Consumption of 100% Fruit Juice and Body Weight in Children and Adults

Nguyen, Michelle; Jarvis, Sarah E.; Chiavaroli, Laura; Mejia, Sonia Blanco; Zurbau, Andreea; Khan, Tauseef A.; Tobias, Deirdre K.; Willett, Walter C.; Hu, Frank B.; Hanley, Anthony J.; Birken, Catherine S.; Sievenpiper, John L.; Malik, Vasanti S.

doi:10.1001/jamapediatrics.2023.6124

Cited by 9 publications

(4 citation statements)

References 77 publications

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“…Furthermore, the first item of the questionnaire is unable to distinguish between fresh fruit and fresh fruit juice. While for the former plenty of consumption is recommended by worldwide food and health organizations [ 99 ], for the latter a recent meta-analysis suggests reducing consumption to limit excessive calorie intake and prevent weight gain [ 100 ]. From this perspective, it is desirable to develop a more detailed tool able to discriminate the two types of products.…”

Section: Discussionmentioning

confidence: 99%

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

Franchini,

Biasini,

Sogari

et al. 2024

Nutr J

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Background Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors. Methods MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed. Results A sample of 1485 participants (median (IQR) age 21.0 (19.0–22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen. Conclusions Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

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Section: Discussionmentioning

confidence: 99%

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

Franchini,

Biasini,

Sogari

et al. 2024

Nutr J

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“…This baseline understanding of non-taxable SSB consumption is an important contribution to the literature as it may inform future changes to the SSB tax legislation that may capture a broader array of less healthy beverages. Globally, most SSB taxes do not apply to these beverages (4), and this may be for several reasons: rst, evidence of the potential negative health impacts of 100% fruit juice consumption is mixed (27)(28)(29), though the most recent evidence suggests a moderate association between juice consumption and metabolic disorder, particularly among children (29); second, consumption of sweetened milks may have a modest association with increased adiposity and weight gain, but may also contribute to consumption of vitamin D and calcium (and other micronutrients depending on forti cation policies in different jurisdictions), which are both public health nutrients of concern (30). SSBs prepared at point-of-purchase (e.g.…”

Section: Discussionmentioning

confidence: 99%

Beverage consumption among adults in Newfoundland and Labrador, Canada prior to the implementation of a sugar-sweetened beverage tax

Zaltz,

Prowse,

et al. 2024

Preprint

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Background Lawmakers in Newfoundland and Labrador (NL) recently passed Canada’s first sugar-sweetened beverage (SSB) tax. SSB tax evaluations rely on detailed understandings of beverage consumption patterns prior to policy implementation, but there is no recent literature about such patterns among NL residents during the pre-tax period. Methods We recruited a convenience sample of NL adults ages 19 and older and measured participant characteristics via online surveys and beverage intake via previously-validated, semi-quantitative beverage frequency questionnaires. We described the prevalence and mean intake of taxable SSBs, non-taxable SSBs, unsweetened beverages, and diet (non-nutritive sweetened) beverages. We explored bivariate associations between consumption of these beverages and sociodemographic characteristics identified as potential correlates of SSB intake. Results The sample (n = 1233) was 65% female, 57% between ages 30–59 years, and nearly all (94%) white. More than half (56.4%) consumed taxable SSBs weekly, and 63.3% consumed non-taxable SSBs weekly. The most-consumed taxable SSB was regular pop (mean (SD) 2092 (3120) mL/week); the most-consumed non-taxable SSB was coffee with added milk or sugar (mean (SD) 3859 (2895) mL/week). The prevalence of consuming taxable SSBs decreased with increasing age (18-30y 73%, 30-44y 65%, 45-59y 50%, 60y + 43%, p < 0.001), and was higher among males (60% vs. 54%, p = 0.04) and those reporting food insecurity (64% vs. 51%, p < 0.001). The prevalence of unsweetened beverage consumption was higher among those with more education (high school 81%, some post-secondary 88%, post-secondary or more 96%, p < 0.001), those working vs. not (92% vs. 87%, p = 0.006), and those above the poverty threshold (93% vs. 84%, p < 0.001). Weight status was only associated with diet beverage consumption (overweight/obese 54%, not overweight/obese 35%, p < 0.001). Conclusions Our findings align with prior studies of socioeconomic position and SSB consumption in Canada, which collectively demonstrate that, on average, those with lower knowledge and material resources consume more SSBs and fewer unsweetened beverages. This research provides necessary understanding of social patterning of beverage consumption in NL prior to tax implementation. Post-tax evaluations of this policy should investigate potential impacts of the tax on diet and health inequalities, as well as potential unintended consequences of beverage substitutions towards non-taxed SSBs.

