Over the last decade, the nation's war on obesity has targeted some fairly obvious culprits, including fast food, pastries, fried foods and soda.
But recent scientific studies and a new government-sponsored documentary that aired last week on HBO have identified a new, less obvious enemy: fruit juice.
This might surprise the many parents and school districts that in recent years have proudly ditched soda in favor of 100 percent juice. But health experts increasingly agree that it is not a better alternative.
"Juice is just like soda, and I'm saying it right here on camera," pediatric obesity specialist Robert Lustig said in the documentary Weight of the Nation, produced in conjunction with the Centers for Disease Control and Prevention. "There is no difference. When you take fruit and squeeze it, you throw the fiber in the garbage. That was the good part of the fruit. The juice is nature's way of getting you to eat your fiber."
Since 2001, the American Academy of Pediatrics has advised limiting daily juice consumption to 4 to 6 ounces for children 6 and younger and 8 to 12 ounces (the size of a soda can) for children 7 to 18. The academy's head of environmental health, Jerome Paulson, took it even further when he told the Tribune in December that children do not need to drink any juice at all.
"Don't drink an apple," he said. "Eat an apple."
An important difference between fruit juice and fruit, researchers point out, is that calories and sugar delivered in liquid form don't trigger feelings of fullness and can lead to excess consumption.
Beverage-makers dispute claims that fruit juice and obesity are linked. The Juice Products Association said it supports the pediatrics group's recommendations on juice but added that "current scientific evidence does not support a relationship between being overweight and juice consumption."
"Scientific evidence strongly maintains the nutritional benefits of 100 percent juice," the association said. "In fact, studies show that drinking 100 percent fruit juice is associated with a more nutritious diet overall, including reduced intake of dietary fat, saturated fat and added sugars."
As proof, the association cited a cross-sectional study — a snapshot in time — funded by the juice industry that found a correlation between consumption of 100 percent fruit juice and higher nutrient intake in children.
In response, University of North Carolina global nutrition professor Barry Popkin cited six other studies that show correlations between increased fruit juice consumption and increased risk of obesity and diabetes.
"There are no studies that show the opposite — that drinking a glass or two of fruit juice each day will have positive long-term health benefits on weight or diabetes," added Popkin, author of The World Is Fat: The Fads, Trends, Policies, and Products That Are Fattening the Human Race.
In recent months, so-called "sugar sweetened beverages" (often sweetened not with sugar but with high-fructose corn syrup) have come under increasing attack for their contribution to the obesity epidemic. Whether this label should be applied to fruit juice is subject to debate, with some organizations counting only those juices with sugar added.
But even 100 percent juice beverages can contain as much sugar as soda. In addition, most commercial fruit juice is derived from concentrates, which often results in a higher sugar content than if the product were, say, simply squeezed from oranges.
Current USDA guidelines suggest eating about two cups of fruit a day, with the majority consisting of whole fruit rather than juice. That would cap consumption for even the most active adults and children to 1 cup or 8 ounces of juice a day.
In schools, current guidelines allow juice to be substituted for fruit in no more than half of the planned meals "because it lacks dietary fiber and when consumed in excess can contribute extra calories," according to the USDA.
With holdings that include Minute Maid and Odwalla, Coca-Cola ranks as the No. 1 fruit juice maker in the world and is a member of the Juice Products Association. Rhona Applebaum, vice president and chief scientific and regulatory officer for the company, said she's aware of the pediatric academy's recommendation on fruit juice but might still give her son triple that amount.
"I respect what they have to say," Applebaum said. "But as a mom, if my 16-year-old can handle the calories and wants a nutritious beverage, I don't think there's anything wrong with him having a glass of orange juice in the morning and then later with his lunch and dinner. But I want to make sure it's calcium fortified because I want him to build strong bones."
Applebaum said she saw most of the Weight of the Nation documentary and is generally pleased with its messages on diet and exercise. But she said equating juice with soda is an "over-exaggeration."
While juice delivers calories and sugar on par with soda, she said "orange juice also provides your recommended daily allowance of vitamin C and folic acid and more potassium than a banana. It's all about the how, how much and how often."
By MONICA ENG, Chicago Tribune