Intake of 100% Fruit Juice Is Associated with Improved Diet Quality of Adults: NHANES 2013-2016 Analysis

Health effects of 100% fruit and vegetable juices: evidence from human subject intervention studies

The health effects of 100% fruit and vegetable juices (FVJ) represent a controversial topic. FVJ contain notable amounts of free sugars, but also vitamins, minerals, and secondary compounds with proven biological activities like (poly)phenols and carotenoids. The review aimed to shed light on the potential impact of 100% FVJ on human subject health, comprehensively assessing the role each type of juice may have in specific health outcomes for a particular target population, as reported in dietary interventions. The effects of a wide range of FVJ (orange, grapefruit, mandarin, lemon, apple, white, red, and Concord grapes, pomegranate, cranberry, chokeberry, blueberry, other minor berries, sweet and tart cherry, plum, tomato, carrot, beetroot, and watermelon, among others) were evaluated on a series of outcomes (anthropometric parameters, body composition, blood pressure and vascular function, lipid profile, glucose homeostasis, biomarkers of inflammation and oxidative stress, cognitive function, exercise performance, gut microbiota composition and bacterial infections), providing a thorough picture of the contribution of each FVJ to a health outcome. Some juices demonstrated their ability to exert potential preventive effects on some outcomes while others on other health outcomes, emphasising how the differential composition in bioactive compounds defines juice effects. Research gaps and future prospects were discussed. Although 100% FVJ appear to have beneficial effects on some cardiometabolic health outcomes, cognition and exercise performance, or neutral effects on anthropometric parameters and body composition, further efforts are needed to better understand the impact of 100% FVJ on human subject health.

Health effects of drinking 100% juice: an umbrella review of systematic reviews with meta-analyses

CONTEXT

Low fruit and vegetable intakes are major modifiable determinants of disease. One hundred percent juice may facilitate intake and deliver essential nutrients and bioactive compounds. However, the position of 100% juice in healthy eating guidelines remains controversial due to its lower dietary fiber and higher free-sugar contents compared with whole fruits and vegetables.

OBJECTIVE

To conduct an umbrella review of systematic literature reviews with meta-analyses (MAs) to summarize the health benefits of drinking 100% fruit and/or vegetable juice.

DATA SOURCES

Four databases (Medline, The Cochrane Library, EMBASE, and CINAHL) were systematically searched for MAs of 100% juice and any health outcomes.

DATA ANALYSIS

Screening, quality, risk of bias, and content overlap tools were applied, and extracted data were narratively synthesized. No eligible studies for vegetable juice were found. Fifteen systematic literature reviews (51 primary MAs, 6 dose-response, and 87 subanalyses; 50-1200 mL/day; hours to years of duration) were included. Ten MAs (19.6%) reported health benefits (4 for blood pressure, 2 for vascular function, 3 for inflammation, 1 for stroke mortality), 3 MAs (5.9%) reported adverse risks (1 each for cardiovascular disease mortality, prostate cancer, type 2 diabetes risk), while most (74.5%) reported no effect (blood lipids, body composition, liver function, metabolic health, cancers, and inflammation). Risks were limited to cohort studies and benefits were found in both cohort and intervention studies.

CONCLUSION

The findings collate evidence showing some potential health benefits associated with 100% juice consumption, with fewer potential risks. The balance of evidence does not support the exclusion of 100% juice from food-based guides to healthy eating, although caution may be warranted in certain groups or individuals, and the body of evidence is not yet conclusive.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022380588.

Polyphenol-rich black currant and cornelian cherry juices ameliorate metabolic syndrome induced by a high-fat high-fructose diet in Wistar rats

Diets high in fat and sugar lead to metabolic syndrome (MetS) and related chronic diseases. We investigated the effects of commercially available, cold-pressed polyphenol-rich black currant (BC) and cornelian cherry (CC) juices on the prevention of MetS in Wistar rats induced by a 10-weeks high-fat high-fructose (HFF) diet. Juice consumption, either BC or CC, with a HFF diet resulted in lower serum triglycerides compared to only the HFF consumption. Both juices also mitigated the effects of HFF on the liver, pancreas, and adipose tissue, by preserving liver and pancreas histomorphology and reducing visceral fat and adipocyte size. Furthermore, supplementation with both juices reduced glucagon and up-regulated insulin expression in the pancreas of the rats on the HFF diet, whereas the BC also showed improved glucose regulation. BC juice also reduced the expression of IL-6 and hepatic inflammation compared to the group only on HFF diet. Both juices, especially BC, could be a convenient solution for the prevention of MetS in humans.

