Abstract

BackgroundThe 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.MethodsThe 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.ResultsPreschool 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.ConclusionThese 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.

Highlights

  • The role of fruit juice in pediatric dietary guidelines continues to be controversial, with respect to concerns about unhealthy dietary habits and the potential promotion of excessive weight gain

  • Average total fruit intake was slightly less than 1.5 cups/day; this amount steadily declined to less than a cup per day by mid-adolescence

  • The results of the current study provide evidence that higher intake of 100% fruit juice during the preschool years is associated with better diet quality throughout childhood

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Summary

Introduction

The role of fruit juice in pediatric dietary guidelines continues to be controversial, 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. For children and adolescents aged 2–18 years, guidelines from United States Department of Agriculture (USDA) recommend daily fruit intakes of 1–2 cups depending on age, sex, and physical activity level [2]. It is recommended that at least half of daily total fruit intake for both children and adults be derived from whole fruit [3]. Most children ( after the preschool years) still fail to consume the recommended amount of total fruit per day. Cross-sectional analyses of NHANES data from 2005 to 2010 show that whole and total fruit consumption declines with increasing age. 4–8-year olds ate significantly more whole and total fruit than 9– 13-year olds, who in turn consumed more than 14–18year olds, whose mean total fruit intakes were half of the recommended amount [6]

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