Parents should put the squeeze on juice

January 18, 2000
Web posted at: 12:59 PM EST (1759 GMT)

In this story: The dangers of excess juice How much is too much? RELATEDS

By Lynda Liu

(WebMD) -- When you hear the phrase "All good things in moderation," fruit juice probably doesn't come to mind. But most pediatricians would agree that allowing kids to drink excessive amounts of juice is a recipe for poor health.

"Some parents believe that juices are a healthy thing to give their kids, but juices are essentially sugar and water," says Carlos Lifschitz, M.D., an associate professor of pediatrics at the Children's Nutrition Research Center at Baylor College of Medicine in Houston, Texas.

Although juices have vitamins and some have minerals, the problems associated with drinking too much fruit juice far outweigh the benefits, he says.

Studies have shown a host of potential problems with fruit juice consumption in children, and the American Academy of Pediatrics (AAP) Committee on Nutrition even issued a policy statement in 1991 telling doctors to caution parents about the dangers.

Almost 90 percent of all infants consume fruit juice by the time they are one year old, according to the AAP.

The dangers of excess juice

Fruit juices can fill kids up so that they're not hungry at the dinner table and too full to eat more nutritious foods, Lifschitz says.

Restricting intake of fruit juice will help prevent some of its associated gastrointestinal problems. Some fruit juices -- including apple, pear and prune -- contain sorbitol, a naturally occurring but problematic sugar alcohol. Because sorbitol is not completely absorbed in the small bowel, it makes its way to the large bowel where it ferments and produces gas, Lifschitz says.

In addition, many of the juices that contain sorbitol also have an imbalance in the ratio of the sugars fructose and glucose, which may reduce fructose absorption. These factors can lead to cramps, diarrhea or a loss of appetite in a child, Lifschitz says.

Several studies have reported this malabsorption, or incomplete absorption, including a study published in the October 1999 Archives of Pediatrics and Adolescent Medicine. In the study, researchers gave infants either pear juice, which contains sorbitol and a "bad" fructose-glucose ratio, or white grape juice, which contains no sorbitol and has a "good" fructose-glucose ratio. They drank between 90 and 120 milliliters (between .4 and .5 cups).

Researchers tested for malabsorption by looking for excess hydrogen gas in the breath of the children. They found signs of malabsorption in five of the seven infants given pear juice, as compared to only two of the seven who drank grape juice. Furthermore, only children fed pear juice showed increases in physical activity, which researchers believe might be caused by discomfort resulting from the malabsorption. The authors recommended giving children only non-sorbitol juices (for example, grape and citrus).

How much is too much?

"It's difficult to know what's a good amount when you're not giving anything necessary," says Lifschitz. He recommends no more than one ounce daily per three pounds of body weight, or about 1.2 cups for the average two-year-old and 1.8 cups for a five-year-old.

It's also important that juice is not the main source of liquid for a child (that should be water), nor their main source of nutrition, says Lifschitz. And no child under four months of age should be given anything but mother's milk or formula.

RELATEDS AT :

Busting the Sugar-Hyperactivity Myth
Feeding Picky Eaters

---

RELATED SITES:

American Academy of Pediatrics: Use of Juice in Diets of Young Children
American Dietetic Association

Note: Pages will open in a new browser window

External sites are not endorsed by CNN Interactive.

---

LATEST HEALTH STORIES:

China SARS numbers pass 5,000
Report: Form of HIV in humans by 1940
Fewer infections for back-sleeping babies
Pneumonia vaccine may help heart, too