Relationship between 100% juice consumption and nutrient intake and weight of adolescents

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.

The Relationship between Fluid Milk, Water, and 100% Juice and Health Outcomes among Children and Adolescents

Beverages can provide improved nutrient intake and hydration, but also pose concerns related to overnutrition or contamination for children and adolescents who are in a time of critical growth. This narrative review aims to understand the impact of milk, 100% juice, and water consumption on health-related outcomes in youth. The literature review conducted used PubMed, Web of Science, and CABI global. Forty-five research articles met the quality criteria and were included. Health organization and governmental resources were also reviewed to identify current intake and consumption recommendations. All beverages in this review were associated with a variety of desirable and undesirable findings that spanned over 40 different health outcomes. Most studies that assessed milk lacked clear distinction between milk type (flavored vs. unflavored) or fat percentage, making it difficult to understand the impact of milk consumption. The relationship between milk intake and anthropometric-related outcomes were mixed within and across studies. Water was consistently associated with better hydration, while 100% juice and flavored milk intake was associated with more desirable dietary patterns or nutrients that children are currently not consuming adequate amounts of. The implications of these findings were discussed in the context of the National School Lunch Program (NSLP), while considering the impact of issues such as contaminated water and lactose intolerance. This review suggests that water may be an optimal default beverage option in the NSLP to promote hydration and accommodate beverage preferences for those with lactose intolerance.

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.

Perspective: Chaos in a Bottle-A Critical Evaluation of Beverage Categorization in Nutrition Research

Beverage consumption is an important contributor to total daily calorie intake among children and adolescents. While associations between excess calories from beverages and development of obesity are well established, a standardized approach for beverage categorization does not exist. As a result, there is marked heterogeneity in assessment and categorization of beverage intake across studies. The purpose of this article is to critically review beverage categorization in recent (published since 2010) observational studies that evaluated beverage intake in relation to weight/adiposity in US youth, and to put forth an initial proposal for a standardized beverage classification system. Standardized beverage classification is critical to ensure transparency in nutrition science research and facilitate comparison of findings across studies. A systematic literature search identified 37 eligible studies, across which beverage categorization varied considerably. The most heterogeneity was observed for categorization of "sugar-sweetened beverages" and the greatest consistency was observed for categorization of 100% juices. This review provides an evidence-based starting point for urgently needed, collaborative work to determine priorities for beverage categorization and leverage existing standards of identity in order to create and disseminate a standardized beverage classification system. A standardized approach will inform meaningful assessment of beverage consumption in research studies and facilitate impactful translation of research findings into public health nutrition policy.

Perspective: The Role of Beverages as a Source of Nutrients and Phytonutrients

The Dietary Guidelines for Americans (DGA) provide nutrition advice for Americans >2 y of age. The 2020-2025 DGA proposes a life stage approach, focusing on birth through older adulthood. Limited recommendations for beverages exist except for milk, 100% fruit juice, and alcohol. The goal of this article is to provide a better understanding of the role of beverages in the diet using current scientific evidence. A Medline search of observational studies, randomized controlled trials, and meta-analyses was undertaken using key beverage words. We highlight the role beverages can play as a part of the DGA and considered beverages not traditionally included, such as those that are phytonutrient dense. Our primary consideration for beverage consumption targeted healthy Americans aged ≥2 y. However, with the proposed expansion to the life span for the 2020-2025 DGA, we also reviewed evidence for infants and toddlers from birth to 24 mo. Examples are provided on how minor changes in beverage choices aid in meeting recommended intakes of certain nutrients. Guidance on beverage consumption may aid in development of better consumer products to meet broader dietary advice. For example, beverage products that are nutrient/phytonutrient dense and lower in sugar could be developed as alternatives to 100% juice to help meet the fruit and vegetable guidelines. Although beverages are not meant to replace foods, e.g., it is difficult to meet the requirements for vitamin E, dietary fiber, or essential fatty acids through beverages alone, beverages are important sources of nutrients and phytonutrients, phenolic acids and flavonoids in particular. When considering the micronutrients from diet alone, mean intakes of calcium (in women), potassium, and vitamins A, C, and D are below recommendations and sodium intakes are well above. Careful beverage choices could close these gaps and be considered a part of a healthy dietary pattern.

