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Fruit juice should not be introduced into the diet of infants prior to 1 year, according to a 2017 policy statement by the American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition and the Committee on Nutrition.

In addition, no more than 4 ounces of fruit juice per day should be given to toddlers aged 1-3 years, and no more than 4-6 ounces to children aged 4-6 years. For children aged 7-18 years, fruit juice intake should be limited to 8 ounces (Pediatrics. 2017 Jun;139[6]:e20170967).

doga yusuf dokdok/iStockphoto
“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” Melvin B. Heyman, MD, of the University of California, San Francisco, and coauthor of the policy statement, said in a press release. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

In fact, the AAP recommends that human milk be the only nutrient for infants up to 6 months of age, or a prepared infant formula for mothers who cannot breastfeed or choose not to breastfeed their infants. In a study of 168 children aged either 2 years or 5 years, consumption of 12 fluid ounces or more per day of fruit juice was associated with short stature and with obesity (Pediatrics. 1997 Jan;99[1]:15-22).

If toddlers are given fruit juice, it should be in a cup rather that a bottle, sippy cup, or box of juice that they can carry around for long periods. Also, infants and toddlers should not be put to bed with a bottle of fruit juice, according to the statement. Prolonged exposure of the teeth to the sugars in juice can result in dental caries.

Fruit juice is sometime erroneously used instead of oral electrolyte solutions to rehydrate infants and young children with gastroenteritis or diarrhea, but the high carbohydrate content of fruit juice “may exceed the intestine’s ability to absorb carbohydrate, resulting in carbohydrate malabsorption. Carbohydrate malabsorption causes osmotic diarrhea, increasing the severity of the diarrhea already present,” according to the statement. Also, if fruit juice is used to replace fluid losses in infants, it may cause hyponatremia.

There are several medical conditions in which it is prudent to determine how much fruit juice is being consumed:

  • Overnutrition or undernutrition.
  • Chronic diarrhea, excessive flatulence, abdominal pain, and bloating.
  • Dental caries.
  • Poor or excessive weight gain.

Fruit juice is viewed by parents as nutritious, but toddlers and young children should be encouraged to eat whole fruit instead.

“We know that excessive fruit juice can lead to excessive weight gain and tooth decay,” coauthor Steven A. Abrams, MD, of the University of Texas, Austin, said in a press release. “Pediatricians have a lot of information to share with families on how to provide the proper balance of fresh fruit within their child’s diet.”

The authors said they had no relevant financial conflicts.

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The AAP’s new policy statement regarding limiting juice consumption has potential to make a big difference in the prevention of two largely preventable diseases – obesity and dental caries. Recognizing that obesity and dental caries are silent epidemics in the United States, and that overconsumption of sugar is a common risk factor for both of these diseases, the AAP’s new policy statement is overdue. Fruit juice has as much sugar as soda drinks, yet parents feel it is a healthy drink alternative because juice comes from fruit. Parents often introduce juice to their children at a very young age and serve them more juice than is needed. Also, young children commonly consume juice in a sippy cup or bottle, which can lead to dental decay, because the frequent sipping of the juice fuels the acid-producing bacteria that contribute to enamel erosion.

Dr. Patricia Braun
The 16-year-old previous AAP juice consumption policy statement recommended the introduction of juice at 6 months of age (Pediatrics. 2001 May;107[5]:1210-3). Programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have followed this old policy statement. Parents can get confused when the pediatrician tells them to wait to introduce juice until age 1 year, and then they hear different messages from other resources. The new AAP policy statement will help drive programs, such as WIC and school-lunch programs, to limit access to juice and increase access to more whole fruits. Serving children more whole fruits and vegetables provides them with the micronutrients and natural fiber of fruit, but with half the sugar. Indirectly, we also hope that this policy statement will encourage children to drink more water as an alternative to juice. Having access to safe drinking water is critical for everyone.

As pediatricians, my colleagues and I are challenged to help children maintain a healthy weight and healthy mouths, and we have long battled the early introduction and overconsumption of juice. Medical and dental health care professionals, along with public health programs, can rally around this new policy statement.

Patricia Braun, MD, is a professor of pediatrics at the University of Colorado, Denver, and a practicing pediatrician at Denver Health. She had no conflicts of interest.

