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    Maaza

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    Arpit Nigam
    This document discusses fruit drinks and their health impacts. It begins by noting the rise in fruit drink consumption due to changing lifestyles and marketing. It then defines fruit juice, fruit drinks, and nectars according to their fruit concentrate levels. While juices contain nutrients, fruit drinks are low in fiber and nutrients compared to whole fruits. The fruit drink market is large and growing, especially among children, which is a health concern if consumption displaces more nutritious foods. Guidelines recommend limiting juice to 50% of daily fruit intake and not feeding it to young infants. While juices contain vitamins, excessive consumption has been linked to issues like diarrhea, dental cavities, obesity, and malnutrition.

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    Maaza

    Uploaded by

    Arpit Nigam
    198 views3 pages
    This document discusses fruit drinks and their health impacts. It begins by noting the rise in fruit drink consumption due to changing lifestyles and marketing. It then defines fruit juice, fruit drinks, and nectars according to their fruit concentrate levels. While juices contain nutrients, fruit drinks are low in fiber and nutrients compared to whole fruits. The fruit drink market is large and growing, especially among children, which is a health concern if consumption displaces more nutritious foods. Guidelines recommend limiting juice to 50% of daily fruit intake and not feeding it to young infants. While juices contain vitamins, excessive consumption has been linked to issues like diarrhea, dental cavities, obesity, and malnutrition.

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    MAaza

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    This document discusses fruit drinks and their health impacts. It begins by noting the rise in fruit drink consumption due to changing lifestyles and marketing. It then defines fruit juice, fruit drinks, and nectars according to their fruit concentrate levels. While juices contain nutrients, fruit drinks are low in fiber and nutrients compared to whole fruits. The fruit drink market is large and growing, especially among children, which is a health concern if consumption displaces more nutritious foods. Guidelines recommend limiting juice to 50% of daily fruit intake and not feeding it to young infants. While juices contain vitamins, excessive consumption has been linked to issues like diarrhea, dental cavities, obesity, and malnutrition.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    198 views3 pages

    Maaza

    Uploaded by

    Arpit Nigam
    This document discusses fruit drinks and their health impacts. It begins by noting the rise in fruit drink consumption due to changing lifestyles and marketing. It then defines fruit juice, fruit drinks, and nectars according to their fruit concentrate levels. While juices contain nutrients, fruit drinks are low in fiber and nutrients compared to whole fruits. The fruit drink market is large and growing, especially among children, which is a health concern if consumption displaces more nutritious foods. Guidelines recommend limiting juice to 50% of daily fruit intake and not feeding it to young infants. While juices contain vitamins, excessive consumption has been linked to issues like diarrhea, dental cavities, obesity, and malnutrition.

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    V I E W P O I N T

    Fruit Drinks:
    How Healthy and Safe?
    Fruit drinks are popularly used in most urban
    households. Historically, the use of fruit juices
    began with consumption of orange juice, as a source
    of vitamin C to prevent scurvy. However, today
    markets are flooded with a large variety of juices
    e.g., mango, apple, guava, litchi, grape, pineapple,
    etc. The main reason for increased consumption is
    changing lifestyles and rising level of health
    consciousness among consumers and parents.
    They believe that these drinks provide superior
    nutrition because of their fortified status and high
    beverage cost. Child preference, easy availability,
    convenience, naturalness and marketing strategies
    have given fruit drink industry a booming growth.
    Recent pesticide issue of soft drinks has further
    augmented sales of fruit drinks.
    DEFINITIONS: FRUIT JUICE, FRUIT DRINK
    AND NECTAR
    American Academy of Pediatrics (AAP) defines
    fruit juice as either natural or 100% concentrate
    without added sweeteners. Anything less than 100%
    concentrate is labeled as drink, beverage, or
    cocktail(1). Fruit drinks are defined as calorically
    sweetened beverages with a small percentage of fruit
    juice or juice flavoring containing carbonated
    water(2). Fruit drinks have less than 20%
    concentrate and nectars have around 20 to 99%
    concentrate. Sometimes, fortifiers such as vitamin C
    or calcium are also added to the fruit drinks.
    Fruits and 100% juices contain water, simple
    carbohydrates (sucrose, fructose, glucose, sorbitol),
    high amount of vitamins (C, A) and minerals
    (potassium, calcium etc.)(1). However fruit drinks,
    even 100% juice is not equivalent to whole fruits.
    Fruits supply fibers and phytochemicals to diet,
    which are not present in juices. Fruit juice devoids
    the child of opportunities to learn skills like peeling,
    chewing, and differentiating between colors,
    textures and shapes. Fruit drinks, thought to be
    INDIAN PEDIATRICS