Associations between 100% Orange Juice Consumption and Dietary, Lifestyle and Anthropometric Characteristics in a Cross-Sectional Study of U.S. Children and Adolescents

Concerns about orange juice’s sugar content have spurred discussions regarding its potential contributions to childhood obesity. The objective of this study was to evaluate the association between 100% orange juice (OJ) consumption and dietary, lifestyle and anthropometric characteristics in children and adolescents. Baseline anthropometric, dietary and lifestyle data from the Growing Up Today Study I (GUTS I) and GUTS II were collected via self-reported questionnaires from 26,554 participants. The mean values of these variables were then computed for children grouped by categories of OJ consumption, and linear trend testing was used to determine whether OJ consumption was linearly related to these variables. Multivariate adjustment modeling was used to calculate odds ratios of being obese or overweight/obese by OJ consumption. Among both boys and girls, OJ intake was positively associated with height, height-for-age z-score (HAZ), intakes of total energy, total energy excluding OJ, fruits and non-starchy vegetables and physical activity. BMI, BMI z-score and BMI-for-age percentile did not differ by OJ consumption. After adjustment for cohort, age, race, total energy intake without OJ, physical activity and screen time, prevalence of overweight/obesity significantly decreased by OJ intake in boys compared to non-consumers (odds ratio (OR) and 95% confidence interval (CI)): 1.17 (1.02, 1.33) for 1–3 glasses per month, 1.11 (0.98, 1.26) for 1–6 glasses per week, 1.00 (0.85, 1.18) for 1 glass per day, 0.91 (0.73, 1.13) for ≥1 glass per day, p-trend = 0.0403). Prevalence of obesity similarly decreased by OJ intake in boys. Prevalence of overweight/obesity and obesity did not significantly differ by OJ intake in girls. The results indicate that children consuming more OJ tended to practice healthier dietary and lifestyle habits without increased prevalence or odds of obesity or overweight.

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

Fruit intake is generally associated with better diet quality and overall health. This report examined the effect of 100% fruit juice (considered a part of total fruit servings) and its replacement with whole fruits equivalents on nutrient intake and diet quality. National Health and Nutrition Examination Survey 2013-2016 data (24-h dietary recall) from adults 19+ years (n = 10,112) were used to assess the diet quality and nutrient intakes and to isocalorically replace with 100% fruit juice intakes whole fruit equivalents in a modeling analysis. About 15.6% adults were 100% fruit juice consumers. Consumers had higher diet quality (10% higher Healthy Eating Index, HEI 2015 score), and higher intakes of energy, calcium, magnesium, potassium, vitamin C and vitamin D than non-consumers. Consumption of 100% fruit juice was also associated with lower risk of being overweight/obese (-22%) and having metabolic syndrome (-27%). Replacing 100% fruit juice with whole fruits equivalents did not affect nutrient intake except for a modest increase (+6.4%) in dietary fiber. Results show that 100% fruit juice intake was associated with better diet quality and higher nutrient intake. Replacement of 100% fruit juice intake with whole fruits equivalents had no significant effect on nutrients except for dietary fiber.

Food Sources of Energy and Nutrients of Public Health Concern and Nutrients to Limit with a Focus on Milk and other Dairy Foods in Children 2 to 18 Years of Age: National Health and Nutrition Examination Survey, 2011⁻2014

Many children are not meeting current nutrient recommendations. The objective of this study was to determine the food sources of energy, nutrients of public health concern, and nutrients to limit with a focus on dairy foods. Twenty-four-hour dietary recall data from children 2–5 (n = 1511), 6–11 (n = 2193), and 12–18 years (n = 2172) participating in NHANES 2011–2014 were analyzed. Energy, fiber, calcium, potassium, vitamin D, added sugars, saturated fatty acids (SFA), and sodium intakes were sample-weighted and ranked on percentage contribution to the diet using specific food group intake and disaggregated data for dairy foods. For children 2–5, 6–11, and 12–18 years, milk, sweet bakery products, and sweetened beverages, respectively were the top food sources of energy, respectively. For calcium, potassium, and vitamin D, milk was the top ranked food source in all age groups. For children 2–5, 6–11, and 12–18 years, milk, sweet bakery products, and pizza, respectively were the top three ranked food sources of SFA; and sugar sweetened beverages and sweet bakery products were to top two food group sources of added sugars. Cured meats/poultry, pizza, and pizza, respectively, were the top ranked food sources of sodium for the three age groups. Identification of food sources of these nutrients can help health professionals implement appropriate dietary recommendations and plan age-appropriate interventions.

Relationship Between Adherence to Individual Goals Within the 5-2-1-0 Guidelines for Obesity Prevention and Number of PACER Laps in Adolescents

BACKGROUND

The purpose of this study was to evaluate the relationship between adolescents' adherence to the 5-2-1-0 goals and the number of completed Progressive Cardiovascular Endurance Run (PACER) laps.

METHODS

Participants included 1792 students aged 10 to 16 years who were randomly selected across 9 data collection periods between 2012 and 2014. The Survey of Physical Activity and Nutrition was used to measure time spent in physical activity and sedentary behavior, and dietary intake and the dependent variable was the number of PACER laps achieved. The Kruskal-Wallis test and pairwise post hoc comparisons were conducted.