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“…In Reply We would like to thank Cassettari et al for their letter and comments on our systematic review and meta-analysis of 100% fruit juice consumption and body weight in children and adults . We acknowledge that the 0.03 kg/m 2 (95% CI, 0.01-0.05) change in body mass index (BMI) in children is small.…”

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confidence: 98%

100% Fruit Juice and Body Weight—Reply

Nguyen,

Sievenpiper,

Malik

2024

JAMA Pediatr

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COMMENT & RESPONSEIn Reply We would like to thank Cassettari et al for their letter and comments on our systematic review and meta-analysis of 100% fruit juice consumption and body weight in children and adults. 1 We acknowledge that the 0.03 kg/m 2 (95% CI, 0.01-0.05) change in body mass index (BMI) in children is small. While this difference may not be clinically meaningful and is smaller than that for sugar-sweetened beverages, 2 this BMI gain may have important implications at the population level. Our findings also suggest that younger children showed greater BMI gains than older children. Small gains in BMI over time may increase substantially over the years, which is especially important during critical developmental periods in childhood. Emphasizing the need to limit the consumption of 100% fruit juice, especially in younger children, and to consume whole fruit rather than the fruit juice form is an important public health strategy for children to develop healthy weight trajectories. The observed BMI gain is per 8-oz serving (a typical serving size), indicating the importance of smaller portion sizes at a level obtainable from a single portion of whole fruit (4-6 oz) and in accordance with agespecific dietary guidelines. 3 To our knowledge, no randomized clinical trials (RCTs) in children have been conducted in this area, and thus our findings are drawn from prospective cohort studies, acknowledging potential limitations with observational study designs.Our findings from prospective cohort studies in adults suggest that the association between 100% fruit juice and body weight may be partially mediated by excess energy, as shown in our subgroup analysis by whether studies adjusted for total energy intake. Studies that did not adjust for total energy showed a significant positive association with body weight gain, whereas studies that did adjust for energy intake showed a significant inverse association. This is an important consideration since 100% fruit juice is expected to contribute to weight gain through calories; thus adjusting for total energy will attenuate associations and is equivalent to assessing the relationship between intake of 100% fruit juice and body weight independent of calories. The consumption of liquid calories can lead to incomplete compensation of energy at subsequent meals resulting in positive energy balance 4 and has also been shown to have an association with greater weight gain compared to the ingestion of solid calories. 5 The positive association found in prospective cohort studies was neither supported nor refuted by our meta-analysis of RCTs, which had wide confidence intervals that included the effect estimate seen in cohort studies and was limited by short study durations (median of 6 weeks) and small sample sizes. Although not statistically significant, subgroup analysis of RCTs found differential effects by dose and juice type.There remains a need for high-quality RCTs in both children and adults that assess different types of fruit juice and different intake levels. In...

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Consumption of 100% Fruit Juice and Body Weight in Children and Adults

Cited by 9 publications

References 77 publications

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

Beverage consumption among adults in Newfoundland and Labrador, Canada prior to the implementation of a sugar-sweetened beverage tax

100% Fruit Juice and Body Weight—Reply

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