Fruit Juice in Infants, Children, and Adolescents: Current Recommendations

Abstract

Historically, fruit juice was recommended by pediatricians as a source of vitamin C and as an extra source of water for healthy infants and young children as their diets expanded to include solid foods with higher renal solute load. It was also sometimes recommended for children with constipation. Fruit juice is marketed as a healthy, natural source of vitamins and, in some instances, calcium. Because juice tastes good, children readily accept it. Although juice consumption has some benefits, it also has potential detrimental effects. High sugar content in juice contributes to increased calorie consumption and the risk of dental caries. In addition, the lack of protein and fiber in juice can predispose to inappropriate weight gain (too much or too little). Pediatricians need to be knowledgeable about juice to inform parents and patients on its appropriate uses.

Consumption of low‐calorie sweetened beverages is associated with higher total energy and sugar intake among children, NHANES 2011–2016

“…Four ounces was selected because this reflects half of one 8‐oz serving of a given beverage. Furthermore, 4 oz corresponds to the lower limit of the American Academy of Pediatrics recommendations, which state that fruit juice intake be limited to 4 oz or less, particularly for younger children among whom fruit juice is a primary contributor to SB intake …”

“…Furthermore, 4 oz corresponds to the lower limit of the American Academy of Pediatrics recommendations, which state that fruit juice intake be limited to 4 oz or less, particularly for younger children among whom fruit juice is a primary contributor to SB intake. 17 All analyses were performed using SAS 9.4, using complex survey procedures to account for the NHANES survey design. Sample weights were used to generate national level estimates for the US population.…”

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

“…When considering intake of total fruit, which includes 100% fruit juice, it is important to note that fruit juice, which is often less expensive and more accessible, does not necessarily carry the same benefits of whole fruit [4]. Although 100% fruit juice is a good source of important nutrients, such as vitamin C, folate, and potassium [22,23], its high sugar content, lack of fruit fiber, and potential for excess intake are concerning [24,25]. Accordingly, recommendations from the American Academy of Pediatrics (AAP) suggest limiting fruit juice consumption to no more than 8 fluid ounces for children 7 to 18 years of age [22].…”

Sugar‐sweetened beverage behaviors of Tennessee school children: How do parent‐ and child‐report compare on school days and nonschool days?

“…Pediatric health care providers should include anticipatory guidance about healthful drink choices at every well‐child visit (Muth, ). In accordance with American Academy of Pediatrics Guideline s , children should not drink juice during the first year of life; no more than 4 ounces of juice a day from 1 to 3 years; no more than 6 ounces/day in 4–6‐year‐old children, and no more than 8 ounces/day in children 7–18 years of age (Heyman & Abrams, ). Furthermore, promoting water consumption and advocating for access to clean water at daycare centers, schools, home, and after‐school activities, including sports are essential roles of nurse leaders (Muth, ).…”

“…Pediatric health care providers should include anticipatory guidance about healthful drink choices at every well-child visit (Muth, 2018). In accordance with American Academy of Pediatrics Guideline s , children should not drink juice during the first year of life; no more than 4 ounces of juice a day from 1 to 3 years; no more than 6 ounces/day in 4-6-year-old children, and no more than 8 ounces/ day in children 7-18 years of age (Heyman & Abrams, 2017).…”