RESULTS

Only 0.95% (N = 17) participants met all 4 goals outlined within the 5-2-1-0 guidelines. Whereas 10.04% met 3 (N = 180), 41.63% met 2 (N = 746), 34.99% met 1 (N = 627), and 12.39% did not meet any goals (N = 222). Pairwise comparisons indicated there were significant differences: between groups not meeting any of the 5-2-1-0 goals and other groups (meeting one goal [p = .000], 2 goals [p = .000], 3 goals [p = .000], and all 4 [p = .008]).

CONCLUSIONS

The positive relationship between PACER laps and adherence to the 5-2-1-0 goals suggests targeted and sequential behavioral changes may have positive implications on adolescents' cardiovascular fitness and body mass index.

Satisfying America's Fruit Gap: Summary of an Expert Roundtable on the Role of 100% Fruit Juice

The 2015 to 2020 Dietary Guidelines for Americans (DGAs) recognize the role of 100% fruit juice in health and in helping people meet daily fruit recommendations and state that 100% fruit juice is a nutrient-dense beverage that should be a primary choice, along with water and low-fat/fat-free milk. The DGAs note that children are consuming 100% fruit juice within recommendations (that is, 120 to 180 mL/d for children aged 1 to 6 y and 236 to 355 mL/d for children aged 7 to 18 y). Evidence shows that compared to nonconsumers, those who consume 100% fruit juice come closer to meeting daily fruit needs and have better diet quality. In children, 100% fruit juice is associated with increased intakes of nutrients such as vitamin C, folate, and potassium. When consumed within the DGA recommendations, 100% fruit juice is not associated with overweight/obesity or childhood dental caries and does not compromise fiber intake. Preliminary data suggest that polyphenols in some 100% fruit juices may inhibit absorption of naturally occurring sugars. Given its role in promoting health and in helping people meet fruit needs, experts participating in a roundtable discussion agreed that there is no science-based reason to restrict access to 100% fruit juice in public health nutrition policy and programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Reducing or eliminating 100% fruit juice could lead to unintended consequences such as reduced daily fruit intake and increased consumption of less nutritious beverages (for example, sugar-sweetened beverages).

100% citrus juice: Nutritional contribution, dietary benefits, and association with anthropometric measures

Citrus juices such as 100% orange (OJ) and grapefruit juice (GJ) are commonly consumed throughout the world. This review examines the contributions of OJ and GJ to nutrient intake, diet quality, and fruit intake, and supports citrus juices as nutrient-dense beverages. This review also explores the research examining associations between OJ and GJ intake and anthropometric measures. Citrus juices are excellent sources of vitamin C and contribute other key nutrients such as potassium, folate, magnesium, and vitamin A. OJ intake has been associated with better diet quality in children and adults. OJ intake has not been associated with adverse effects on weight or other body measures in observational studies in children and adults. In adults, some observational studies report more favorable body mass index or body measure parameters in OJ consumers compared to nonconsumers. Intervention studies in adults report no negative impacts of OJ or GJ consumption on anthropometric measures, although these measures were typically not the primary outcomes examined in the studies. Moderate consumption of citrus juices may provide meaningful nutritional and dietary benefits and do not appear to negatively impact body weight, body composition, or other anthropometric measures in children and adults.

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

Identification of modifiable behaviors is important for pediatric weight management and obesity prevention programs. This study examined obesogenic behaviors in children with obesity in a Northern California obesity intervention program using data from a parent/teen-completed intake questionnaire covering dietary and lifestyle behaviors (frequency of breakfast, family meals, unhealthy snacking and beverages, fruit/vegetable intake, sleep, screen time, and exercise). Among 7956 children with BMI ≥ 95th percentile, 45.5% were females and 14.2% were 3-5, 44.2% were 6-11, and 41.6% were 12-17 years old. One-quarter (24.9%) were non-Hispanic white, 11.3% were black, 43.5% were Hispanic, and 12.0% were Asian/Pacific Islander. Severe obesity was prevalent (37.4%), especially among blacks, Hispanics, and older children, and was associated with less frequent breakfast and exercise and excess screen time, and in young children it was associated with consumption of sweetened beverages or juice. Unhealthy dietary behaviors, screen time, limited exercise, and sleep were more prevalent in older children and in selected black, Hispanic, and Asian subgroups, where consumption of sweetened beverages or juice was especially high. Overall, obesity severity and obesogenic behaviors increased with age and varied by gender and race/ethnicity. We identified several key prevalent modifiable behaviors that can be targeted by healthcare professionals to reduce obesity when counseling children with obesity and their parents.

