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Children’s Hospital of Pittsburgh Recommends Limiting Juice to Maintain Kids’ Health

PITTSBURGH, November 15, 2001—Anything in excess is bad, the saying goes. And that includes fruit juice. Children today are drinking too much fruit juice, as well as fruit-flavored drinks and soda. This over-consumption is leading to numerous health problems, from tooth decay to obesity to intestinal distress. The overuse is so prevalent that the American Academy of Pediatrics (AAP) has developed a policy on The Use and Misuse of Fruit Juice in Pediatrics.

At Children’s Hospital of Pittsburgh, clinical nutritionist Cindy Miller, RD, and pediatrician Debra Bogen, MD, said the dangers of children drinking too much juice are many. The leading problems are:

• Tooth decay – Juice, whether it is 100 percent fruit juice or a fruit-flavored drink, can settle on teeth and cause decay. Specifically, the problem results when children carry a bottle or “sippy” cup with them and drink constantly throughout the day or go to bed with the juice. Their teeth are continually exposed to sugar, which does not give saliva the opportunity to wash away bacteria that form the acids that cause decay.
• Obesity – Today, 1 in 4 kids is overweight, Miller said. She finds that many overweight children are adding a lot of sugar calories to their diets by drinking too much juice. She said some children she has treated in weight management programs drink as many as 500 to 1,000 or more calories a day. The resulting increase in weight also can put a child at risk for Type II diabetes, a disease that is increasing in incidence among teenagers.
• Intestinal problems – Too much juice, especially apple or pear juices, can cause diarrhea. These juices contain sorbitol, a carbohydrate not absorbed easily through digestion.
• Negatively impacted growth – Drinking juice throughout the day can suppress children’s appetites. As a result, they do not eat as much solid food to get the iron, zinc, protein and other nutrients they need for proper growth and development.
• Low bone density – Children often drink juice instead of milk, which should be the drink of choice for all children. Even calcium-fortified juices cannot completely substitute milk because they are missing vitamin D. Milk contains vitamin D, which helps the body absorb calcium. Milk also contains protein and other minerals that cannot be acquired by drinking juice. However, if a child is lactose-intolerant and is eating a healthy diet that provides the proper nutrients, calcium-fortified juice can be a good alternative to milk, Dr. Bogen said.

So, what’s a parent to do if children enjoy the taste of juice? Dr. Bogen and Miller said 100 percent juice has a place in a child’s diet and have a few recommendations for maintaining moderation that are in-line with the AAP policy:

• If children want juice, give them 100 percent fruit juice, which has more nutritional value than fruit-flavored drinks. Also, do not give children unpasteurized juice, such as apple cider, which can harbor e-coli and other bacteria that can make children sick.
• Instead of giving children juice, give them fresh fruit. The fruit has less sugar, more fiber and nutrients, and will quell a child’s hunger.
• Limit the amount of juice children drink to control calorie intake and encourage proper nutrition. Do not give children juice until they can hold and drink from a cup (typically 6 to 9 months of age). Even then, dilute the juice with water. Once they are toddlers (1 to 6 years old), children can drink four to six ounces of juice a day. Although older children and adolescents (ages 7 to 18) can drink more juice according to AAP guidelines, they still should be limited to eight to 12 ounces a day.
• Toddlers should not be allowed to carry a bottle or cup of juice around all day or take it to bed with them. If you want to give your child juice, Dr. Bogen suggests putting juice in a small cup that children must leave in the kitchen. If they are thirsty, they can walk to the kitchen for a drink. By not constantly drinking, children give their saliva a chance to protect their teeth.

NOTE: Children’s Hospital nutritionists and pediatricians are available for interviews.

Contacts:
Melanie Tush Finnigan, 412-692-5016, Melanie.Finnigan@chp.edu

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