AAP supports limits on juice consumption in pediatric diet

1. The American Academy of Pediatrics (AAP) states that children under 1 year of age should not drink juice. Children ages 1-3 may have a maximum of 4 ounces of 100% juice daily, if at all. Children 4-6 years may have 4-6 ounces. Seven through 18-year-olds should be limited to 8 ounces of 100% juice daily.

2. Juice has limited nutritional benefit in the pediatric diet. Juice is implicated in various adverse health outcomes, including malnutrition, abdominal pain, and chronic diarrhea.

Policy Rundown: In the past, pediatricians have recommended fruit juice as an additional source of vitamins and water for children. However, the potential detrimental effects of juice may outweigh the limited benefits. Although 100% juice, and fortified juice, contains high levels of some essential vitamins (vitamin A, C, D, calcium, potassium), juice lacks in protein and fiber. In this policy statement, the AAP recommends limiting juice intake to a maximum of 4 ounces in children 1-3 years old, 4-6 ounces in 4-6-year-olds, and no more than 8 daily ounces in 7-18-year-olds. Instead, children should be encouraged to eat whole fruit to meet their daily nutritional goals. Children under 1 year old should not drink any juice unless clinically indicated. The AAP does not support the use of juice for treatment of dehydration and diarrhea. In fact, excess consumption of juice may lead to diarrhea, abdominal distension, flatulence, and tooth decay. As such, pediatricians are encouraged to consider excessive juice consumption when evaluating a pediatric patient for dental caries, chronic diarrhea, and abdominal pain. Juice consumption can also lead to malnutrition, through excessive consumption and/or reliance on juice to serve as a substitute for whole fruits. Juice drinks are composed of up to 99% fruit juice and they are not equivalent in nutritional value to 100% fruit juice. Although 100% juice can be a healthy part of a balanced diet for children over 1 year old, there is no nutritional benefit of juice over whole fruit consumption. Finally, pediatricians are encouraged to advocate for policies that reduce consumption of fruit juice in favor of increasing availability and thus consumption of whole fruits and vegetables. Pediatricians should routinely discuss the role of juice, and elucidate the difference between 100% fruit juice and juice drinks, with parents and children.

Click to read the policy published today in Pediatrics

Image: PD

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