Fresh fruit is preferable for older children because it provides dietary fiber and less sugar than juice, according to updated policy statement
Fruit juice offers no nutritional benefit to children under
age 1 and should not be included in their diet, according to a new policy
statement issued by the American Academy of Pediatrics that marks the Academy’s
first change in recommendations on fruit juice since 2001.
Over past years, the Academy advised against offering fruit
juice to children under the age of 6 months, but has expanded that time frame
to include the entire first year of life.
The statement, “Fruit Juice in Infants, Children, and Adolescents: Current Recommendations,” to be published in the June
issue of Pediatrics (online May 22) accounts for the rising rates of obesity
and concerns about dental health based on evidence accumulated over recent
“Parents may perceive fruit juice as healthy, but it is not
a good substitute for fresh fruit and just packs in more sugar and calories,”
said Melvin B. Heyman, MD, FAAP, co-author of the statement. “Small amounts in
moderation are fine for older kids, but are absolutely unnecessary for children
The new recommendations state that 100-percent fresh or
reconstituted fruit juice can be a healthy part of the diet of children older
than 1 year when consumed as part of a well-balanced diet. Consumption,
however, should be limited depending on a child’s age.
The policy statement recommendations include:
- Intake of juice
should be limited to, at most, 4 ounces daily for toddlers age 1-3. For
children age 4-6, fruit juice should be restricted to 4 to 6 ounces daily; and
for children ages 7-18, juice intake should be limited to 8 ounces or 1 cup of
the recommended 2 to 2 ½ cups of fruit servings per day.
- Toddlers should
not be given juice from bottles or easily transportable “sippy cups” that allow
them to consume juice easily throughout the day. The excessive exposure of the
teeth to carbohydrates can lead to tooth decay, as well. Toddlers should not be
given juice at bedtime.
- Children should
be encouraged to eat whole fruits and be educated about the benefits of the
fruit as compared with juice, which lacks dietary fiber and may contribute to
excessive weight gain.
- Human milk or
infant formula is sufficient for infants, and low-fat/nonfat milk and water are
sufficient for older children.
- Consumption of
unpasteurized juice products should be strongly discouraged for children of all
- Children who
take specific forms of medication should not be given grapefruit juice, which
can interfere with the medication’s effectiveness. In addition, fruit juice is not appropriate in the treatment
of dehydration or management of diarrhea.
The Academy supports policies that seek to reduce fruit
juice consumption and promote fresh fruit. This support extends to developing
policies for the Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC), provided that the policies do not have negative nutritional
consequences for children without access to fresh fruit.
“We know that excessive fruit juice can lead to excessive weight
gain and tooth decay,” co-author Steven A. Abrams, MD, FAAP said.
“Pediatricians have a lot of information to share with families on how to
provide the proper balance of fresh fruit within their child’s diet.