Adolescents' beverage choice at school and the impact on sugar intake

BACKGROUND/OBJECTIVES

To examine students' beverage choice in school, with reference to its contribution to students' intake of non-milk extrinsic (NME) sugars.

SUBJECTS/METHODS

Beverage and food selection data for students aged 11-18 years (n=2461) were collected from two large secondary schools in England, for a continuous period of 145 (school A) and 125 (school B) school days. Descriptive analysis followed by cluster analysis of the beverage data were performed separately for each school.

RESULTS

More than a third of all items selected by students were beverages, and juice-based beverages were students' most popular choice (school A, 38.6%; school B, 35.2%). Mean NME sugars derived from beverages alone was high (school A, 16.7 g/student-day; school B, 12.9 g/student-day). Based on beverage purchases, six clusters of students were identified at each school (school A: 'juice-based', 'assorted', 'water', 'cartoned flavoured milk', 'bottled flavoured milk', 'high volume juice-based'; school B: 'assorted', 'water with juice-based', 'sparkling juice/juice-based', 'water', 'high volume water', 'high volume juice-based'). Both schools included 'high volume juice-based' clusters with the highest NME sugar means from beverages (school A, 28.6 g/student-day; school B, 24.4 g/student-day), and 'water' clusters with the lowest. A hierarchy in NME sugars was found according to cluster; students in the 'high volume juice-based' cluster returned significantly higher levels of NME sugars than students in other clusters.

CONCLUSIONS

This study reveals the contribution that school beverages combined with students' beverage choice behaviour is making to students' NME sugar intake. These findings inform school food initiatives, and more generally public health policy around adolescents' dietary intake.

Consumption of various forms of apples is associated with a better nutrient intake and improved nutrient adequacy in diets of children: National Health and Nutrition Examination Survey 2003-2010

Background

Consumption of fruit has been associated with a variety of health benefits, yet, 75% of children have usual intakes of total fruit below minimum recommended amounts. Apples are the second most commonly consumed fruit in the United States; however, no studies have examined the impact of apple consumption on nutrient intake and adequacy in children's diets.

Objective

The purpose of this study is to examine the association between apple (various forms) consumption with nutrient intake and nutrient adequacy in a nationally representative sample of children.

Design

Participants were children aged 2–18 years (n=13,339), from the National Health and Nutrition Examination Survey 2003–2010. Least square means of total energy and nutrient intake, and the percentage of the population below the estimated average requirement (EAR) or above the adequate intake (AI) among apple consumers and non-consumers were examined.

Results

Consumers of total apple products had higher (p<0.01) total intakes of fiber, magnesium, and potassium and lower intakes of total fat, saturated fatty acids, monounsaturated fatty acid, and sodium than non-consumers. Apple consumers had higher (p<0.01) total sugar intake, but lower intake of added sugars compared to non-consumers. A lower (p<0.01) percentage of apple consumers were below the EAR for 13 of the 16 nutrients studied. Apple consumers had approximately a 10 percentage unit difference below the EAR for calcium and magnesium, and vitamins A, C, D, and E, than non-consumers. The percentage above the AI for fiber was significantly (p<0.0001) higher among total apple consumers (6.24±0.45 g) compared to non-consumers (0.57±0.07 g). The results were similar for individual apple products (i.e. apple juice, applesauce, and whole apples).

Conclusion

Consumption of any forms of apples provided valuable nutrients in the diets of children.

Assessment of changes in energy metabolism parameters provoked by carbon tetrachloride in Wistar rats and the protective effect of white grape juice

The objective of this study was to evaluate the effect of organic and conventional grape juices consumption on the behavior of rats and their neuroprotective effect on the activity of brain energy metabolism enzymes in different brain areas of adult rats on the experimental model of hepatic encephalopathy. Male Wistar rats (90-days-old) were treated once a day with conventional or organic white grape juice by gavage for 14 days (7 μL/g). On the 15th day the rats received carbon tetrachloride (CCl₄) in a single dose of 3.0 mL/kg. Cerebral cortex, hippocampus and cerebellum were dissected to measure the activity of creatine kinase (CK) and pyruvate kinase (PK). No changes in feeding behavior were observed after the treatment with the grapes juices. However, there was an increase in grooming behavior in the open field test provoked by both juices. CCl₄ inhibited CK activity in cerebral cortex and hippocampus of the rats and CCl₄ also reduced PK activity in all brain structures studied. Furthermore, both white grape juices prevented the decrease in the activity of CK and PK. Therefore, we can suggest that organic and conventional white grape juices could restore the activity of enzymes with a central role in brain energy metabolism.

Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI) Z-score among Brazilian adolescents

OBJECTIVE

To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI) z-score change among adolescents.

METHODS

The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004) (hereafter, baseline) and 299 in wave II (2005) (hereafter, follow-up). BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression.

RESULTS

The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04) and sweetened natural fruit juices (β = 0.05, p = 0.03) was positively associated with the rise in BMI z-score.

CONCLUSIONS

Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

Do Canadians meet Canada's Food Guide's recommendations for fruits and vegetables?

National dietary guidelines pertaining to the intake of fruits and vegetables (FV) were recently amended, in both Canada and the United States, to provide specific recommendations about dark green and orange vegetables and juice consumption. However, little is known about the extent to which Canadians meet the updated recommendations for FV. This study fills current gaps by applying the National Cancer Institute's methodology for assessing the distribution of usual intake of foods to examine reported FV intake using 24-h recalls from the 2004 Canadian Community Health Survey, cycle 2.2, a nationally representative health survey. After identifying plausible respondents, usual intake distributions were estimated after adjustment for respondents' age, sex, body mass index, frequency of FV consumption, sequence effect, weekend–weekday effect, income, and ethnicity. The majority of Canadians did not meet Health Canada's 2007 recommendations for FV intake. Only 26% of the population aged 2 years and older consumed the minimum number of daily servings recommended for their respective age–sex group. Approximately 1 in 5 Canadians consumed at least 1 daily serving of dark green vegetables, and 9% consumed 1 or more daily servings of orange vegetables or their substitutes. Juice was a substantial contributor to FV intake, particularly for children and teens who, on average, consumed 32%–41% of their daily FV servings as juice. These findings provide insight into the quantity and composition of FV intake and adherence to national dietary recommendations in Canada.

100% orange juice consumption is associated with better diet quality, improved nutrient adequacy, decreased risk for obesity, and improved biomarkers of health in adults: National Health and Nutrition Examination Survey, 2003-2006

BACKGROUND

Consumption of 100% orange juice (OJ) has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS) in a nationally representative sample of adults.

METHODS

Data from adults 19+ years of age (n = 8,861) participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI) of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005). Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS.

RESULTS

Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%), UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p < 0.05) percentage (% ± SE) of the population meeting the EAR for vitamin A (39.7 ± 2.5 vs 54.0 ± 1.2), vitamin C (0.0 ± 0.0 vs 59.0 ± 1.4), folate (5.8 ± 0.7 vs 15.1 ± 0.9), and magnesium (51.6 ± 1.6 vs 63.7 ± 1.2). Consumers were also more likely to be above the AI for potassium (4.1 ± 0.8 vs 1.8 ± 0.2). HEI-2005 was significantly (p < 0.05) higher in consumers (55.0 ± 0.4 vs 49.7 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, whole fruit, and whole grain. Consumers had a lower (p < 0.05) mean body mass index (27.6 ± 0.2 vs 28.5 ± 0.1), total cholesterol levels (197.6 ± 1.2 vs 200.8 ± 0.75 mg/dL), and low density lipoprotein-cholesterol levels (112.5 ± 1.4 vs 116.7 ± 0.93 mg/dL). Finally, compared to non-consumers of 100% OJ, consumers were 21% less likely to be obese and male consumers were 36% less likely to have MetS.

CONCLUSION

The results suggest that moderate consumption of 100% OJ should be encouraged to help individuals meet the USDA daily recommendation for fruit intake and as a component of a healthy diet.

A qualitative study to explore how parental expectations and rules influence beverage choices in early adolescence

OBJECTIVE

To understand parent beverage expectations for early adolescents (EAs) by eating occasion at home and in various settings.

METHODS

Descriptive study using focus group interviews and the constant comparative method for qualitative data analysis.

RESULTS

Six focus groups were completed, and 2 were conducted in Spanish. Participants (n = 49) were mostly female (86%) and non-Hispanic white (49%) and Hispanic (33%). Parent expectations for EA beverage intake were based on health beliefs, EA preferences, and cost, whereas those related to portion sizes and frequency varied by beverage type. Parents managed beverage expectations at home and away from home by making healthful beverages available and accessible, or by offering or allowing only specific beverages.

CONCLUSIONS AND IMPLICATIONS

Results from this qualitative study involving a small sample of parents showed that expectations were influenced by practical concerns and managed primarily through availability practices. These issues could be addressed to improve EA beverage consumption.

Components of the diet associated with child adiposity: a cross-sectional study

OBJECTIVE

This study sought to determine which components of youths' diets were related to adiposity while controlling for potential often-neglected confounders such as moderate to vigorous physical activity (MVPA) and dietary reporting error. Secondary goals of this study were to determine the extent to which MVPA confounded the associations between diet and adiposity and whether associations between diet and adiposity would differ depending on reporting error.

