Volume 15, Number 8
The consumption of sugar-sweetened beverages (SSBs) has long been associated with increased risk for obesity, diabetes, cardiovascular disease, and other health problems. Because of this, many persons in the population assumed that “diet” beverages were a healthier option, which themselves have now been associated with increased health risks. Along the way, 100% fruit juices have been presumed to be a healthy option.
Compared to a sugar-sweetened beverage (SSB), 100% fruit juice certainly sounds healthier than a “sweetened” fruit juice. This perception appears to be erroneous. While 100% fruit juices do contain some vitamins and nutrients that are not present in most SSBs, the bottom line is that they are still predominantly sugar and water. A recent analysis published in JAMA Network Open concluded that the all-cause mortality risk associated with the consumption of 100% fruit juices is essentially no different than the increased risk associated with the consumption of other SSBs.
While 100% fruit juices have not been found to be a healthier choice than SSBs, the consumption of whole fresh fruits does have health benefits. And simply drying or freezing fruits before consumption does not appear to reduce these benefits. The health benefits of whole fruits are lost when they are processed into canned products to have long shelf lives, especially when sugar is added. With respect to 100% fruit juices, the loss of the physical structure of the fruit and the loss of fiber are considered problematic. Juices tend to be less satiating than solid foods, often leading to the consumption of more calories. Also, there is a more rapid release of sugars into the bloodstream with juices, resulting in a higher glycemic response and increased production of insulin.
There is evidence that population consumption of SSBs, and 100% fruit juices, can be affected by public health and/or legislative efforts. A three-year campaign in Howard County, Maryland, aimed at decreasing consumption of SSBs, did have the desired effect, according to the results summarized in a 2017 article in JAMA Internal Medicine. Interestingly, even though the campaign did not specifically encourage avoidance of 100% fruit juices, it did emphasize attention to portion sizes, and sales of 100% fruit juice actually declined along with sales of SSBs. Jurisdictions where SSBs have an added tax have found a decrease in the consumption of sugared beverages. Because of the similarity between 100% fruit juice and other SSBs, extending SSB taxes to 100% fruit juices is being championed by some health experts.
Even though 100% fruit juices may not have added sugars, current evidence suggests that it is reasonable to think about 100% fruit juice as sugar and water, just like other SSBs.
Paul J. Hershberger, Ph.D.
… is a clinical health psychologist. He is Professor, Director of Research, and Director of the Division of Behavioral Health, Department of Family Medicine, Wright State University Boonshoft School of Medicine.
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