    complete source of energy, vitamins and minerals


    are actually a mere sweet drinks and poor source of
    nutrition. Whole fruits are less calorigenic as
    compared to fruit juices and fruit drinks.
    THE BUSINESS BOOM IN FRUIT DRINK MARKET
    The mean juice consumption in US is as high as
    2 billion gal/y, with an average 9.2 gal/y/person
    with children consuming the maximum (28%)(3,4).
    The fruit juice consumption in pre-school children
    increased from 3.2 to 5.5 fl/oz/day(5). By one year of
    age, 90% children in US are consuming fruit
    juices(1). Even in India, in-home juice consumption
    has increased from 30 to 80% in last 3 years(6). The
    Indian fruit drink market is estimated to be 1200
    crores(7). The commonly available brands in Indian
    market are from Dabur (Coolers and Real), Pepsi
    (Tropicana, Tropics, Slice), Coca Cola (Maaza),
    Mother Diary (Safal) and Godrej (Xs range). These
    are marketed in different flavors: orange, mango,
    pineapple, lichi, apple, grape etc and include fruit
    juices, fruit drinks and nectars. The fruit drink
    market is growing further at the rate of 20-25%.
    The major share (60%) is contributed by fruit
    drinks while fruit juices account for only 30% and
    nectars for the remaining 10% market(6). The
    growing popularity and unrestricted consumption
    of fruit drinks especially in children is a serious
    concern.
    RECOMMENDED DAILY ALLOWANCE (RDA)
    Fruits are one of the 5 major food groups in food
    pyramid. American Academy of Pediatrics (AAP)
    recommends that those who require 1600
    Kilocalories (1-4 years of age) require 2 fruit
    servings and those who require 2800 Kilocalories
    (10-18 years of age) require 4 fruit servings(1). In
    them 50% can be provided as fruit juice (not fruit
    drink) with each serving of 6 oz. No juices are
    recommended for infants less than 6 months of age.
    The committee advocates and encourages use of
    fruits as compared to juices to meet the daily
    requirements and energy balance. However, fruit
    intake in diet is found to be low. In American
    215

    VOLUME 45__MARCH 17, 2008

    GUPTA, et al.
    Key Messages: Tips For Parental Education on Fruit Juice
    Encourage children to eat whole fruits.
    Juices should not constitute more than 50% of the daily recommended intake of fruits.
    Do not feed fruit juices to infants below 6 months.
    Fruit juices or drinks should not replace milk in the diet.
    Consume only 100% fruit juice and that too in appropriate amount.
    Fruit juices can be a healthy sources of minerals and vitamins if given judiciously but may have adverse effects
    if consumed excessively.

    juices have high quantity of sorbitol which is


    nonabsorbable and high fructose-glucose ratios. A
    health care professional should be consulted before
    recommending fruit juice in diarrhea, dental caries,
    and malnutrition. Few studies have shown that
    intake of fruit juices in huge quantity is associated
    with short stature, obesity, diabetes mellitus and
    malnutrition(8). However, Skinner, et al.(12)
    recently showed that in a sample of young children
    there was no association between short stature and
    obesity and high fruit juice intake.

    children, only 80% of the RDA is met for fruits and


    that too 54% from fruit juices. The pattern of juice
    consumption in one study was as follows: mixed
    (39%), apple (30%), orange (23%), grape (7%), and
    pear (1%)(8). Corresponding data are not available
    for Indian children.
    POTENTIAL HAZARDS OF FRUIT DRINKS
    Children have preference for fruit drinks as they taste
    good, packaging has an eye appeal, are inexpensive
    and convenient and hence are replacing important
    food items in diet. Mothers use them very commonly
    in diet. A survey of infant feeding in Asian families
    in England showed that at 5 months of age, 75% of
    Pakistani and White mothers, 63% of Indian mothers
    and 61% of Bangladeshi mothers were giving fruit
    juices as source of non milk drink(9).

    APPROPRIATE CONSUMPTION OF FRUIT DRINKS


    Fruit drinks, if consumed in appropriate quantity,
    can be a part of balanced diet for children, and are
    not always harmful. Studies have shown that vitamin
    C and flavinoids in juices have beneficial long term
    health effects like decreasing the risk of cancer and
    heart disease(13). Vitamin C by increasing iron
    absorption to almost double can reduce the incidence
    of anemia in population consuming diet with low
    iron content and bioavailability(14). However, the
    awareness and education of these details is lacking
    among general population.