METHODS

An ethnically diverse urban sample of 342 children aged 9-10 years and 323 adolescents aged 17-18 years were recruited for this cross-sectional study. Body mass index (BMI) and waist circumference (WC) were measured in the school; dietary assessment included three 24-hour recalls via telephone in the evenings, and MVPA assessment included 5 days of accelerometry. Over (n = 68), under (n = 250), or plausible (n = 347) dietary intake reporters were identified with the Huang calculation method. Linear regression assessed the relationship between adiposity indicators (BMI z-score and WC) and components of the diet (energy intake, food groups, macronutrients) after controlling for reporting error, demographic variables, and MVPA.

RESULTS

When dietary reporting error and potential confounders such as MVPA and demographic variables were controlled, energy intake (EI), vegetables, refined grains, total fat, total protein, and total carbohydrate were positively related to BMI z-score and WC and artificially sweetened beverages to WC. MVPA was a significant confounder. For BMI z-score, but not WC, relationships and strength of these relationships differed depending on dietary reporting error group (plausible, underreporter, overreporter).

CONCLUSIONS

Among plausible reporters, as expected, EI, refined grains, and all macronutrients were positively related to adiposity; however, artificially sweetened beverages and vegetables, which are low-energy-dense foods, were also positively related to adiposity. Reporting error interfered with associations between diet and BMI z-score but not WC, suggesting WC is a more robust measure of adiposity in relation to diet.

Fruit juice consumption is associated with improved nutrient adequacy in children and adolescents: the National Health and Nutrition Examination Survey (NHANES) 2003-2006

OBJECTIVE

To examine the contribution of 100 % fruit juice (FJ) consumption to dietary adequacy of shortfall nutrients by children and adolescents.

DESIGN

Cross-sectional.

SETTING

Secondary analysis of data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES).

SUBJECTS

Children and adolescents aged 2-18 years (n 7250). Usual intake, determined from two 24 h dietary recalls, was calculated using the National Cancer Institute method. The population was dichotomized into consumers or non-consumers of 100 % FJ. The age/gender-specific percentage of the two consumption groups with intakes less than the Estimated Average Requirement or that exceeded the Adequate Intake for selected nutrients was determined. A Z-statistic for differences in population proportions was used to determine significance (P < 0.05).

RESULTS

Children aged 2-5 years had the highest percentage of 100 % FJ consumers (71.1 %), followed by children aged 6-12 years (57.0 %) and adolescents aged 13-18 years (44.5 %). Compared with 100 % FJ consumers, a significantly higher percentage of non-consumers had intakes below the Estimated Average Requirement for vitamin A (24.4 (SE 2.5) % v. 42.2 (SE 2.5) %), vitamin C (0.1 (SE 0.2) % v. 38.9 (SE 4.1) %), folate (8.8 (SE 1.5) % v. 22.1 (SE 2.4) %), P (11.6 (SE 2.1) % v. 21.3 (SE 2.6) %) and Mg (25.8 (SE 1.7) % v. 46.1 (SE 2.0) %). A greater percentage of 100 % FJ consumers exceeded the Adequate Intake for K (2.4 (SE 0.5) v. 0.5 (SE 0.2) %) compared with non-consumers.

CONCLUSIONS

Consumption of 100 % FJ is associated with improved nutrient adequacy and can contribute to a healthy diet.

One hundred percent orange juice consumption is associated with better diet quality, improved nutrient adequacy, and no increased risk for overweight/obesity in children

The purpose of this study was to examine the association of 100% orange juice (OJ) consumption by children 2 to 18 years of age (n = 7250) participating in the 2003 to 2006 National Health and Nutrition Examination Survey with intakes of select nutrients, MyPyramid food groups, diet quality-measured by the Healthy Eating Index-2005, weight status, and associated risk factors. The National Cancer Institute method was used to estimate the usual intake of 100% OJ consumption, selected nutrients, and MyPyramid food groups. Percentages of the population below the Estimated Average Requirement were determined. Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese. Usual per capita intake of 100% OJ was 1.7 oz/d. Among consumers, the usual intake of 100% OJ for children (n = 2183; 26.2% of population) was 10.2 oz/d. Consumers had higher (P < .05) energy intakes than nonconsumers (9148 ± 113 vs 8625 ± 473 kJ). However, there were no differences in weight or body mass index in consumers and nonconsumers, and there was no significant difference in the risk of being overweight or obese between consumers and nonconsumers (odds ratio, 0.86; 95% confidence interval, 0.70-1.05). Compared with nonconsumers, consumers had a higher (P < .01) percentage (% ± SE) of the population meeting the Estimated Average Requirement for vitamin A (19.6 ± 2.0 vs 30.2 ± 1.4), vitamin C (0.0 ± 0.0 vs 29.2 ± 1.2), folate (1.3 ± 0.3 vs 5.1 ± 0.6), and magnesium (25.5 ± 2.0 vs 39.0 ± 11). The Healthy Eating Index-2005 was significantly (P < .01) higher in consumers (52.4 ± 0.4 vs 48.5 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, and whole fruit. Moderate consumption of 100% OJ should be encouraged in children as a component of a healthy diet.

