In the Journals

AAP: Fruit juice should not be given to children younger than 1 year

Due to its high sugar and calorie content, in addition to its lack of protein and fiber, fruit juice should not be given to infants younger than 1 year, according to a joint AAP policy statement from the Committee on Nutrition and the Section on Gastroenterology, Hepatology and Nutrition.

“Children and adolescents continue to be the highest consumers of juice and juice drinks,” Melvin B. Heyman, MD, FAAP, from the Division of Pediatric Gastroenterology, Hepatology and Nutrition at the University of California, and Steven A. Abrams, MD, FAAP, from the Department of Pediatrics at Dell Pediatric Research Institute, wrote. “Unfortunately, children 2 to 18 years of age consume nearly half of their fruit intake as juice, which lacks dietary fiber and predisposes to excessive calorie intake.”

While child consumption of fruit juice has decreased in recent years, the researchers noted that special considerations should still be taken regarding consumption of these beverages, especially in light of rising obesity rates and growing concerns about dental health among children.

A variety of products exist that contain varying ratios and forms of fruit juice, however, the FDA requires all products labeled as “fruit juice” to contain 100% juice. Unlike these products, offshoots require special FDA instructions, including labeling reconstituted juice as such. Beverage with less than 100% fruit juice are required to state the percentage on labeling, and manufacturers must describe their product as “drinks,” “beverages” or “cocktails,” the researchers wrote.

“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” Heyman said in a press release. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

Regarding age-appropriate fruit juice consumption, it is suggested that infants avoid all fruit juice until 1 year of age. Mashed or pureed whole fruit is encouraged, and juice can be used as an addition to a meal or snack after 1 year.

Toddlers and young children (aged 1-6 years) may also overconsume fruit juice and drinks and are encouraged to consume whole fruit rather than juice, which can cause energy imbalances similar to those created by soda. The researchers noted that too much juice can contribute to diarrhea and over- or undernutrition.

While children and teenagers between the ages of 7 and 18 years had fewer nutritional issues regarding fruit juices as they consume fewer of these beverages, the researchers suggested this age group be limited to 8 oz. daily, equating to half of their recommended daily fruit servings.

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

The statement addressed a variety of ways in which physicians can promote appropriate and healthy consumption of these beverages in their patients:

  • Juice should be limited to a maximum of4 oz. daily in toddlers (1-3 years) and 4-6 oz. daily for children (4-6 years);
  • Toddlers should not be given juice from bottles or easily transportable covered cups. Additionally, they should not receive juice at bedtime;
  • Children should be encouraged to eat whole fruit to meet their recommended daily fruit intake and be educated on the benefits of fiber and on the caloric intake of juices and whole fruits;
  • Families should be educated that human milk and/or infant formula is sufficient for infants, and low-fat or nonfat milk and water are sufficient for older children;
  • When evaluating malnutrition (over- or undernutrition), chronic diarrhea, excessive flatulence, abdominal pain and bloating, pediatricians should determine the amount of juice being consumed; and
  • Pediatricians should support policies to reduce the consumption of fruit juice and to promote the consumption of whole fruit by toddlers and young children. – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

Due to its high sugar and calorie content, in addition to its lack of protein and fiber, fruit juice should not be given to infants younger than 1 year, according to a joint AAP policy statement from the Committee on Nutrition and the Section on Gastroenterology, Hepatology and Nutrition.

“Children and adolescents continue to be the highest consumers of juice and juice drinks,” Melvin B. Heyman, MD, FAAP, from the Division of Pediatric Gastroenterology, Hepatology and Nutrition at the University of California, and Steven A. Abrams, MD, FAAP, from the Department of Pediatrics at Dell Pediatric Research Institute, wrote. “Unfortunately, children 2 to 18 years of age consume nearly half of their fruit intake as juice, which lacks dietary fiber and predisposes to excessive calorie intake.”

While child consumption of fruit juice has decreased in recent years, the researchers noted that special considerations should still be taken regarding consumption of these beverages, especially in light of rising obesity rates and growing concerns about dental health among children.

A variety of products exist that contain varying ratios and forms of fruit juice, however, the FDA requires all products labeled as “fruit juice” to contain 100% juice. Unlike these products, offshoots require special FDA instructions, including labeling reconstituted juice as such. Beverage with less than 100% fruit juice are required to state the percentage on labeling, and manufacturers must describe their product as “drinks,” “beverages” or “cocktails,” the researchers wrote.

“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” Heyman said in a press release. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

Regarding age-appropriate fruit juice consumption, it is suggested that infants avoid all fruit juice until 1 year of age. Mashed or pureed whole fruit is encouraged, and juice can be used as an addition to a meal or snack after 1 year.

Toddlers and young children (aged 1-6 years) may also overconsume fruit juice and drinks and are encouraged to consume whole fruit rather than juice, which can cause energy imbalances similar to those created by soda. The researchers noted that too much juice can contribute to diarrhea and over- or undernutrition.

While children and teenagers between the ages of 7 and 18 years had fewer nutritional issues regarding fruit juices as they consume fewer of these beverages, the researchers suggested this age group be limited to 8 oz. daily, equating to half of their recommended daily fruit servings.

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

The statement addressed a variety of ways in which physicians can promote appropriate and healthy consumption of these beverages in their patients:

  • Juice should be limited to a maximum of4 oz. daily in toddlers (1-3 years) and 4-6 oz. daily for children (4-6 years);
  • Toddlers should not be given juice from bottles or easily transportable covered cups. Additionally, they should not receive juice at bedtime;
  • Children should be encouraged to eat whole fruit to meet their recommended daily fruit intake and be educated on the benefits of fiber and on the caloric intake of juices and whole fruits;
  • Families should be educated that human milk and/or infant formula is sufficient for infants, and low-fat or nonfat milk and water are sufficient for older children;
  • When evaluating malnutrition (over- or undernutrition), chronic diarrhea, excessive flatulence, abdominal pain and bloating, pediatricians should determine the amount of juice being consumed; and
  • Pediatricians should support policies to reduce the consumption of fruit juice and to promote the consumption of whole fruit by toddlers and young children. – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.