Current perspectives and challenges in the estimation of fruit juice consumption across the lifecycle in Europe

Fruit juice (FJ) is typically low in energy, contains natural sugars, important amounts of micronutrients and is not permitted to have added sugars/sweeteners. However, its role in a healthy diet is under scrutiny partly due to the wider adoption of the definition for free sugars in nutrition policy. This review aimed to identify data on FJ consumption from national food consumption surveys across Europe, to examine current intakes, percent consumers and its contribution to intakes of energy, total sugars, free sugars, vitamin C, folate and potassium. Data were extracted on the population mean intake of FJ and its contribution to nutrient intakes across the lifecycle and crude estimates of population mean intakes across countries were reported for the total population and for consumers only. This review highlighted significant gaps/challenges regarding the availability of country-specific national food consumption surveys across Europe and specifically data on FJ consumption (including complexities surrounding categorisations). Nonetheless, using a comparable/homogenous definition, the mean intake of FJ among consumers was approximately 1 × 150 ml glass/day for adults/older adults, with lower intakes among infants (86 g/d), children (108 g/d) and teenagers (112 g/d). FJ made important contributions to intakes of vitamin C while making little contribution to energy intakes but also contributed 2-14 % of free sugars intake (which may be considered modest compared to other sources). The complexity of collating and interpreting data on FJ intake as elucidated in this review raises questions surrounding the categorisation of FJ in research and presents significant challenges for policymakers with respect to dietary guidance for FJ.

Fruit juice - a scoping review for Nordic Nutrition Recommendations 2023

Fruit juice has a similar nutrient content as whole fruit and may in this respect be part of a healthy diet. However, a lower amount or lack of fibre and a higher concentration of sugars and energy could also contribute to less satiation and increase the risk of excess energy intake. The aim of this scoping review is to describe the overall evidence for the role of fruit juice as a basis for setting and updating food-based dietary guidelines in the Nordic Nutrition Recommendations 2023. PubMed was searched for systematic reviews and meta-analyses and evidence was extracted on relevant health outcomes. Current available evidence indicates that low to moderate consumption of fruit juice is not associated with an apparent risk of chronic diseases and may have protective effects on cardiovascular disease. The association between the intake of fruit juice and weight gain remains unclear and might be of concern for some groups of people. Overall, the evidence regarding health effects of fruit juice is limited.

Platelet hyperactivity: a comparison of water-soluble, bioactive compound levels in commercial tomato products and water-soluble tomato concentrate, a supplement with an approved EFSA antiplatelet health effect

The aim of this study was to evaluate and compare the concentration of water-soluble bioactive compounds in tomato products (polyphenols profile, water-soluble vitamins and nucleophilic substances) with the concentration of the same bioactive molecules existing in a water-soluble patented tomato extract, water-soluble tomato extract (WSTC), commercially available as FruitFlow®. This patented tomato extract has been recognised by EFSA (European Food Safety Authority) in a specific Health Claim declaration as having an "Antiplatelet health effect". More than 100 commercial tomato samples, coming from 18 different processing tomato companies worldwide, were analysed and compared with the FruitFlow® supplement. According to the multivariate statistical analyses applied to the data matrix, it is possible to conclude that the commercial tomato products measured (pastes, purees, others) show a significantly higher concentration of water-soluble bioactive molecules (nucleosides/nucleotides and polyphenols) responsible for an anti-platelet aggregation effect than the FruitFlow® dietary supplement.

Impact of Fruit and Fruit Juice on Death and Disease Incidence: A Sex-Specific Longitudinal Analysis of 18 603 Adults

BACKGROUND

The health benefits of fruits are well established, but fruit juice has been more controversial. Fruit and juice are often ingested with other foods, which prompted our investigation to determine whether fruit consumed as juice may negate the beneficial effects of consuming whole fruit in people with cardiovascular disease.

METHODS AND RESULTS

We retrospectively analyzed data from a population-based study in Australia (the 45 and Up Study) linked with hospitalization and mortality data up to September 2018. Kaplan-Meier survival estimates and Cox proportional hazards models were used to examine effects of fruit, fruit juice, and the combination of fruit and fruit juice in relation to death and disease incidence among men and women living with cardiovascular disease. A total of 7308 deaths occurred among 18 603 participants diagnosed with cardiovascular disease over a 13-year follow-up. After multivariable adjustment, inadequate fruit intake (hazard ratio [HR], 1.12 [95% CI, 1.01-1.24]) and high fruit juice intake (HR, 1.26 [95% CI, 1.12-1.41]) predicted all-cause mortality in women. Also, high fruit juice intake plus either adequate fruit intake (HR, 1.18 [95% CI, 1.02-1.37]) or inadequate fruit intake (HR, 1.43 [95% CI, 1.21-1.69]) predicted mortality in women. No relationships were found in men after multivariable adjustments. Also, we found no prognostic value for fruit and fruit juice intake on disease incidence.

CONCLUSIONS

In adults with cardiovascular disease, we found that fruit juice (in combination with adequate or inadequate fruit intake) predicted mortality in women but not in men. These effects became less clear when focusing on disease incidence.

