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The Juicy Details

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Ask most parents to name a healthy beverage for their kids, and they’ll tell you “juice.” But when you talk to physicians, nutritionists and dietitians, a different story emerges. Pediatrician Christopher Morton, dietitian Barbara Ann Hughes, Ph.D., pediatric nutritionist Leslie Stanford, Ph.D.; and registered dietitian Anne Boney, M.Ed. share their recommendations concerning fruit juice.

Fruit juice is not fruit.

Many parents believe juice is a healthy drink that provides the same nutritional value as fruit. “I think that parents think ‘juice = fruit = healthy,’ and there really isn’t that correlation,” explains Boney. The primary difference between fruit and juice is that fruit provides fiber, which is beneficial to the body and ensures a healthy digestive system. Hughes explains, “You get more fiber; it’s good for [children’s] teeth and the taste and texture of [eating] fruit is a developmental experience.”

Too much juice can be a bad thing.

Just as many restaurants have super-sized meals, toddler sippy cups have become alarmingly large. “Part of the reason we think we’re seeing excessive juice drinking is that kids like juice, and sippy cups are bigger,” Stanford says and urges parents to follow suggested serving size guidelines. Kids should be drinking juice out of cups, not bottles, says Hughes. In moderation, fruit juice is a perfectly acceptable drink for kids (see AAP recommendations below), but Morton encourages parents to set juice limits. “You don’t want to overdo it because you can get diarrhea, gas and cavities,” he says. Juice can even lead to serious upset bellies, especially for young children. According to Stanford, “We have seen children, especially toddlers, who are drinking excessive amounts of juice and it exacerbates diarrhea.”

A primary concern is that juice discourages some children from eating healthy meals. “If they are sipping on juice all day long, they are not going to get hungry and eat well. It takes the place of other things they should be drinking like milk,” says Boney. She recommends that parents dilute juices with water. “It makes the 4 ounces of juice daily go further,” she says.

Stanford also cautions parents to be wary of juices that have not been pasteurized. “This is a particular concern with cider,” she says. “Some unpasteurized juices may contain harmful bacteria.”

“Juice is a non-essential drink; it’s better to give kids milk or water,” says Morton. “[My own kids] usually get milk or water with meals and an occasional orange juice or apple juice fortified with vitamin C.”

Sometimes juice is the perfect drink.

Kids with allergies are among the few who really need an enriched juice daily. For example, calcium fortified orange juice can be helpful for kids who have “a true dairy allergy that doesn’t allow milk or soy,” says Morton. Also, when kids — especially small children — are constipated, juice can be a big help. Morton recommends, “Kids with bad constipation should get 4 to 6 ounces of pear or prune juice diluted with water, divided up [in small amounts] throughout their day.”

Read the labels.

Not all juices are created equal. And not all juices are actually juices. Boney explains: “In general, what I have found is parents don’t know the difference between juice and juice drink.” When buying juice, look for a label that includes the phrase “100% juice.” Then check the ingredient list; the juice should be listed as the first ingredient. Look, too, for juices that are fortified with vitamin C or calcium.

Juice plays a role in childhood obesity.

In recognition of the role that sugary drinks may play in childhood obesity, several state legislatures recently passed bills to remove vending machines from elementary schools and required middle school vending machines to stock only 100% fruit juice alongside water, sports drinks and other no-calorie or low-calorie beverages. Hughes thinks this is a step in the right direction. “I believe the misuse of juice — too many calories from the drinking of juice — contributes to the development of larger and more fat cells in the body,” she explains.

Our experts agree, when reaching for juice: read labels, monitor quantity and don’t substitute juice for water or milk.

American Academy of Pediatrics Recommendations:

Source: http://pediatrics.aappublications.org/cgi/content/full/107/5/1210 (PEDIATRICS Vol. 107 No. 5 May 2001, pp. 1210-1213, AMERICAN ACADEMY OF PEDIATRICS: The Use and Misuse of Fruit Juice in Pediatrics, Committee on Nutrition)

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