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- Title
Consumption of 100% Fruit Juice and Body Weight in Children and Adults: A Systematic Review and Meta-Analysis.
- Authors
Nguyen, Michelle; Jarvis, Sarah E.; Chiavaroli, Laura; Mejia, Sonia Blanco; Zurbau, Andreea; Khan, Tauseef A.; Tobias, Deirdre K.; Willett, Walter C.; Hu, Frank B.; Hanley, Anthony J.; Birken, Catherine S.; Sievenpiper, John L.; Malik, Vasanti S.
- Abstract
This systematic review and meta-analysis investigates the association between 100% fruit juice intake and body weight in children and adults. Key Points: Question: What is the association between 100% fruit juice intake and body weight in children and adults? Findings: This systematic review and meta-analysis of 42 eligible studies, including 17 among children (n = 45 851) and 25 among adults (n = 268 095), found a positive association between intake of 100% fruit juice and weight gain in children. Analysis of cohort studies in adults found a significant positive association among studies unadjusted for total energy, suggesting potential mediation by calories; an analysis of trials in adults found no significant association between 100% fruit juice consumption and body weight. Meaning: Study findings support guidance to limit consumption of fruit juice to prevent the intake of excess calories and weight gain. Importance: Concerns 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. Objective: To synthesize the available evidence on 100% fruit juice consumption and body weight in children and adults. Data Sources: MEDLINE, Embase, and Cochrane databases were searched through May 18, 2023. Study Selection: Prospective 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 Synthesis: Data 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 Measures: Change 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. Results: A 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 Relevance: Based 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.
- Subjects
MEDICAL information storage &; retrieval systems; FRUIT juices; FOOD consumption; BODY mass index; RESEARCH funding; BODY weight; META-analysis; DESCRIPTIVE statistics; SYSTEMATIC reviews; MEDLINE; MEDICAL databases; CONFIDENCE intervals; WEIGHT gain; FOOD portions; CHILDREN; ADULTS
- Publication
JAMA Pediatrics, 2024, Vol 178, Issue 3, p237
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2023.6124