Does an apple a day keep away diseases? Evidence and mechanism of action

Apples and their products exemplify the recently reemphasized link between dietary fruit intake and the alleviation of human disease. Their consumption does indeed improve human health due to their high phytochemical content. To identify potentially relevant articles from clinical trials, some epidemiological studies and meta-analyses, and in vitro and in vivo studies (cell cultures and animal models), PubMed was searched from January 1, 2012, to May 15, 2022. This review summarized the potential effects of apple and apple products (juices, puree, pomace, dried apples, extracts rich in apple bioactives and single apple bioactives) on health. Apples and apple products have protective effects against cardiovascular diseases, cancer, as well as mild cognitive impairment and promote hair growth, healing of burn wounds, improve the oral environment, prevent niacin-induced skin flushing, promote the relief of UV-induced skin pigmentation, and improve the symptoms of atopic dermatitis as well as cedar hay fever among others. These effects are associated with various mechanisms, such as vascular endothelial protection, blood lipids lowering, anti-inflammatory, antioxidant, antiapoptotic, anti-invasion, and antimetastatic effects. Meanwhile, it has provided an important reference for the application and development of medicine, nutrition, and other fields.

An integrative analytical framework to identify healthy, impactful, and equitable foods: a case study on 100% orange juice

To identify healthy, impactful, and equitable foods, we combined health scores from six diverse nutrient profiling systems (NPS) into a meta-framework (meta-NPS) and paired this with dietary guideline adherence assessment via multilevel regression and poststratification. In a case-study format, a commonly debated beverage formulation - 100% orange juice (OJ) - was chosen to showcase the utility and depth of our framework, systematically scoring high across multiple food systems (i.e. a Meta-Score percentile = 93rd and Stability percentile = 75th) and leading to an expected increase of US dietary fruit guideline adherence by ∼10%. Moreover, the increased adherence varies across the 300 sociodemographic strata, with the benefit patterns being sensitive to absolute or relative quantification of the difference of adherence affected by OJ. In sum, the adaptable, integrative framework we established deepens the science of nutrient profiling and dietary guideline adherence assessment while shedding light on the nuances of defining equitable health effects.

Non-thermal emerging processing Technologies: Mitigation of microorganisms and mycotoxins, sensory and nutritional properties maintenance in clean label fruit juices

The increase in the fruit juice consumption and the interest in clean label products boosted the development and evaluation of new processing technologies. The impact of some emerging non-thermal technologies in food safety and sensory properties has been evaluated. The main technologies applied in the studies are ultrasound, high pressure, supercritical carbon dioxide, ultraviolet, pulsed electric field, cold plasma, ozone and pulsed light. Since there is no single technique that presents high potential for all the evaluated requirements (food safety, sensory, nutritional and the feasibility of implementation in the industry), the search for new technologies to overcome the limitations is fundamental. The high pressure seems to be the most promising technology regarding all the aspects mentioned. Some of the outstanding results are 5 log reduction of E. coli, Listeria and Salmonella, 98.2% of polyphenol oxidase inactivation and 96% PME reduction. However its cost can be a limitation for industrial implementation. The combination of pulsed light and ultrasound could overcome this limitation and provide higher quality fruit juices. The combination was able to achieve 5.8-6.4 log cycles reduction of S. Cerevisiae, and pulsed light is able to obtain PME inactivation around 90%, 61.0 % more antioxidants, 38.8% more phenolics and 68.2% more vitamin C comparing to conventional processing, and similar sensory scores after 45 days at 4 °C comparing to fresh fruit juice. This review aims to update the information related to the application of non-thermal technologies in the fruit juice processing through systematic and updated data to assist in industrial implementation strategies.

Red Fruit Juice Concentration by Osmotic Distillation: Optimization of Operating Conditions by Response Surface Methodology

Osmotic distillation (OD) was implemented at laboratory scale to concentrate a red fruit juice produced from a blend of blood orange, prickly pear, and pomegranate juice. The raw juice was clarified by microfiltration and then concentrated by using an OD plant equipped with a hollow fiber membrane contactor. The clarified juice was recirculated on the shell side of the membrane module, while calcium chloride dehydrate solutions, used as extraction brine, were recirculated on the lumen side in a counter-current mode. The influence of different process parameters, such as brine concentration (20, 40, and 60% w/w), juice flow rate (0.3, 2.0, and 3.7 L min^-1), and brine flow rate (0.3, 2.0, and 3.7 L min^-1) on the performance of the OD process in terms of evaporation flux and increase in juice concentration, was investigated according to the response surface methodology (RSM). From the regression analysis, the evaporation flux and juice concentration rate were expressed with quadratic equations of juice and brine flow rates, as well as the brine concentration. The desirability function approach was applied to analyse the regression model equations in order to maximize the evaporation flux and juice concentration rate. The optimal operating conditions were found to be 3.32 L min^-1 brine flow rate, 3.32 L min^-1 juice flow rate, and an initial brine concentration of 60% w/w. Under these conditions, the average evaporation flux and the increase in the soluble solid content of the juice resulted in 0.41 kg m^-2 h^-1 and 12.0 °Brix, respectively. Experimental data on evaporation flux and juice concentration, obtained in optimized operating conditions, resulted in good agreement with the predicted values of the regression model.

