Consumption of 100% Fruit Juice and Body Weight in Children and Adults

Author:

Nguyen Michelle1,Jarvis Sarah E.1,Chiavaroli Laura123,Mejia Sonia Blanco12,Zurbau Andreea12,Khan Tauseef A.12,Tobias Deirdre K.45,Willett Walter C.46,Hu Frank B.467,Hanley Anthony J.189,Birken Catherine S.11011,Sievenpiper John L.1231213,Malik Vasanti S.13

Affiliation:

1. Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

2. Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, Ontario, Canada

3. Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada

4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

5. Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts

6. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

7. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts

8. Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada

9. Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada

10. Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada

11. Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada

12. Division of Endocrinology & Metabolism, St Michael’s Hospital, Toronto, Ontario, Canada

13. Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

Abstract

ImportanceConcerns have been raised that frequent consumption of 100% fruit juice may promote weight gain. Current evidence on fruit juice and weight gain has yielded mixed findings from both observational studies and clinical trials.ObjectiveTo synthesize the available evidence on 100% fruit juice consumption and body weight in children and adults.Data SourcesMEDLINE, Embase, and Cochrane databases were searched through May 18, 2023.Study SelectionProspective cohort studies of at least 6 months and randomized clinical trials (RCTs) of at least 2 weeks assessing the association of 100% fruit juice with body weight change in children and adults were included. In the trials, fruit juices were compared with noncaloric controls.Data Extraction and SynthesisData were pooled using random-effects models and presented as β coefficients with 95% CIs for cohort studies and mean differences (MDs) with 95% CIs for RCTs.Main Outcomes and MeasuresChange in body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) was assessed in children and change in body weight in adults.ResultsA total of 42 eligible studies were included in this analysis, including 17 among children (17 cohorts; 0 RCTs; 45 851 children; median [IQR] age, 8 [1-15] years) and 25 among adults (6 cohorts; 19 RCTs; 268 095 adults; median [IQR] age among cohort studies, 48 [41-61] years; median [IQR] age among RCTs, 42 [25-59]). Among cohort studies in children, each additional serving per day of 100% fruit juice was associated with a 0.03 (95% CI, 0.01-0.05) higher BMI change. Among cohort studies in adults, studies that did not adjust for energy showed greater body weight gain (0.21 kg; 95% CI, 0.15-0.27 kg) than studies that did adjust for energy intake (−0.08 kg; 95% CI, −0.11 to −0.05 kg; P for meta-regression <.001). RCTs in adults found no significant association of assignment to 100% fruit juice with body weight but the CI was wide (MD, −0.53 kg; 95% CI, −1.55 to 0.48 kg).Conclusion and RelevanceBased on the available evidence from prospective cohort studies, in this systematic review and meta-analysis, 1 serving per day of 100% fruit juice was associated with BMI gain among children. Findings in adults found a significant association among studies unadjusted for total energy, suggesting potential mediation by calories. Further trials of 100% fruit juice and body weight are desirable. Our findings support guidance to limit consumption of fruit juice to prevent intake of excess calories and weight gain.

Publisher

American Medical Association (AMA)

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