939.9 +/- 56.8 ng/L). The postprandial increase in plasma CCK concentrations (difference in plasma CCK concentrations from fasting to postprandial) after Phase I (2.4 +/- 0.3 pmol/L) and Phase II (2.5 +/- 0.4 pmol/L) was significantly greater than the postprandial increase at baseline (1.1 +/- 0.5 pmol/L). Collectively, these results suggest that in patients with metabolic syndrome, improved adiposity signaling and increased postprandial CCK concentrations may act together as a possible compensatory control mechanism to maintain low intakes and facilitate weight loss, despite an increase in fasting ghrelin concentrations and subjective measures of hunger.