Thermosonication of Orange-Carrot Juice Blend: Overall Quality during Refrigerated Storage, and Sensory Acceptance

Ultrasound combined with high temperatures (thermosonication) is an alternative to thermal treatments applied for juice preservation purposes. Blend juices, such as orange-carrot juice, are an interesting option for consumers due to their diversity of unique flavors. The main aim of the present study is to investigate thermosonication's impact on the overall quality of an orange-carrot juice blend over 22-day storage at 7 °C, in comparison to thermal treatment. Sensory acceptance was assessed on the first storage day. The juice blend was prepared based on using 700 mL of orange juice and 300 g of carrot. The effect of ultrasound treatment at 40, 50, and 60 °C for 5 and 10 min, as well as of thermal treatment at 90 °C for 30 s, on the physicochemical, nutritional, and microbiological quality of the investigated orange-carrot juice blend was tested. Both the ultrasound and the thermal treatment could maintain pH, °Brix, total titratable acidity, total carotenoid content, total phenolic compounds, and the antioxidant capacity of untreated juice samples. All ultrasound treatments improved samples' brightness and hue value, and made the juice brighter and redder. Only ultrasound treatments at 50 °C/10 min and at 60 °C/10 min have significantly reduced total coliform counts at 35 °C. Thus, they were selected along with untreated juice for sensory analysis, whereas thermal treatment was used for comparison purposes. Thermosonication at 60 °C for 10 min recorded the lowest scores for juice flavor, taste, overall acceptance, and purchase intention. Thermal treatment and ultrasound at 60 °C for 5 min recorded similar scores. Minimal variations in quality parameters were observed over 22-day storage in all treatments. Thermosonication at 60 °C for 5 min has improved samples' microbiological safety and resulted in good sensorial acceptance. Although thermosonication has the potential to be used in orange-carrot juice processing, further investigations are necessary to enhance its microbial effect on this product.

Antioxidant-Enriched Diet on Oxidative Stress and Inflammation Gene Expression: A Randomized Controlled Trial

The Mediterranean Diet (MedDiet) is associated with beneficial effects against chronic non-communicable diseases (CNCDs). In particular, the content of micronutrients leads to an improvement of the oxidative and inflammatory profiles. A randomized, parallel, controlled study, on 24 subjects, was conducted to evaluate if 2-week supplementation with a mixed apple and bergamot juice (MAB juice), had a positive impact on the body composition, the biochemical profile, and oxidative and inflammatory gene expression (Superoxide dismutase (SOD1), Peroxisome Proliferator-Activated Receptor γ (PPARγ), catalase (CAT), chemokine C-C motif ligand 5 (CCL5), Nuclear Factor Kappa B Subunit 1 (NFKB1), Vitamin D Receptor (VDR), and Macrophage Migration Inhibitory Factor (MIF)), respect to a MedDiet. Body composition evaluation analysis showed a gain in lean mass (p < 0.01). Moreover, a significant reduction in total cholesterol/HDL index (p < 0.01) was pointed out between the two groups. Gene expression analysis highlighted an increase in MIF (p ≤ 0.05), PPARγ (p < 0.001), SOD1 (p ≤ 0.05), and VDR (p ≤ 0.05) expressions when comparing MedDiet and MedDiet + MAB juice groups. These data based on the nutrigenomics approach demonstrated that supplementing 2 weeks of MAB juice to the MedDiet could contribute to a reduction in the risk of CNCDs.

Fibre and micronutrient intakes among fruit juice consumers and non-consumers in the UK and France: Modelling the effects of consumption of an orange pomace juice product

BACKGROUND

Fruit intake, including consumption of 100% fruit juice, is generally associated with a better diet quality and overall health. However, fruit and vegetable intakes are below recommendations in many countries.

METHODS

The present study examined fruit juice intake and total energy and nutrient intakes according to juice consumption or non-consumption in participants in the National Dietary and Nutrition Survey Rolling Programme 2014-2016 in the UK (n = 2723) and the Individual and National Study on Food Consumption 2006-2007 (n = 4079) in France. Total energy and nutrient intakes were also estimated for scenarios in which orange juice with pomace was either added to the daily diet or replaced 100% orange juice or beverages containing fruit juice.

