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Original Paper |
Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York (B.A.D.)
Research Institute, Bassett Healthcare, Cooperstown (B.A.D., H.L.R., M.J.N., P.J.), New York
Address reprint requests to: Dr. Barbara A. Dennison, Research Institute, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326.
Background: Excessive fruit juice consumption in young children has been associated with nonorganic failure to thrive and short stature in some children and with obesity in others.
Objective: To evaluate, in a sample of healthy young children, whether the associations between fruit juice intakes and growth parameters differ by the type of fruit juice consumed.
Design: Cross-sectional study.
Setting: General primary care health center in upstate New York.
Participants: One hundred sixteen two-year-old children and one hundred seven five-year-old children, who were scheduled for a nonacute visit, and their primary care-takers or parents were recruited over a two-year period.
Methods: For 163 children (73% of total), 14 days of dietary records were available. The dietary records were entered and analyzed using the Nutrition Data System (NDS). Type of fruit juice was classified according to Nutrition Coordinating Center food codes. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale.
Results: The children consumed, on average, 5.5 fluid oz/day of fruit juices, which were classified by the NDS software as 35% apple juice, 31% orange juice, 25% grape juice and 9% other types and/or mixtures of fruit juice. Children with higher fruit juice intakes had lower total fat, saturated fat and cholesterol intakes. Child height was inversely related to apple juice intake (p=0.007) and grape juice intake (p=0.02), after adjustment for child age, gender and energy intake (excluding fruit juice) and maternal height. Apple juice intake was correlated with child body mass index (p<0.05) and ponderal index (p<0.005), after adjustment for the above covariates. Total cholesterol, LDL-cholesterol, triglyceride and lipoprotein(a) levels were not related to intakes of any of the fruit juices examined. The children’s ratios of total cholesterol to HDL cholesterol were correlated with grape juice intakes, while HDL-cholesterol levels were inversely related to grape juice intakes. There were no significant relationships between fruit juice intake and measures of anemia (hematocrit or mean corpuscular volume).
Conclusions: The previously reported associations between short stature and high intakes of fruit juice were observed for intakes of both apple juice and grape juice. The associations between high fruit juice intakes and obesity were observed with apple juice intakes only. Because most of the fruit juice mixtures were classified as single fruit juices, the findings, especially those with grape juice, need to be cautiously interpreted. High intakes of fruit juice, however, appear to be associated with growth extremes in young children. Thus, it would seem prudent for parents and caretakers to moderate the fruit juice intakes of their young children.
Key words: child nutrition, obesity, body height, fruit juice, beverages, diet, nutrition policy, growth disorders
Abbreviations: AAP=American Academy of Pediatrics • BMI=body mass index • Lp(a)=Lipoprotein(a) • NCC=Nutrition Coordinating Center • NDS=Nutrition Data System • SAS=Statistical Analysis System
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