Dietary energy density is associated with body weight status and vegetable intake in U.S. children

The objective was to determine the relationship between dietary energy density (ED; kcal/g) and measured weight status in children. The present study used data from a nationally representative sample of 2442 children between 2 and 8 y old who participated in the 2001-2004 NHANES. Survey measures included 24-h dietary recall data, measurement of MyPyramid servings of various food groups, and anthropometry. The relationship among dietary ED, body weight status as calculated using the 2000 CDC growth charts, and food intake was evaluated using quartiles of ED. Additionally, other dietary characteristics associated with ED among children are described. Specific survey procedures were used in the analysis to account for sample weights, unequal selection probability, and the clustered design of the NHANES sample. In this sample, dietary ED was positively associated with body weight status in U.S. children aged 2-8 y. Obese children had a higher dietary ED than lean children (2.08 ± 0.03 vs. 1.93 ± 0.05; P = 0.02). Diets high in ED were also found to be associated with greater intakes of energy and added sugars, more energy from fat; and significantly lower intake of fruits and vegetables. Interventions that lower dietary ED by means of increasing fruit and vegetable intake and decreasing fat consumption may be an effective strategy for reducing childhood obesity.

Dried fruit consumption is associated with improved diet quality and reduced obesity in US adults: National Health and Nutrition Examination Survey, 1999-2004

Epidemiological studies examining potential associations between dried fruit consumption, diet quality, and weight status are lacking. The goal of this study was to examine the association of dried fruit consumption with nutrient intake, diet quality, and anthropometric indicators of overweight/obesity. A secondary analysis of dietary and anthropometric data collected from adult (19+ years) participants (n = 13 292) of the 1999-2004 National Health and Nutrition Examination Survey was conducted. Dried fruit consumers were defined as those consuming amounts ⅛ cup-equivalent fruit per day or more and identified using 24-hour recalls. Diet quality was measured using the Healthy Eating Index 2005. Covariate-adjusted means, SEs, prevalence rates, and odds ratios were determined to conduct statistical tests for differences between dried fruit consumers and nonconsumers. Seven percent of the population consumed dried fruit. Mean differences (P < .01) between consumers and nonconsumers in adult shortfall nutrients were dietary fiber (+6.6 g/d); vitamins A (+173 μg retinol activity equivalent per day), E (+1.5 mg α-tocopherol per day), C (+20 mg/d), and K (+20 mg/d); calcium (+103 mg/d); phosphorus (+126 mg/d); magnesium (+72 mg/d); and potassium (+432 mg/d). Dried fruit consumers had improved MyPyramid food intake, including lower solid fats/alcohol/added sugars intake, and a higher solid fats/alcohol/added sugars score (11.1 ± 0.2 vs 8.2 ± 0.1) than nonconsumers. The total Healthy Eating Index 2005 score was significantly higher (P < .01) in consumers (59.3 ± 0.5) than nonconsumers (49.4 ± 0.3). Covariate-adjusted weight (78.2 ± 0.6 vs 80.7 ± 0.3 kg), body mass index (27.1 ± 0.2 vs 28.1 ± 0.2), and waist circumference (94.0 ± 0.5 vs 96.5 ± 0.2 cm) were lower (P < .01) in consumers than nonconsumers, respectively. Dried fruit consumption was associated with improved nutrient intakes, a higher overall diet quality score, and lower body weight/adiposity measures.

Is the intake of sugar-containing beverages during adolescence related to adult weight status?

Objective

To investigate the relationship between the intake of sugar-containing beverages (SCB) at the age of 13 years and adult weight status 24–30 years later.

Design

A longitudinal study with 30 years of follow-up from adolescence (age 13 years in 1976) to adulthood (up to 2000 and 2006). Dietary intake was assessed through cross-check dietary history face-to-face interviews by a dietitian. Beverages were divided into two categories: (i) total SCB and (ii) SCB excluding 100 % fruit juices. Percentage of total fat (%total fat) and percentage of trunk fat (%trunk fat) were obtained through dual-energy X-ray absorptiometry measurements; body weight and height were measured by trained staff.

