Young children are often given fruit juice with meals or along with a snack. The sugar content in 100% fruit juice is high, and these sugars are nutritionally equivalent to those in sugar-sweetened beverages. The American Academy of Pediatrics (AAP) recommends that children ages six and younger drink no more than four to six ounces of fruit juice daily, and that those ages seven and older have no more than eight to 12 ounces daily. Because young children drink more fruit juice than any other age group-and often more than the recommended amount-there are concerns that these drinks may contribute to weight gain and childhood obesity.

Researchers identified eight longitudinal studies, involving a total of 34,470 children, to determine the effect of 100% fruit juice consumption on body mass index (BMI) or BMI z score, which is a measure of weight relative to height, adjusted for the child's age and sex. Specifically, they analyzed the change in BMI z score associated with a one-serving-per-day increase in 100% fruit juice. The follow-up time among the studies ranged from six months to 10 years.

In three of the four studies involving younger children-those ages one to six years at baseline-100% fruit juice consumption was significantly associated with an increased BMI z score over time, which means that weight increases were out of proportion to height increases. Greater changes in BMI z score were associated with younger age at baseline and with a longer period of time during which changes in BMI z scores were measured. Changes in BMI z scores, however, were not large enough to be clinically meaningful. None of the four studies involving older children-those ages seven to 18 years at baseline-found an association between fruit juice consumption and change in BMI z score.

The researchers recommend that randomized controlled trials be conducted to examine the effect of fruit juice intake on weight gain and obesity in young children. Until these studies are performed, the researchers support the AAP recommendations regarding juice intake among children.

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