RESULTS

Fruit juice consumers had higher intakes of fruits and vegetables than non-consumers, were more likely to reach 5-a-day targets for fruit and vegetable consumption, and had significantly higher intakes of folate, vitamin C, potassium, magnesium, and fibre. Juice consumers also had higher total energy and sugar intakes, but lower body mass index than non-juice consumers. Modelling consumption of orange juice with pomace increased fibre and potassium intakes in orange juice consumers, and also increased fibre, most micronutrients, and 5-a-day achievements in non-juice consumers.

CONCLUSIONS

These national survey results demonstrate that fruit juice consumers in the UK and France had higher intakes of fruits and vegetables than fruit juice non-consumers, and significantly higher intakes of several micronutrients and fibre. Furthermore, modelling of consumption of orange juice with pomace increased fibre and select micronutrient intakes, particularly among fruit juice non-consumers.

Association of 100% Fruit Juice Consumption with Cognitive Measures, Anxiety, and Depression in US Adults

Cognitive decline, anxiety, and depression are significant contributors to human ill health and decreased quality of life. Intake of fruits including 100% juice is associated with beneficial effects on several health outcomes. The current study explored the potential associations between consumption of 100% fruit juice and neurocognitive markers in adults. Twenty-four-hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 1988-1994, 1999-2018 for adults 20+ years (N = 62,606) were used to assess 100% fruit juice intake, and NHANES questionnaire data were used for the assessment of neurocognition. Association of usual intake of 100% fruit juice with neurocognitive outcomes were assessed by regression analysis after adjusting for demographic, lifestyle, dietary, and health-related covariates. About 21% of adults were fruit juice consumers and the intake was a little over 2 oz per day. Consumers of 100% fruit juice had 16.3% fewer days per month of feeling anxious compared to non-consumers. There were no significant associations of 100% fruit juice usual intake with other neurocognitive measures. A large number of potential confounding variables have been identified to be associated with one or more neurocognitive measures suggesting that these may be important parameters to include in future studies.

Protective Effects of Orange Sweet Pepper Juices Prepared by High-Speed Blender and Low-Speed Masticating Juicer against UVB-induced Skin Damage in SKH-1 Hairless Mice

Sweet pepper fruits (Capsicum annuum L.) contain various nutrients and phytochemicals that enhance human health and prevent the pathogenesis of certain diseases. Here, we report that oral administration of orange sweet pepper juices prepared by a high-speed blender and low-speed masticating juicer reduces UVB-induced skin damage in SKH-1 hairless mice. Sweet pepper juices reduced UVB-induced skin photoaging by the regulation of genes involved in dermal matrix production and maintenance such as collagen type I α 1 and matrix metalloproteinase-2, 3, 9. Administration of sweet pepper juices also restored total collagen levels in UVB-exposed mice. In addition, sweet pepper juices downregulated the expression of pro-inflammatory proteins such as cyclooxygenase-2, interleukin (IL)-1β, IL-17, and IL-23, which was likely via inhibiting the NF-κB pathway. Moreover, primary antioxidant enzymes in the skin were enhanced by oral supplementation of sweet pepper juices, as evidenced by increased expression of catalase, glutathione peroxidase, and superoxide dismutase-2. Immunohistochemical staining showed that sweet pepper juices reduced UVB-induced DNA damage by preventing 8-OHdG formation. These results suggest that sweet pepper juices may offer a protective effect against photoaging by inhibiting the breakdown of dermal matrix, inflammatory response, and DNA damage as well as enhancing antioxidant defense, which leads to an overall reduction in skin damage.

Differences in Dietary Quality by Sexual Orientation and Sex in the United States: NHANES 2011-2016

BACKGROUND

There are persistent disparities in weight- and diet-related diseases by sexual orientation. Lesbian and bisexual females have a higher risk of obesity and cardiovascular disease compared with heterosexual females. Gay and bisexual males have a higher risk of diabetes and cardiovascular disease compared with heterosexual males. However, it remains unknown how sexual orientation groups differ in their dietary quality.

OBJECTIVE

This study aimed to determine whether dietary quality differs by sexual orientation and sex among US adults.

DESIGN

This was a cross-sectional study of 24-hour dietary recall data from a nationally representative sample of adults aged 20 through 65 years participating in the 2011-2016 National Health and Nutrition Examination Survey.

PARTICIPANTS/SETTING

Study participants were adults (n = 8,851) with complete information on dietary intake, sexual orientation, and sex.

MAIN OUTCOME MEASURES

The main outcome measures were daily energy intake from 20 specific food and beverage groups and Healthy Eating Index-2015 (HEI-2015) scores for sexual orientation groups (heterosexual vs gay/lesbian/bisexual).

STATISTICAL ANALYSES PERFORMED

Ordinary least squares regressions were used to calculate adjusted means for each food and beverage group and HEI-2015, stratified by sex and controlling for covariates (eg, age and race/ethnicity) and survey cycles (2011-2012, 2013-2014, and 2015-2016).