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The AAP’s new policy statement regarding limiting juice consumption has potential to make a big difference in the prevention of two largely preventable diseases – obesity and dental caries. Recognizing that obesity and dental caries are silent epidemics in the United States, and that overconsumption of sugar is a common risk factor for both of these diseases, the AAP’s new policy statement is overdue. Fruit juice has as much sugar as soda drinks, yet parents feel it is a healthy drink alternative because juice comes from fruit. Parents often introduce juice to their children at a very young age and serve them more juice than is needed. Also, young children commonly consume juice in a sippy cup or bottle, which can lead to dental decay, because the frequent sipping of the juice fuels the acid-producing bacteria that contribute to enamel erosion.

Dr. Patricia Braun
The 16-year-old previous AAP juice consumption policy statement recommended the introduction of juice at 6 months of age (Pediatrics. 2001 May;107[5]:1210-3). Programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have followed this old policy statement. Parents can get confused when the pediatrician tells them to wait to introduce juice until age 1 year, and then they hear different messages from other resources. The new AAP policy statement will help drive programs, such as WIC and school-lunch programs, to limit access to juice and increase access to more whole fruits. Serving children more whole fruits and vegetables provides them with the micronutrients and natural fiber of fruit, but with half the sugar. Indirectly, we also hope that this policy statement will encourage children to drink more water as an alternative to juice. Having access to safe drinking water is critical for everyone.

As pediatricians, my colleagues and I are challenged to help children maintain a healthy weight and healthy mouths, and we have long battled the early introduction and overconsumption of juice. Medical and dental health care professionals, along with public health programs, can rally around this new policy statement.

Patricia Braun, MD, is a professor of pediatrics at the University of Colorado, Denver, and a practicing pediatrician at Denver Health. She had no conflicts of interest.

Body

 

The AAP’s new policy statement regarding limiting juice consumption has potential to make a big difference in the prevention of two largely preventable diseases – obesity and dental caries. Recognizing that obesity and dental caries are silent epidemics in the United States, and that overconsumption of sugar is a common risk factor for both of these diseases, the AAP’s new policy statement is overdue. Fruit juice has as much sugar as soda drinks, yet parents feel it is a healthy drink alternative because juice comes from fruit. Parents often introduce juice to their children at a very young age and serve them more juice than is needed. Also, young children commonly consume juice in a sippy cup or bottle, which can lead to dental decay, because the frequent sipping of the juice fuels the acid-producing bacteria that contribute to enamel erosion.

Dr. Patricia Braun
The 16-year-old previous AAP juice consumption policy statement recommended the introduction of juice at 6 months of age (Pediatrics. 2001 May;107[5]:1210-3). Programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have followed this old policy statement. Parents can get confused when the pediatrician tells them to wait to introduce juice until age 1 year, and then they hear different messages from other resources. The new AAP policy statement will help drive programs, such as WIC and school-lunch programs, to limit access to juice and increase access to more whole fruits. Serving children more whole fruits and vegetables provides them with the micronutrients and natural fiber of fruit, but with half the sugar. Indirectly, we also hope that this policy statement will encourage children to drink more water as an alternative to juice. Having access to safe drinking water is critical for everyone.

As pediatricians, my colleagues and I are challenged to help children maintain a healthy weight and healthy mouths, and we have long battled the early introduction and overconsumption of juice. Medical and dental health care professionals, along with public health programs, can rally around this new policy statement.

Patricia Braun, MD, is a professor of pediatrics at the University of Colorado, Denver, and a practicing pediatrician at Denver Health. She had no conflicts of interest.

Title
Potential to make big difference
Potential to make big difference

 

Fruit juice should not be introduced into the diet of infants prior to 1 year, according to a 2017 policy statement by the American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition and the Committee on Nutrition.

In addition, no more than 4 ounces of fruit juice per day should be given to toddlers aged 1-3 years, and no more than 4-6 ounces to children aged 4-6 years. For children aged 7-18 years, fruit juice intake should be limited to 8 ounces (Pediatrics. 2017 Jun;139[6]:e20170967).

doga yusuf dokdok/iStockphoto
“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” Melvin B. Heyman, MD, of the University of California, San Francisco, and coauthor of the policy statement, said in a press release. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

In fact, the AAP recommends that human milk be the only nutrient for infants up to 6 months of age, or a prepared infant formula for mothers who cannot breastfeed or choose not to breastfeed their infants. In a study of 168 children aged either 2 years or 5 years, consumption of 12 fluid ounces or more per day of fruit juice was associated with short stature and with obesity (Pediatrics. 1997 Jan;99[1]:15-22).

