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

Amy Saxe-Custack,Jenny Lachance,Mona Hanna-Attisha

doi:10.3390/nu12010025

Abstract

Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice’s high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers’ market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least ¼ cup per day, and 30% reported an increased intake of at least ½ cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children’s dietary behaviors, particularly with regard to the intake of whole fruits.

Highlights

Consumption of fruit has been associated with a reduced risk of obesity and chronic disease [1,2,3,4,5,6], better psychological well-being [1,7,8,9], and improved gut health [1,10], intake fails to meet dietary recommendations among all but the youngest children in the US [11,12]
In August 2018, a successful fruit and vegetable prescription program that had been initiated at a large pediatric clinic co-located with a farmers’ market was expanded to another Flint clinic to test replicability and preliminary effectiveness
Our findings suggest that pediatric fruit and vegetable prescriptions may be an effective method of increasing the intake of fresh whole fruit and fruit fiber among children, while having little to no influence on the consumption of 100% fruit juice

Summary

Introduction

Consumption of fruit has been associated with a reduced risk of obesity and chronic disease [1,2,3,4,5,6], better psychological well-being [1,7,8,9], and improved gut health [1,10], intake fails to meet dietary recommendations among all but the youngest children in the US [11,12]. Considering the growing evidence of an association between greater fruit and vegetable consumption during childhood and reduced chronic diseases in adulthood [13,14,15,16], both short- and long-term implications of programs that successfully increase fruit intake among children are likely to be significant. Recommendations from the American Academy of Pediatrics (AAP) suggest limiting fruit juice consumption to no more than 8 fluid ounces for children

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