A longitudinal study of fruit juice consumption during preschool years and subsequent diet quality and BMI

Abstract

Background The role of fruit juice in pediatric dietary guidelines continues to be controversial, particularly with respect to concerns about unhealthy dietary habits and the potential promotion of excessive weight gain. The objective of the current study was to determine the association between preschool fruit juice consumption and the following outcomes during childhood and adolescence: whole and total fruit intake, diet quality, likelihood of meeting current dietary recommendations, and BMI change. Methods The data were previously collected from 100 children enrolled in the Framingham Children’s Study at 3–6 years of age and subsequently followed for 10 years. Dietary data were collected annually using multiple sets of 3-day diet records. Compliance with dietary recommendations was estimated based on 2015–2020 Dietary Guidelines for Americans and diet quality was measured using the associated Healthy Eating Index (HEI). Mixed linear and logistic regression models were used for statistical analyses. Results Preschool children (3–6 years) who drank ≥1.0 (vs. < 0.5) cup of 100% fruit juice/day consumed 0.9 cups/day more total fruit (p < 0.0001) and 0.5 cups/day more whole fruit (p < 0.0001) during adolescence (14–18 years). Total HEI scores during adolescence for those with the highest preschool juice intakes were almost 6 points higher than those with the lowest fruit juice intakes (p = 0.0044). Preschoolers consuming < 0.5 cups/day of fruit juice had sharply declining whole fruit intake throughout childhood compared with those preschoolers consuming ≥1.0 cups/day who had stable intakes of whole fruit throughout childhood. Those children who consumed ≥0.75 cups/day of fruit juice during preschool (vs. less) were 3.8 times as likely to meet Dietary Guidelines for whole fruit intake during adolescence (p < 0.05). Finally, in multivariable models, there was no association between fruit juice consumption and BMI change throughout childhood. Conclusion These data suggest that preschool consumption of 100% fruit juice is associated with beneficial effects on whole fruit intake and diet quality without having any adverse effect on BMI during childhood and into middle adolescence.

Fruit Juices: Are They Helpful or Harmful? An Evidence Review

“…A French study found that FJ consumers tended to eat more whole fruits and vegetables than non-consumers and had significantly greater intake of fibre (18.6 g (SEM 0.2) vs. 19.8 g (SEM 0.3) (p value < 0.0001)) [59]. This and other studies [54] suggest that FJ is not replacing whole fruit or vegetables in the diet or being a marker of low fibre intakes; common concerns about FJ consumption.…”

“…In a prospective study of more than 500 British children, no association was found between FJ consumption and body fatness at age 5 or 7 years [53]. A second prospective study followed up 100 US children from the age of 3-6 years, finding that regular FJ consumption was not associated with changes in body mass index but did predict higher whole fruit consumption in adolescence [54]. A third prospective study followed 7301 children aged 9-16 years for two years on average [55].…”

“…The only RCT located tested 480 mL daily for 12 weeks, finding no adverse effects on body weight [50]. The longitudinal study by Wan et al, 2020 found that consumption of 1.5 cups daily (equivalent to 224 mL) was not associated with excess weight gain [54]. The limited evidence from these studies suggests that intakes below 224 mL (8 oz) daily would be appropriate for school-aged children.…”

Fruit Pouch Consumption and Dietary Patterns Related to BMIz at 18 Months of Age

“…The significantly lower mean BMIz at 18 months of the children who consumed fruit juice at least once per week, compared with that of children who did not consume any fruit juice at all, may possibly be explained by a generally healthier diet. This could be viewed as consistent with previous findings that have linked fruit juice consumption to whole fruit consumption [21]. Yet, in this study, there were no association between whole fruit consumption and BMIz or overweight at 18 months of age among children in the NorthPop cohort.…”

“…Fruit juice is an established source of free sugars and considered a potential risk factor of overweight [ 11 , 18 , 19 ]. However, the relationship between fruit juice consumption and body-mass index (BMI) in children is inconsistent [ 20 , 21 , 22 ]. By contrast, whole fruit is thought of as healthy [ 23 ] and consumption is recommended due to its content of nutrients and fibers [ 18 ].…”