    By displacing milk in diet the number of children


    meeting RDA for calcium has drastically reduced to
    just 50% and thus a great health concern. The
    calcium in these juices is not biologically equivalent
    to milk calcium. The iron in the marketed juices
    is also absorbed variably. High vitamin C in
    them promotes iron absorption but polyphenolic
    compounds in certain juices inhibit iron absorption.
    Fruit drinks are thought to be good source of
    minerals and hence inappropriately used in diarrhea
    when it is known that they are not balanced fluids in
    this condition and even aggravate diarrhea or rather
    cause toddlers diarrhea(5). Fruit drinks are common
    cause of tooth decay and promote picky feeding(10).
    Unpasteurized juices can be a source of serious
    bacterial infections. Change in bowel habits i.e.,
    abdominal distension, flatulence and diarrhea are
    frequently observed with fruit drinks(11). This is
    because of carbohydrate malabsorption as these
    INDIAN PEDIATRICS

    ROLE OF IAP AND CONSUMERS


    With markets overflowing with wide variety of fruit
    drinks and consumers half aware of the benefits and
    adverse effects, it is a serious issue to be addressed.
    Also, no clear system or guidelines regarding
    nutritive and energy density, health preferences and
    risk related with fruit drinks exists in India. Unlike
    AAP, the Indian Academy of Pediatrics (IAP) has
    not formulated any guidelines regarding fruit juice
    consumption in children. It needs to set up a Task
    force to look into these issues and formulate new, or
    216

    VOLUME 45__MARCH 17, 2008

    VIEWPOINT: FRUIT DRINKS


    Opinion Research. Cited by: Clydesdale FM,
    Kosala KM, Ikeda JP. All you want to know about
    fruit juice. Nutrition Today 1994; 2: 14-28.

    adopt, or adapt the existing AAP guidelines. Drinks


    do not label the exact concentration and this may
    misguide consumers. There are no guidelines printed
    on labels regarding the safe intake for different age
    groups. Pasteurization details are not clearly
    mentioned. Thus guidelines for manufacturers need
    to be made. Parents should be made aware of these
    minute details and to read the label to identify the
    exact nature of the constituents of the fruit drink to
    know what they are offering to their child.
    Contributors: PG conceived the article. HG collected
    literature, and drafted the manuscript. PG helped in
    drafting and critically analyzed the literature and edited the
    manuscript. Both authors approved the final manuscript.
    Funding: None.

    5.

    Dennison BA. Fruit juice consumption by infants


    and children: a review. J Am Coll Nut.1996; 15: 4S11S.

    6.

    Sharma A. More juice in the fruit market. From:


    http://www.rediff.com/money/2004/jul/31spec3.
    htm. Accessed February 10, 2008.

    7.

    Jagannathan V. Minute Maid crosses 2 million sales


    mark. From http://www.domain-b.com/companies/
    companies_c/coca-colaindia/20070510_million.
    htm. Accessed February 10, 2008.

    8.

    Dennison BA, Rockwell HL, Baker SL. Excess fruit


    juice consumption by preschool - aged children is
    associated with short stature and obesity. Pediatrics
    1997; 99: 15-22.

    9.

    Watt RG. A national survey of infant feeding in


    Asian families: summary of findings relevant to oral
    health. Br Dental J 2000; 188: 16-20.

    10.

    Davis JR, Stegeman CA. The Dental Hygienist


    Guide to Nutritional Care. Philadelphia: WB
    Saunders; 1998.

    Competing interests: None stated.

    Hema Gupta and Piyush Gupta,


    Department of Pediatrics,
    University College of Medical Sciences and
    GTB Hospital, Delhi 110 095, India.
    Email: hema_g10@hotmail.com
    REFERENCES
    1.

    American Academy of Pediatrics. The use and


    misuses of fruit juices in Pediatrics. Pediatrics 2001;
    107: 1210-1213.

    11.

    American Academy of Pediatrics, Committee on


    Nutrition: The use of fruit juices in diet of young
    children. Am Acad Pediatr News 1991; 7: 2.

    2.

    Pompkin BM, Armstrong LE, Bray GM, Caballero


    B, Frei B, Willett WC. A new proposed guidance
    system for beverage consumption in the United
    States. Am J Clin Nut 2006; 83: 529-542.

    12.

    Skinner JD, Carruth BR, Moran J, Houck K,


    Colletta F. Fruit juice intake is not related
    to childrens growth. Pediatrics 1999; 103:
    58-64.

    3.

    Agriculture Research Service. Food and Nutrient


    Intakes by Individuals in United States by Sex and
    Age, 1994-1996.Washington, DC: US Department
    of Agriculture; 1998. NFS Report No. 96-2.

    13.

    Ames BN. Micronutrients prevent cancer and delay


    aging. Toxicol Lett 1998; 102-103: 5-18.

    14.

    Hollman PC, Hertlog MG, Kalan MB. Role of


    dietary flavinoids in protection against cancer and
    coronary heart disease. Biochem Soc Trans 1996;
    24: 785-789.

    4.

    National Family Opinion Research. Share of Intake


    Panel (database) Greenwich, CT: National Family

    INDIAN PEDIATRICS

    217

    VOLUME 45__MARCH 17, 2008

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