Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars

Chen, Victoria; Khan, Tauseef; Chiavaroli, Laura; Ahmed, Amna; Lee, Danielle; Kendall, Cyril W.C.; Sievenpiper, John L.

doi:10.1038/s41430-023-01258-y

Cited by 6 publications

(6 citation statements)

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“…The article by Chen and colleagues [ 1 ] provides a re-analysis of the relationship between fruit juices (FJ) and risk of obesity and type 2 diabetes based on EFSA’s draft Scientific Opinion on the Tolerable Upper Intake Level for dietary sugars. The draft opinion was made available for public consultation between July and September 2021 to collect comments from the scientific community and other stakeholders.…”

mentioning

confidence: 99%

Comment on “Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars” by Chen et al. 2023

Valtueña Martínez,

Turck,

Craciun

et al. 2023

Eur J Clin Nutr

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confidence: 99%

Comment on “Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars” by Chen et al. 2023

Valtueña Martínez,

Turck,

Craciun

et al. 2023

Eur J Clin Nutr

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“…It is of vital significance how ‘100 %’ or ‘natural’ fruit juices (in this case OJ) are defined. Multiple studies have shown that although 100 % OJ does not seem to augment the risk of CVDs and type 2 diabetes mellitus (T2DM) or even might protect against them ( 41 , 42 ) , artificially/sugar-sweetened beverages are considered as potent risk factors and that their health impacts must be distinguished from those of natural fruit juices ( 43 , 44 ) . Nonetheless, we find the overall evidence to advocate the daily use of fruit juices (including 100 % OJ) to be lacking and in need of further high-quality investigations.…”

Section: Discussionmentioning

confidence: 99%

Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials

et al. 2023

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Dyslipidaemia is a metabolic anomaly which has been related to numerous morbidities. Orange juice (OJ) is a popular flavonoid-rich drink consumed worldwide. Due to the existing controversies regarding its impact on blood lipids, we decided to investigate the impact of OJ supplementation on lipid profile parameters. Major scientific databases (Cochrane library, Scopus, PubMed and Embase) were searched. Pooled effects sizes were reported as weighted mean difference (WMD) and 95 % confidence intervals (CIs). Out of 6334 articles retrieved by the initial search, 9 articles met our inclusion criteria. Overall, supplementation with OJ did not exert any significant effects on blood levels of TG (WMD −1·53 mg/dl, 95 % CI −6·39, 3·32, P = 0·536), TC (WMD −5·91 mg/dl, 95 % CI −13·26, 1·43, P = 0·114) or HDL-C (WMD 0·61 mg/ dl, 95 % CI −0·61, 1·82, P = 0·333). OJ consumption did reduce LDL-C levels significantly (WMD −8·35 mg/dl, 95 % CI −15·43, −1·26, P = 0·021). Overall, we showed that the consumption of OJ may not be beneficial in improving serum levels of TG, TC or HDL-C. Contrarily, we showed that daily intake of OJ, especially more than 500 ml/d, might be effective in reducing LDL-C levels. In the light of the existing inconsistencies, we propose that further high-quality interventions be conducted in order to make a solid conclusion.

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“…9 Even natural juices, which contain natural nutrients, should be consumed with caution, as they have been associated with weight gain, the development of metabolic syndrome, and type 2 diabetes. 10,11 Although sugar-sweetened beverages, artificially sweetened beverages, and natural juices are associated with adverse health conditions that are closely related to kidney health, limited mention of CKD prevention is found in the current guidelines. 7,9 Previous studies on the association between sweetened beverage consumption and kidney health are limited and show conflicting results.…”

Section: Introductionmentioning

confidence: 99%

“…In alignment with those results, the World Health Organization guideline suggests that artificial sweeteners should not be used to achieve weight control or reduce the risk of noncommunicable diseases . Even natural juices, which contain natural nutrients, should be consumed with caution, as they have been associated with weight gain, the development of metabolic syndrome, and type 2 diabetes …”

Section: Introductionmentioning

confidence: 99%

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Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study

Heo,

Koh,

Park

et al. 2024

JAMA Netw Open

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ImportanceAn increasing body of evidence indicates an association between consuming sugar or its alternatives and cardiometabolic diseases. However, the effects of the consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices on kidney health remain unclear.ObjectiveTo investigate the association of the intake of sugar-sweetened beverages, artificially sweetened beverages, and natural juices with the risk of chronic kidney disease (CKD), and the effect of substituting these beverage types for one another on this association.Design, Setting, and ParticipantsThis prospective, population-based cohort study analyzed data from the UK Biobank. Participants without a history of CKD who completed at least 1 dietary questionnaire were included. The follow-up period was from the date of the last dietary questionnaire until October 31, 2022, in England; July 31, 2021, in Scotland; and February 28, 2018, in Wales. Data were analyzed from May 1 to August 1, 2023.ExposuresConsumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices.Main Outcomes and MeasuresThe primary outcome was incident CKD. Multivariable Cox proportional hazards models were used to estimate the associations between the 3 beverage types and incident CKD. A substitution analysis was used to evaluate the effect on the associations of substituting one beverage type for another.ResultsA total of 127 830 participants (mean [SD] age, 55.2 [8.0] years; 66 180 female [51.8%]) were included in the primary analysis. During a median (IQR) follow-up of 10.5 (10.4-11.2) years, 4459 (3.5%) cases of incident CKD occurred. The consumption of more than 1 serving per day of sugar-sweetened beverages was associated with higher risk of incident CKD (adjusted hazard ratio [AHR], 1.19 [95% CI, 1.05-1.34]) compared with not consuming sugar-sweetened beverages. The AHR for participants consuming more than 0 to 1 serving per day of artificially sweetened beverages was 1.10 (95% CI, 1.01-1.20) and for consuming more than 1 serving per day was 1.26 (95% CI, 1.12-1.43) compared with consuming no artificially sweetened beverages. By contrast, there was no significant association between natural juice intake and incident CKD (eg, for &gt;1 serving per day: HR, 0.99 [95% CI, 0.87-1.11]; P = .10). Substituting sugar-sweetened beverages with artificially sweetened beverages did not show any significant difference in the risk of CKD (HR, 1.03 [95% CI, 0.96-1.10]). Conversely, replacing 1 serving per day of sugar-sweetened beverage with natural juice (HR, 0.93 [95% CI, 0.87-0.97]) or water (HR, 0.93 [95% CI, 0.88-0.99]) or replacing 1 serving per day of artificially sweetened beverage with natural juice (HR, 0.90 [95% CI, 0.84-0.96]) or water (HR, 0.91 [95% CI, 0.86-0.96]) was associated with a reduced risk of incident CKD.Conclusions and RelevanceFindings from this cohort study suggest that lower consumption of sugar-sweetened beverages or artificially sweetened beverages may reduce the risk of developing CKD.

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Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars

Cited by 6 publications

References 36 publications

Comment on “Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars” by Chen et al. 2023

Comment on “Relation of fruit juice with adiposity and diabetes depends on how fruit juice is defined: a re-analysis of the EFSA draft scientific opinion on the tolerable upper intake level for dietary sugars” by Chen et al. 2023

Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials

Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study

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