Headline Headtrips

In recent weeks, we’ve had headlines tell us:

Fruit juice packs pounds on preschoolers

and:

Fruit Juice Not Linked With Children's Weight

Which one is true? You will never know from reading the news reports because both stories were taken from press releases. And sadly, as is often the case, the journalists and reporters didn’t go to the original sources — the actual studies — to give the real story.

The first clue to unsound claims is an emotional appeal. The first story made its way around the world with this and other dire warning headlines such as “Fruit juice bad news for children.” The articles themselves are equally disconcerting. Attempting to worry us, making an issue appear more complicated than it is, and creating controversy and uncertainty where there is none, are all techniques played to sell us on something when good supportive science is lacking. Anytime something makes you feel scared about your food, body or health that is your BALONEY ALERT that you are being manipulated. That’s sales, not science.

Let’s look at the foreboding story first. Most research on preschool children to date has found that excessive fruit juice leads to stunted growth because it displaces the fats and other foods that growing children need. That’s why pediatricians and other child nutritional experts have long recommended limiting preschoolers to 4 to 6 ounces of juice a day. So this new claim that too much juice leads to fatter little ones is puzzling.

It came from a study in Pediatrics looking at whether nutritional counseling messages could influence childhood weight gain and if fruit juices and restrictive eating caused preschool children to become fat. About 2,800 recipients in New York’s special nutritional supplement Women, Infants, and Children (WIC) programs were surveyed. The researchers found an association between excessive daily fruit juice and children gaining a miniscule 0.009 standard deviation more in weight each month — but only in the children who were larger to begin with. They found no association between fruit juice consumption and “excessive” weight gain among smaller children. In other words, the children with a genetic tendancy to be heavier continued to grow proportionately more and stay in their normal growth curves. Thinner children at the lower BMIs normal for them, stayed in their growth curves. Children growing appropriately and generally staying on their individual growth curves is something pediatricians have long viewed as a good thing.

Their other findings concurred with the body of evidence to date. Children whose diets were restricted were larger than children whose food intakes were not restricted. “Dieting” and restrained eating works no better for weight management in children as it does in adults. Yet, incredibly, the researchers suggested that limiting fruit juice could be a strategy for preventing “overweight” in children. They didn’t test this hypothesis, but it is popularly believed today.

They also found that nutritional educational messages to parents made no difference in the children’s weight changes; something that has been borne out in the body of research.

The study behind the headlines reassuring parents that fruit juices are nothing to fear and won’t cause their children to become fat was also published in Pediatrics. These researchers used information from the National Health and Nutrition Examination Survey 1999–2002, which is a continuous evaluation of a nationally-representative sample of the population, including dietary intakes and physical examinations. They found that most preschoolers in our country drank less than 6 ounces of fruit juice, as recommended by pediatricians.

Meaning: All of this upset about juice is really not a public health issue at all. Most parents are doing just fine feeding their children. Parents needn't fear they are hurting their children. Hopefully, parents will not react to the first story by not giving their children any juice for fear they will gain weight.

They also found:

•Weight status of the child had no association with the amount of total beverages, milk, 100% fruit juice, fruit drink, or soda consumed. [This actually concurs with the body of sound evidence, epidemiological and clinical, which has shown fat and thin children’s diets do not explain their weights. If you think otherwise, look closely at those studies. Often, they will be of very short duration and unable to show any lasting weight changes. But more often, they have not actually found any weight differences at all. Countless studies find a difference in calories consumed among children and merely assume that might make a difference in their weights, when they haven’t actually been able to find that at all.]

•There was no clinically significant association between the types of milk (percentage of fat) consumed and weight status. [Despite what seems intuitively correct and is certainly popular today, whole milk, 2%, low-fat or fat-free milk makes no difference in children’s weights.]

The lead researcher, Dr. Theresa Nicklas, a professor of pediatrics at Baylor College of Medicine, said: "An analysis done by the U.S. Dietary Guidelines Advisory Committee found that 100 percent fruit juices provide substantial amounts of vitamin C, potassium and folate to the diet that would otherwise not be consumed."

Take home message: Kids naturally come in all shapes and sizes. Worrying about and trying to change what kids eat and drink is never going to change that. Yet to suggest that a naturally fatter child should be denied the same enjoyment and benefits of foods and drinks that other kids enjoy, based on nothing but beliefs, is unthinkable.