Health Alert: Low-Income Kids Drink Too Much Juice
Tuesday, March 06, 2012
The university's C.S. Mott Children’s Hospital National Poll on Children’s Health recently released results that show that many kids in low-income families are getting more than the recommended amount of one serving of juice each day.
The Poll asked parents of young children of all economic levels about their children’s juice consumption. Overall, 35 percent of parents report that their children 1-5 years old have two or more cups of juice on a typical day – twice the amount recommended by the American Academy of Pediatrics (AAP).
Juice and obesity, tooth decay
“It is important to limit juice consumption in young children because there is such a strong link between consumption of sugar-sweetened beverages and child health problems like obesity and early tooth decay,” said Sarah Clark, M.P.H., Associate Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan and Associate Director of the National Poll on Children’s Health. “For many obese children, sugary beverages make up a large proportion of their daily energy intake.”
RI experts: serious implications
Physicians in Rhode Island took the report seriously as a call for change.
"I think that it will take time to re-educate families about the potential downsides of too much juice in a child's diet, including obesity, tooth decay, and vitamin D deficiency," said Gregory Fox, MD, a pediatric endocrinologist at Hasbro Children's Hospital. "Unfortunately the world has changed over the last generation and our children are less likely to burn off a few extra juice calories."
Fox said that he begins to discuss juice at six months with parents, "before children have a chance to establish a taste for juice," he said. "For toddlers who are starting to cross lines on their growth curve due to extra calories from juice, I ask parents to remove it from the home on a daily basis, and consider it a treat, not a staple."
Leading cause of dental decay
“From a dental standpoint, juices and other sugar sweetened beverages have continued to be a leading cause of dental decay in our children," said George J. DuPont, DDS, a pediatric dentist at Samuels Sinclair Dental Center at Rhode Island Hospital. "Despite urges from dentists and pediatricians to try to limit juice consumption, parents often feel they are giving their child a healthy option to other beverages."
Even 100% juices with "no sugar added" contain a large amount of sugar, DuPont said, adding that juices are also often acidic, which also increases the likelihood of dental decay. "The association between carbohydrate rich beverages such as juice and early childhood cavities is strong," he said. "Especially at risk are children who sleep with a bottle filled with juices or other high carbohydrate containing beverages. Early childhood cavities in the primary dentition has been shown to lead to a higher risk of dental cavities in the permanent dentition, increased risk for delays in growth and development, increased emergency room visits and hospitalizations, and increased costs of treatment."
Dump juice for milk
“I completely agree with the findings of this study," said Barbara Robinson, MPH, a pediatric clinical nutrition specialist at Hasbro Children's Hospital. "As children’s beverages go, lowfat (1%) or non-fat milk is a far superior beverage. It contains protein, calcium, Vitamin D and phosphorus that are needed for growth and particularly for the bone growth and increases in bone density that can only occur in childhood and adolescence. Milk also contains valuable Vitamin A and Riboflavin. Juice has none of these."
Unfortunately, Robinson said, apple juice, which is the most popular juice, is also the least nutritious choice among juices. She allowed that orange juice at least has some naturally occurring Vitamin C, folic acid and potassium but apple juice does not naturally contain these and it has a higher sugar content. "It is better in all cases to eat the actual fruit, rather than the juice and juice is not an equal substitute for fruit. Fruit has fiber, which helps to make a person feel full. And children tend not to consume piece after piece of fruit but they do consume cup after cup of apple juice."
Lower-income kids hit hardest
Although too much juice threatens the health of all kids, it's particularly felt by children of lower-income families, according to the national poll. Of parents whose household income is less than $30,000 annually, 49% report that their children drink two or more cups of juice per day. Only 23% of parents with household incomes of $100,000 or more report that their children drink two or more cups of juice per day.
These findings are concerning, Clark said. “Both childhood obesity and early dental problems are more prevalent in lower-income children, so the children we’re most worried about in terms of these conditions are also those who are drinking the most juice."
Some parents may encourage their children to drink juice because it can help their child receive the recommended servings of fruit consumed each day. “Parents may think juice is an easy way for their child to get a serving of fruit, but it’s often difficult to pick out 100 percent fruit juice amid the sugar-sweetened juice drinks,” Clark said. The AAP recommendation for even 100 percent fruit juice is that it is limited to no more than one serving per day.
“Parents who give their child juice as a healthy alternative may actually be feeding them nearly as much sugar as soda.”
Doctors: poor recommendations
The Poll also found that 35 percent of lower-income parents said that their child’s doctor recommends juice.
“This is an important message for health care providers as well as parents,” Clark says. “Doctors need to be very specific in letting parents know that whole fruit is the best way to have a child get recommended servings of fruit and that fruit juice should be limited to no more than one serving per day for kids 6 years and younger.”
For the full report, go here.
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