RESULTS

Among males, red and processed meat/poultry/seafood (P = .01) and sandwiches (P = .02) were smaller contributors to energy intake for gay/bisexual males compared with heterosexual males. Among females, cereals (P =.04) and mixed dishes (P = .02) were smaller contributors to energy intake for lesbian/bisexual females compared with heterosexual females. Gay/bisexual males had significantly higher total HEI-2015 scores than heterosexual males (mean ± standard deviation 53.40 ± 1.36 vs 49.29 ± 0.32, difference = 4.14; P = .004). Lesbian/bisexual females did not differ in total or component HEI-2015 scores from heterosexual females.

CONCLUSIONS

Although gay/lesbian/bisexual groups were similar for a variety of dietary outcomes compared with heterosexual groups, gay and bisexual men displayed healthier dietary quality for processed meat (by consuming smaller amounts) and overall dietary quality (according to HEI-2015) compared with heterosexual males.

The Association Between Consumption of 100% Fruit Juice and Risk of Age-Related Macular Degeneration: Data From the National Health and Nutrition Examination Survey Database

Age-related macular degeneration (AMD) is the main irreversible blindness disease worldwide. The current study aimed to investigate whether the consumption of 100% fruit juice increases the risk of age-related macular degeneration and find approaches to prevent and reduce the development of age-related macular degeneration from the aspect of dietary habits. A cross-sectional clinical study design was adopted. We screened participants from the 2005 to 2006 NHANES database. The logistic regression model was used to evaluate the relationship between 100% fruit juice consumption and advanced AMD and to adjust variables such as demographics, general health status, body mass index (BMI), health-related behaviors, systemic complications, and ophthalmic complications. The results show that 100% fruit juice consumption did not affect early AMD and any AMD. High consumers of 100% fruit juice are more likely to develop advanced age-related macular degeneration than those who never drink 100% fruit juice.

Fruit juice and childhood obesity: a review of epidemiologic studies

Childhood obesity is a national epidemic, and many efforts have been made to understand its risk factors. The purpose of this review was to provide an updated account of the observational studies evaluating the relationship between 100% fruit juice intake and obesity in children and adolescents, and to highlight the major risk factors that may impact this relationship. PubMed and Scopus were searched for terms related to fruit juice and childhood obesity, and studies assessing 100% fruit juice intake in participants ≤ 19 years old, with obesity-related outcomes (BMI or adiposity), and published before March 9, 2021 were included. There were 17 prospective cohort and 14 cross-sectional studies included in the analysis. Overall, the evidence does not support a relationship between 100% fruit juice intake and measures of obesity in most children. There is some evidence to suggest a minor positive association in some overweight or very young children, but due to fundamental differences and limitations in methodology, further investigation is required. Significant gaps in literature on this topic exist particularly in regards to randomized clinical trials in children, and in studies in racially diverse populations.

Factors Associated with Beverage Intake in Low-Income, Overweight, or Obese Pregnant Women

This study examined consumption proportions and factors associated with sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and 100% fruit juice (FJ) consumption. We recruited Non-Hispanic Black (n = 136) and White (n = 192) low-income overweight or obese pregnant women aged 18 to 46 years (mean = 25.7 years) from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics in Michigan, USA. Independent variables included weight status, trimester, smoking, stress, education, employment, race, and age. Dependent variables were high (consuming ≥ 1 serving/day) versus low consumptions of SSB, ASB, and 100% FJ. Multivariate logistic regression modeling was performed to examine factors associated with beverage consumption. Out of the sample, 48.2%, 6.7%, and 31.3% reported high SSB, ASB, and 100% FJ consumption, respectively. SSB consumption was associated with smoking (OR: 3.77, p < 0.001), education (OR: 0.57, p = 0.03), and race (OR: 1.69, p = 0.03). Artificially sweetened beverage consumption was not associated with any factors examined. One hundred percent FJ consumption was associated with stress (OR: 0.90, p = 0.03) and race (OR: 4.48, p < 0.001). Clinicians may advocate for reductions in SSB and 100% FJ consumption tailored to client consumption characteristics.

Health Benefits of Apple Juice Consumption: A Review of Interventional Trials on Humans

Although numerous studies have reported the benefits of apple consumption on cardiometabolic health parameters and chronic disease prevention, few have focused on the effects of apple juice specifically. Juice consumption may be a convenient way to take advantage of the health effects of the bioactive components present in apples. The present review aims to summarize the current literature on health benefits of apple juice as reported in clinical trials in humans. Of the 67 studies retained, 20 interventional studies on humans were reviewed. Overall, cloudy apple juice consumption was found to be associated with several markers of cardiovascular health that may ultimately be relevant for cancer and neurodegenerative diseases. Most of the documentation was found regarding oxidative stress, as well as observations with other parameters such as markers of inflammation, lipid profile, and diabetes. This review suggests that, in 20 studies, apple juice consumed in moderation exerts positive effects on markers of cardiovascular disease risk (particularly on oxidative stress).