If toddlers are given fruit juice, it should be in a cup rather that a bottle, sippy cup, or box of juice that they can carry around for long periods. Also, infants and toddlers should not be put to bed with a bottle of fruit juice, according to the statement. Prolonged exposure of the teeth to the sugars in juice can result in dental caries.

Fruit juice is sometime erroneously used instead of oral electrolyte solutions to rehydrate infants and young children with gastroenteritis or diarrhea, but the high carbohydrate content of fruit juice “may exceed the intestine’s ability to absorb carbohydrate, resulting in carbohydrate malabsorption. Carbohydrate malabsorption causes osmotic diarrhea, increasing the severity of the diarrhea already present,” according to the statement. Also, if fruit juice is used to replace fluid losses in infants, it may cause hyponatremia.

There are several medical conditions in which it is prudent to determine how much fruit juice is being consumed:

  • Overnutrition or undernutrition.
  • Chronic diarrhea, excessive flatulence, abdominal pain, and bloating.
  • Dental caries.
  • Poor or excessive weight gain.

Fruit juice is viewed by parents as nutritious, but toddlers and young children should be encouraged to eat whole fruit instead.

“We know that excessive fruit juice can lead to excessive weight gain and tooth decay,” coauthor Steven A. Abrams, MD, of the University of Texas, Austin, said in a press release. “Pediatricians have a lot of information to share with families on how to provide the proper balance of fresh fruit within their child’s diet.”

The authors said they had no relevant financial conflicts.

 

Fruit juice should not be introduced into the diet of infants prior to 1 year, according to a 2017 policy statement by the American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition and the Committee on Nutrition.

In addition, no more than 4 ounces of fruit juice per day should be given to toddlers aged 1-3 years, and no more than 4-6 ounces to children aged 4-6 years. For children aged 7-18 years, fruit juice intake should be limited to 8 ounces (Pediatrics. 2017 Jun;139[6]:e20170967).

doga yusuf dokdok/iStockphoto
“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” Melvin B. Heyman, MD, of the University of California, San Francisco, and coauthor of the policy statement, said in a press release. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

In fact, the AAP recommends that human milk be the only nutrient for infants up to 6 months of age, or a prepared infant formula for mothers who cannot breastfeed or choose not to breastfeed their infants. In a study of 168 children aged either 2 years or 5 years, consumption of 12 fluid ounces or more per day of fruit juice was associated with short stature and with obesity (Pediatrics. 1997 Jan;99[1]:15-22).

If toddlers are given fruit juice, it should be in a cup rather that a bottle, sippy cup, or box of juice that they can carry around for long periods. Also, infants and toddlers should not be put to bed with a bottle of fruit juice, according to the statement. Prolonged exposure of the teeth to the sugars in juice can result in dental caries.

Fruit juice is sometime erroneously used instead of oral electrolyte solutions to rehydrate infants and young children with gastroenteritis or diarrhea, but the high carbohydrate content of fruit juice “may exceed the intestine’s ability to absorb carbohydrate, resulting in carbohydrate malabsorption. Carbohydrate malabsorption causes osmotic diarrhea, increasing the severity of the diarrhea already present,” according to the statement. Also, if fruit juice is used to replace fluid losses in infants, it may cause hyponatremia.

There are several medical conditions in which it is prudent to determine how much fruit juice is being consumed:

  • Overnutrition or undernutrition.
  • Chronic diarrhea, excessive flatulence, abdominal pain, and bloating.
  • Dental caries.
  • Poor or excessive weight gain.

Fruit juice is viewed by parents as nutritious, but toddlers and young children should be encouraged to eat whole fruit instead.

“We know that excessive fruit juice can lead to excessive weight gain and tooth decay,” coauthor Steven A. Abrams, MD, of the University of Texas, Austin, said in a press release. “Pediatricians have a lot of information to share with families on how to provide the proper balance of fresh fruit within their child’s diet.”

The authors said they had no relevant financial conflicts.

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