Setting

Amsterdam Growth and Health Longitudinal Study, the Netherlands.

Subjects

One hundred and fourteen males and 124 females.

Results

In males, but not in females, each additional daily serving of SCB excluding 100 % fruit juices at 13 years was associated with 1·14 % higher %total fat (95 % CI 0·04, 2·23 %; P = 0·04) and 1·62 % higher %trunk fat (95 % CI 0·14, 3·10 %; P = 0·03) in adulthood after correction for confounders. No statistically significant relationship was found between the intake of SCB excluding 100 % fruit juices at the age of 13 and BMI in both sexes. In addition, no statistically significant relationships were found between the intake of total SCB and all measures of adult weight status in both sexes.

Conclusions

Intake of SCB excluding 100 % fruit juices at the age of 13 years was positively associated with adult %total fat and %trunk fat in males, but not in females.

Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men

BACKGROUND

Sugar-sweetened beverages are risk factors for type 2 diabetes; however, the role of artificially sweetened beverages is unclear.

OBJECTIVE

The objective was to examine the associations of sugar- and artificially sweetened beverages with incident type 2 diabetes.

DESIGN

An analysis of healthy men (n = 40,389) from the Health Professionals Follow-Up Study, a prospective cohort study, was performed. Cumulatively averaged intakes of sugar-sweetened (sodas, fruit punches, lemonades, fruit drinks) and artificially sweetened (diet sodas, diet drinks) beverages from food-frequency questionnaires were tested for associations with type 2 diabetes by using Cox regression.

RESULTS

There were 2680 cases over 20 y of follow-up. After age adjustment, the hazard ratio (HR) for the comparison of the top with the bottom quartile of sugar-sweetened beverage intake was 1.25 (95% CI: 1.11, 1.39; P for trend < 0.01). After adjustment for confounders, including multivitamins, family history, high triglycerides at baseline, high blood pressure, diuretics, pre-enrollment weight change, dieting, total energy, and body mass index, the HR was 1.24 (95% CI: 1.09, 1.40; P for trend < 0.01). Intake of artificially sweetened beverages was significantly associated with type 2 diabetes in the age-adjusted analysis (HR: 1.91; 95% CI: 1.72, 2.11; P for trend < 0.01) but not in the multivariate-adjusted analysis (HR: 1.09; 95% CI: 0.98, 1.21; P for trend = 0.13). The replacement of one serving of sugar-sweetened beverage with 1 cup (≈237 mL) of coffee was associated with a risk reduction of 17%.

CONCLUSION

Sugar-sweetened beverage consumption is associated with a significantly elevated risk of type 2 diabetes, whereas the association between artificially sweetened beverages and type 2 diabetes was largely explained by health status, pre-enrollment weight change, dieting, and body mass index.

Diet quality is positively associated with 100% fruit juice consumption in children and adults in the United States: NHANES 2003-2006

BACKGROUND

One hundred percent fruit juice (100% FJ) has been viewed by some as a sweetened beverage with concerns about its effect on weight. Little regard has been given to the contribution of 100% FJ to diet quality.

METHODS

In this study data from the 2003-2006 National Health and Nutrition Examination Survey were used to examine the association of 100% FJ consumption with diet quality in participants 2-5 years of age (y) (n = 1665), 6-12 y (n = 2446), 13-18 y (n = 3139), and 19+y (n = 8861). Two 24-hour dietary recalls were used to determine usual intake using the National Cancer Institute method. Usual intake, standard errors, and regression analyses (juice independent variable and Healthy Eating Index-2005 [HEI-2005] components were dependent variables), using appropriate covariates, were determined using sample weights.

RESULTS

The percentage of participants 2-5 y, 6-12 y, 13-18 y, and 19+y that consumed 100% FJ was 71%, 57%, 45%, and 62%, respectively. Usual intake of 100% FJ (ounce [oz]/day) among the four age groups was: 5.8 ± 0.6, 2.6 ± 0.4, 3.7 ± 0.4, and 2.4 ± 0.2 for those in age groups 2-5 y, 6-12 y, 13-18 y, and 19+y, respectively. Consumption of 100% FJ was associated with higher energy intake in 6-12 y, 13-18 y, and 19+y; and higher total, saturated, and discretionary fats in 13-18 y participants. Consumption of 100% FJ was associated with higher total HEI-2005 scores in all age groups (< 0.0001). In 100% FJ consumers, total and whole fruit consumption was higher and intake of added sugars was lower in all age groups.

CONCLUSIONS

Usual intake of 100% FJ consumption exceeded MyPyramid recommendations for children 2-5 y, but was associated with better diet quality in all age groups and should be encouraged in moderation as part of a healthy diet.