Thursday, March 19, 2009

Juice Issues-Various Research Notes

Research on why children shouldn’t be given fruit juices. It is recommended that juice be given after age 3, preferably age 4, since that is when a child’s digestive system is mature enough to completely handle them.

Dr. Tobias Nobrigot, co-author of the study, explains, "Previous studies suggest that the less complete absorption of the carbohydrates in apple and pear juice is commonly attributed to two factors: the imbalance of fructose and glucose—in both apple and pear juice that ratio is approximately two to one—and the presence of sorbitol. White and purple grape contain no sorbitol and the fructose/glucose ratio in each juice is approximately one to one. This study indicates, among other things, that young children gradually develop an ability to absorb the sugars in apple and pear juice. The three year old group handled apple juice nicely but was still digesting the pear juice incompletely. By five, all four juices were being digested properly."
Many experts agree that juice should be introduced in a cup, not a nippled bottle. Recent studies have also shown that excessive juice consumption can contribute to obesity and failure to thrive in some children. Decisions on proper juice amounts should be made in consultation with a pediatrician.
Fruit juice contains four forms of carbohydrates: sorbitol, fructose, glucose, and sucrose. Not only is sorbitol hard for some babies to digest, but juices with a high ratio of fructose to glucose have also been shown to be rough on young gastric systems. Apple and pear juice, in particular, are both high in sorbitol and have a fructose-glucose imbalance. Earlier research has suggested these drinks may pose problems for some babies.
Fruit Juice - Not a Whole Food
Fruit juice, which is consumed heavily by children, is not a whole food and adds little nutritional value. Juicing removes the fiber, and unless the juice is freshly squeezed and consumed immediately, most of the nutrients are lost. Commercial canned or bottled juices are mostly sugar (even if you buy unsweetened) and most likely contain pesticides. Excess sugar can make your child more susceptible to illness.

Many researchers and health care providers are now saying that a lot of fruit juice consumed every day can be harmful to a child's health. This is due to the large, concentrated amounts of sugar (even though it's natural) contained in the juices. In addition, fruit juices contain sorbitol, which isn't absorbed well and can create gas and bloating or even chronic diarrhea. Apple juice has high sorbitol levels. White grape juice doesn't contain sorbitol and may be tolerated better than other juices, although you still have the problem with sugar and pesticides. Drinking large amounts of juice can also decrease the appetite. If your children drink a lot of juice, they may not have an appetite for the food they really need.

A child who drinks a lot of fruit juices may be susceptible to yeast overgrowth. This can lead to chronic nasal congestion, eczema, or throat and ear infections. If your children are drinking too much fruit juice, you can wean them by diluting one-third white grape juice with two-thirds water. You can slowly cut the juice out altogether. Pure water is the best drink for children.
Fruit juice consumption by infants and young children has increased over the past 30 to 40 years because of increased availability, convenience, marketing and children’s preferences. Sweetened beverages are preferred over unsweetened drinks even by neonates, as well as young children [1,2]. By one year of age almost all children drink fruit juice [3]. Concerns about children’s excessive consumption of fruit juice have been raised by a number of professional groups. The American Academy of Pediatrics (AAP) and the American Academy of Pedodontics have expressed concerns about tooth decay and fruit juice [4]. The AAP Committee on Nutrition has expressed concern about sorbitol, a naturally occurring, but nonabsorbable sugar alcohol present primarily in pear juice and apple juice; they cautioned that the "excessive use of fruit juice" may result in gastrointestinal symptoms, such as chronic diarrhea, abdominal pain or bloating [5]. The role of juice carbohydrate malabsorption (especially fructose) in chronic nonspecific diarrhea in children has been recognized for some time [6,7].

Among children referred for evaluation of failure to thrive, excessive fruit juice consumption was reported as a contributing factor in nonorganic failure to thrive in eight children, aged 14 to 27 months [8]. In some children, an association between excessive fruit juice consumption and short stature was reported, while in other children, a relationship between high intakes of fruit juice and obesity was found [9].

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