Sugar in juice could be bad medicine

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To many people, it's a health food; to others, it's simply soda in disguise.

That virtuous glass of juice is feeling the squeeze as doctors, scientists and public health authorities step up their efforts to reduce the nation's girth.

It's an awkward issue for the schools that peddle juice in their cafeterias and vending machines. It's uncomfortable for advocates of a junk food tax, who say they can't afford to target juice and alienate its legions of fans. It's confusing for consumers who think they're doing something good when they chug their morning OJ, sip a 22-ounce smoothie or pack a box of apple juice in their child's lunch.

The inconvenient truth is that 100 percent fruit juice poses the same obesity-related health risks as Coke, Pepsi and other widely vilified beverages.

With so much focus on the outsized role that sugary drinks play in the country's collective weight gain -- and the accompanying rise in conditions such as diabetes, heart disease and cancer -- it's time juice lost its wholesome image, some experts say.

"It's pretty much the same as sugar water," said Dr. Charles Billington, an appetite researcher at the University of Minnesota. In the modern diet, he said, "There's no need for any juice at all."

A glass of juice concentrates all the sugar from multiple pieces of fruit. Ounce per ounce, it contains more calories than soda, although it tends to be consumed in smaller servings. A cup of orange juice has 112 calories, apple juice has 114 and grape juice packs 152, according to the U.S. Department of Agriculture. The same amount of Coke has 97 calories, and Pepsi has 100.

And just like soft drinks, juice is rich in fructose -- the simple sugar that does the most to make food sweet.

University of California, Davis scientist Kimber Stanhope has found that consuming high levels of fructose increases risk factors for heart disease and Type 2 diabetes because it is converted into fat by the liver more readily than glucose. Her studies suggest that it doesn't matter if the fructose comes from soda or juice.

"Both are going to promote equal weight gain," she said, adding that she's perplexed by the fixation on the evils of sugar-sweetened beverages: "Why are they the only culprit?"

Juice is a relatively recent addition to the human diet. For thousands of years, people ate fruit and drank mostly water.

But in the early 1900s, citrus growers in Florida were harvesting more oranges than they could sell. Then they had an epiphany: Promote juice.

"You consume more oranges if you drink them than if you eat them whole," said Alissa Hamilton, author of the book "Squeezed: What You Don't Know About Orange Juice."

The U.S. Army was instrumental in turning orange juice into a commercial product.

It originally served a powdered lemonade to ensure soldiers got enough vitamin C, but it tasted "like battery acid," Ms. Hamilton said. So, during World War II, the Army commissioned scientists to invent a system for freezing OJ in a concentrated form. The patent wound up with Minute Maid, which sold cans of frozen juice concentrate in grocery stores.

In the 1950s, pasteurization technology developed by Tropicana made orange juice even more consumer-friendly because it could be sold ready to drink in cartons, like milk.

Body builder Jack LaLanne and other health gurus touted juice as a natural medicine, and decades of advertising helped secure its place at the breakfast table. Today, roughly half of all Americans consume juice regularly, according to NPD Group, a market research outfit.

The Juice Products Association emphasizes the value of the vitamins, minerals and phytonutrients in juice -- especially when so many American eat so little fresh produce.

"If someone can add a glass of fruit juice at breakfast, that's an important addition to the diet," said Sarah Wally, a dietitian for the trade group.

But scientists increasingly are questioning whether the benefits outweigh the sugar and calories that come with them. "The upside of juice consumption is so infinitesimal compared to the downside that we shouldn't even be having this discussion," said Dr. Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco.

Several researchers have linked juice to more healthful diets and lower weights. A 2008 report of 3,618 children ages 2 to 11 found that kids who drank at least 6 ounces of juice a day consumed less fat and more vitamins and minerals than kids who drank no juice at all.

But many experts say the data simply reflect a correlation between juice and healthful diets, not a causal relationship.

There's also concern that children who drink lots of sweet beverages such as juice will develop a lifelong preference for sweeter foods. A 2004 Dutch study found that 8- to 10-year-olds preferred sweeter drinks after consuming a sugary orangeade for eight days. They also drank more of it as they acclimated to its sweet taste.

Doctors and health officials have been persuaded to de-emphasize juice in recent years.

The American Academy of Pediatrics' nutrition committee revised its policy in 2001 to recommend that children ages 1 to 6 drink no more than one 4- to 6-ounce serving of juice a day and older kids have no more than two.

"Because juice is viewed as nutritious, limits on consumption are not usually set by parents," the committee wrote in The Use and Misuse of Fruit Juice in Pediatrics. "Like soda, it can contribute to energy imbalance," causing the weight gain that leads to obesity.

The government's 2005 dietary guidelines recognize that juices can be good sources of potassium, but recommend whole fruit for the majority of daily fruit servings to ensure adequate intake of fiber.



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