Key points What is the association between 100% fruit juice intake and body weight in children and adults? Findings This systematic review and meta-analysis of 42 eligible studies, including 17 among children (n = 45,851) and 25 among adults (n = 268,095), found a positive association between 100% fruit juice intake and weight gain in children. Analysis of cohort studies in adults found a significant positive association among studies unadjusted for total energy, suggesting possible mediation by calories; An analysis of trials in adults found no significant association between 100% fruit juice consumption and body weight. Meaning The study findings support guidance to limit fruit juice consumption to prevent excessive calorie intake and weight gain. |
Importance
Concerns have been raised that frequent consumption of 100% fruit juice may promote weight gain. Current evidence on fruit juice and weight gain has yielded conflicting results from both observational studies and clinical trials.
Aim
To synthesize the available evidence on 100% fruit juice consumption and body weight in children and adults.
Data sources
The MEDLINE, Embase and Cochrane databases were searched up to May 18, 2023.
Study selection
We included prospective cohort studies of at least 6 months and randomized clinical trials (RCTs) of at least 2 weeks that evaluated the association of 100% fruit juice with body weight change in children and adults. In the trials, fruit juices were compared with non-caloric controls.
Data extraction and synthesis
Data were pooled using random effects models and presented as β coefficients with 95% CI for cohort studies and mean differences (MD) with 95% CI for RCTs.
Main results and measures
We assessed change in body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) in children and change in body weight in adults.
Results
A total of 42 eligible studies were included in this analysis, including 17 among children (17 cohorts; 0 RCTs; 45,851 children; median [IQR] age, 8 [1-15] years) and 25 among adults (6 cohorts; 19 RCTs; 268,095 adults; median age [IQR] across cohort studies, 48 [41-61] years; median age [IQR] across RCTs, 42 [25-59]).
Among cohort studies in children , each additional serving per day of 100% fruit juice was associated with a 0.03 (95% CI, 0.01-0.05) greater change in BMI.
Among adult cohort studies , studies that did not adjust for energy showed greater body weight gain (0.21 kg; 95% CI, 0.15-0.27 kg) than studies that did adjust for intake of energy (−0.08 kg; 95% CI, −0.11 to −0.05 kg; P for meta-regression <0.001).
RCTs in adults found no significant association between allocation to 100% fruit juice and body weight, but the CI was wide (MD, −0.53 kg; 95% CI, −1.55 to 0.48 kg).
Conclusion and relevance
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