Effects of 100% Orange Juice on Markers of Inflammation and Oxidation in Healthy and At-Risk Adult Populations: A Scoping Review, Systematic Review, and Meta-analysis

One hundred percent orange juice (OJ) has no added sugar, naturally contains flavonoids and ascorbic acid, and can modulate the body's oxidative and inflammatory systems. This scoping review, systematic review, and meta-analysis investigated associations between 100% OJ and markers of inflammation or oxidation in healthy adults and those at risk for chronic diseases. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and scoping review extension. Literature in English was searched to July 2021 in Embase and 4 Ovid platform databases. Clinical and observational studies of any duration were eligible. Cochrane Collaboration tools were used to assess the risk of bias in controlled trials. Strength of evidence was determined using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The scoping review presents a qualitative synthesis of evidence in summary and results tables. Twenty-one interventional studies (16 controlled trials and 5 before-after studies) conducted in 307 healthy and 327 at-risk participants were included. Six common markers [C-reactive protein (CRP) or high-sensitivity CRP (hs-CRP), IL-6, TNF-α, malondialdehyde (MDA), oxidized LDL (oxLDL), and antioxidant capacity] measured across 16 studies were systematically reviewed, and results were synthesized narratively. Random-effects model meta-analyses were conducted on 10 studies reporting hs-CRP, IL-6, and/or MDA. After consuming 100% OJ, healthy and at-risk participants showed significantly lower IL-6 concentrations (pooled net difference: -1.51 pg/mL; 95% CI: -2.31, -0.70) and lower, but nonsignificant, hs-CRP (pooled net change: -0.58 mg/L; 95% CI: -1.22, 0.05) and MDA (crossover trials pooled net difference: -0.06 μmol/L; 95% CI: -0.19, 0.08). Findings suggest that 100% OJ may reduce inflammation, but results should be interpreted with caution due to moderate risk of bias, very low strength of evidence, and the low number of subjects. This study was registered on PROSPERO (https://www.crd.york.ac.uk/prospero/) as CRD42021235438.

Towards a Water-Energy-Food (WEF) nexus index: A review of nutrient profile models as a fundamental pillar of food and nutrition security

The Water-Energy-Food (WEF) nexus approach should be promoted as a tool for sustainable management of resources through the interconnection of these three fundamental pillars. Particularly, food security must ensure healthy and balanced diets for everyone, but selecting individual indicators to assess all slants covered by this element is not an easy task. Hence, the objective of this paper is two-fold, to review nutrient profiling (NP) models that allow to categorize foods and evaluate diets based on their nutritional quality, and to choose the most appropriate model to be used within a WEF nexus index. To address this issue, a total of 159 documents were assessed, appraising the geographic distribution, and time evolution of the publications, as well as the characteristics and potential applications of the NP systems. The review concludes that the NRF9.3. model is the most liable option to be used in a WEF nexus index, presenting the best characteristics by means of the definition of scores and thresholds, and the use of an 'across-the-board' criteria and a reference quantity of 100 kcal, alongside offering higher ability to assess diets and foods than the other competitive model (HEI) through the evaluation of nutrients to encourage instead of foods. A secondary outcome of the review is the identification of the NP models as a useful tool to enable institutions with information to establish policies in the field of public health and facilitating the decision-making process according to the current healthy claims.

Consumption of Dried Fruits Is Associated with Greater Intakes of Underconsumed Nutrients, Higher Total Energy Intakes, and Better Diet Quality in US Adults: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2007-2016

BACKGROUND

Dried fruits are shelf-stable alternatives to fresh fruit that avert common barriers to consuming fruit. Consumption of dried fruits may facilitate greater fruit consumption and contribute to better diet quality and nutrient intakes.

OBJECTIVE

Our aims were to assess differences in diet quality and cardiometabolic health between dried fruit consumers and nonconsumers, and evaluate differences in nutrient intakes on days when dried fruits were consumed vs not consumed.

DESIGN

This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2007-2016.

PARTICIPANTS/SETTING

Mean dried fruit intakes were estimated in adults 20 years and older (n = 25,590) who completed a dietary recall. Dried fruit consumers (one-quarter cup-equivalent/day or more) were defined in respondents with 2 complete dietary recalls (n = 22,311). Within-person differences in nutrient intakes were assessed in respondents who consumed dried fruit on 1 of 2 dietary recalls (n = 1,233).

MAIN OUTCOME MEASURES

Cardiometabolic risk factors, diet quality scored using the Healthy Eating Index 2015, and nutrient intakes were assessed.

STATISTICAL ANALYSES

Diet quality and cardiometabolic health were compared in consumers vs nonconsumers using multivariate linear regression, adjusted for demographic and lifestyle factors. Within-person differences in nutrient intakes on days when dried fruits were consumed vs not were assessed using multivariate linear regression.

