Consumption of 100% Fruit Juice and Body Weight in Children and Adults: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis combining randomized trials (adults) and prospective cohort studies (children and adults)
PubMed 38227336 · doi:10.1001/jamapediatrics.2023.6124
What was done
Authors conducted a systematic review and random-effects meta-analysis of MEDLINE, Embase, and Cochrane databases through May 18, 2023. They included prospective cohort studies (>=6 months) and randomized clinical trials (>=2 weeks, compared against noncaloric controls) evaluating 100% fruit juice intake and change in BMI (children) or body weight (adults).
What was found
A total of 42 studies were analyzed: - Children (17 cohorts, 0 RCTs; n = 45,851; median age 8 years): Each additional daily serving of 100% fruit juice was associated with a 0.03 higher BMI change (95% CI, 0.01 to 0.05). - Adult cohorts (6 cohorts; n = 268,095 across all adult studies; median age 48 years): Studies unadjusted for energy intake showed weight gain of 0.21 kg (95% CI, 0.15 to 0.27 kg), whereas energy-adjusted studies showed -0.08 kg (95% CI, -0.11 to -0.05 kg; P for meta-regression < .001). - Adult RCTs (19 RCTs; median age 42 years): No significant association between 100% fruit juice and body weight change was found, though precision was low (MD, -0.53 kg; 95% CI, -1.55 to 0.48 kg).
Why it matters
These findings support dietary guidelines recommending limits on 100% fruit juice consumption to prevent excess calorie intake and modest weight gain, particularly in children.
Limits
Pediatric evidence was entirely observational with zero RCTs, precluding causal inference. Adult RCTs had wide confidence intervals and permitted short intervention durations (as brief as 2 weeks). Potential residual confounding from broader dietary patterns and specific fruit juice types could not be ruled out from the abstract.
Cited by
- supports Epidemiological studies indicate that drinking fruit juice increases the risk for obesity, whereas consuming whole natural fruits does not.