Excessive fruit juice could lead to trouble. (Pediatrics, March 1994)

Over the years, we've written several articles about fruit juice in the diets of young children. In all the discussions, fruit juice has been found to have a negative effect on the children's nutritional well-being. As pediatricians, we're generally down on fruit juice. A recent report in the journal Pediatrics has prompted us to write another article on this subject. And again, it's not favorable.

The report discusses the role of fruit juice in the diets of a group of children evaluated at a large pediatric facility in New York. These children were being studied for failure to thrive (FTT). This is a pediatric term used to denote children who are not gaining in weight or height or both for no obvious reason. In most children with FTT, there is usually no evident physical disease or condition. Sometimes there is a problem with the parent-child interaction. Many times it's an inappropriate diet being given by the parent. Often, no reason can be found. In this particular study, no physical diseases or conditions were found in the children studied. What was found, however, was an inappropriate amount of fruit juices being given to the children, causing them to consume fewer more nourishing foods.

Before we discuss this study further, it's important to review the juice-drinking habits of American infants and toddlers. Apparently, juice occupies a major role in these youngsters' diets. Marketing surveys report "that by 12 months of age, almost 90% of infants consume fruit juices. Children less than 5 years consume more juice than any other age group, averageing an annual 9 gallons per child. Apple juice comprises approximately half of the juice consumed by young children." Fruit juices certainly are popular with children. Children like them because they are sweet; parents like them because they are "natural" and are therefore perceived as healthful and nutritious.

But the fact is, fruit juices contain sugar, and lots of it. And sugar is sugar, whether you want to call it "natural" or not. Fruit juice is simply sugar water, with some vitamins thrown in.

The problem is that fruit juice can turn off a child's appetite to foods that have a more healthful balance of nutrients and better caloric density. In practice, pediatricians see this daily. Perhaps the most common concern voiced by the parents of children in the one- to three-year-old range is that their child's appetite is very poor. Yet, they think nothing of letting their child consume anywhere from 16 to 50 ounces of fruit juice each day. This practice is often defended by parents saying that by giving fruit juice, they know their child is at least getting something nourishing. They often feel that the fruit ...