RESULTS

Mean ± standard error dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented 3.7% of total fruit consumed. Consumers (7.2% of adults) had higher quality diets than nonconsumers (mean ± standard error Healthy Eating Index 2015 score = 60.6 ± 0.5 vs 52.6 ± 0.3; P < 0.001) and lower mean body mass index, waist circumference, and systolic blood pressure (P < 0.01). Total carbohydrate, dietary fiber, potassium, and polyunsaturated fat intakes were greater on days when dried fruits were consumed vs not consumed (P < 0.001). Total calorie intakes were also greater (208-215 kcal; P ≤ 0.002) when dried fruits were consumed.

CONCLUSIONS

Dried fruit consumption is associated with higher diet quality and greater intakes of underconsumed nutrients. However, dried fruits do not appear to displace other calorie sources on days when consumed.

Association of the Healthy Eating Index with Estimated Cardiovascular Age in Adults from the KNHANES 2013-2017

In this paper, we hypothesized that the gap between estimated cardiovascular age (eCV-age) and chronological age had a gender-wise correlation with the Korean Healthy Eating Index (KHEI). We tested the hypothesis in adults aged 20-64 years old using the KNHANES 2013-2017 data. eCV-age was estimated based on the designated risk factors of cardiovascular disease (CVD) and age-gap was calculated by subtracting the eCV-age from the chronological age in 12,317 adults. Adjusted odds ratios for the age-gap were measured according to KHEI, while controlling for covariates to influence risk factors of CVD, using logistic regression analysis with the complex sample survey design. Age-gaps were divided into four groups: >4 (High), 0-4 (Moderate), -4-0 (Mild), and <-4 years (Low). The higher the age-gap, the lower the cardiovascular risk. Persons included in the following categories belonged to the high and moderate age-gap groups: young (<40 years), women, urban living, better than high school education, higher income, lean, mild drinking, and exercising regularly. KHEI scores were overall higher in women than men (p < 0.01). Having breakfast and saturated fat intake were primary factors that influenced the age-gap for men, whereas fresh fruit intake and carbohydrate intake influenced the age-gap in women. The KHEI scores positively correlated with nutrient intake, especially fiber and vitamin C intake in women (p < 0.05). Participants with high KHEI scores increased their chances of belonging to the high age-gap group by 2.16 times for men and 2.10 for women after adjusting for covariates of sex, age, and residence. However, after adding the covariates of education, income, marriage, and obesity, in conjunction with smoking, alcohol, and regular exercise, this reduced to 1.34 times in women. In conclusion, both genders had a positive correlation between age-gap and overall KHEI scores.

Wild Lactobacillus casei Group Strains: Potentiality to Ferment Plant Derived Juices

Plant derived beverages have recently gained consumers’ interest, particularly due to their intrinsic functional properties. They can also act as non-dairy carriers for probiotics and prebiotics, meeting the needs of lactose allergic/intolerant people and vegans. Direct fermentation of fruit and vegetables juices by probiotic lactic acid bacteria could be a tool to increase safety, shelf-life, nutrients bioavailability and to improve sensorial features of plant derived juices. This study aims to screen wild Lactobacillus casei-group strains isolated from dairy matrices for probiotic features, such as acid and bile salts resistance, and test them for the potentiality to ferment celery and orange juices. Strains’ ability to produce exopolysaccharides (EPS) in situ is also checked. These evaluations were performed for the first time in fruit and vegetables matrices by means of an impedometric analysis, recently shown to be a suitable and rapid method to measure microorganisms’ growth, acidification performances and EPS production. This study allowed the selection of three potentially probiotic L. casei-group wild strains able to ferment fruit and vegetable juices and also producing EPS. These strains with three-in-one abilities could be used to produce new functional fermented plant derived juices.

Vitamin C: A Review on its Role in the Management of Metabolic Syndrome

Oxidative stress and inflammation are two interlinked events that exist simultaneously in metabolic syndrome (MetS) and its related complications. These pathophysiological processes can be easily triggered by each other. This review summarizes the current evidence from animal and human studies on the effects of vitamin C in managing MetS. In vivo studies showed promising effects of vitamin C, but most of the interventions used were in combination with other compounds. The direct effects of vitamin C remain to be elucidated. In humans, the current state of evidence revealed that lower vitamin C intake and circulating concentration were found in MetS subjects. A negative relationship was observed between vitamin C intake / concentration and the risk of MetS. Oral supplementation of vitamin C also improved MetS conditions. It has been postulated that the positive outcomes of vitamin C may be in part mediated through its anti-oxidative and anti-inflammatory properties. These observations suggest the importance of MetS patients to have an adequate intake of vitamin C through food, beverages or supplements in order to maintain its concentration in the systemic circulation and potentially reverse MetS.