Too Much Juice
Is juice squeezing important nutrients out of your child's diet?
By Madeleine Greey
There was a time when my son seemed to have only two words in his vocabulary: "No!" and "Juice!" Both words tumbled out of his two-year-old mouth with the same sense of dire urgency. When Nicholas awoke, it was "Juice!" Mid-morning, it was "Juice!" And so on throughout each busy day. I found myself pouring little plastic cups of juice like a mindless robot, until one day I stopped to take stock. My cute little juice-aholic was knocking back more than 24 ounces of the sweet stuff a day. No wonder his other favourite word came my way every time I asked him to sit down and eat.
Juice, like many good things, is best in moderation. Too much of it can lead to a surprising array of problems. The wake-up call for many health-care professionals was a study, published in a 1994 issue of Pediatrics, revealing that excessive juice consumption in toddlers could actually lead to failure to thrive, or growth deficiencies.
Less extreme, but still worrisome to many parents, is the relationship between juice drinking and picky eating. This phenomenon has been witnessed in detail by William Wilkoff, author of Coping with a Picky Eater, who points to a problem he calls "the juice deception."
"Juice is better than soft drinks," writes Wilkoff, "but it is easy to get too much, particularly in a bottle, and it displaces important nutritious components of the child's diet.... In my pediatric nutrition clinic days, more often than not, I would find toddlers were drinking way too much juice - sometimes as much as 24 ounces a day."
That amount far exceeds the Canadian Paediatric Society (CPS) recommendation that children from six to 24 months drink no more than four to six ounces (125 to 200 mL) a day, and children two to 12 years old drink no more than eight to 12 ounces (250 to 375 mL) a day. In other words, parents should limit juice intake to two servings daily.
"Parents have a tendency to offer juice more often than not," says Toronto dietitian Lorry Chen. "Kids love juice and will ask for it, again and again. Most parents aren't even aware that overconsumption is an issue. They think it's nutritious... so why not offer it all the time?"
That's the catch: Juice is nutritious. Most varieties are excellent sources of vitamin C. Depending on the type, juice can also supply folate, potassium - even vitamin A and calcium. It's fat-free, easy to digest, has no additives and is all natural.
Yet despite all of its attributes, juice is high in calories and does fill up tiny tummies quickly. If your little guy is feeling satiated from a juice bottle, chances are he won't want his Pablum. If babies and toddlers are filling up on the sweet liquid, they might routinely refuse solid foods, which may lead to anemia.
There's another concern. Too much juice - especially apple or pear juice - can sometimes lead to watery stools or toddler's diarrhea. Different than infectious diarrhea, toddler's diarrhea occurs when too much sorbitol and fructose enter the digestive tract. "These sugars are not broken down easily in a young child's digestive system," explains Doris Yuen, chairperson of the CPS Nutrition Committee, "and as a result, water actually leaks into the gut, causing diarrhea."
The other type of diarrhea - caused by gastrointestinal infections - can be compounded, warns Yuen, if a child drinks juice. While the old school of medical thought was to prescribe "clear fluids" for gastrointestinal infections and flu-related diarrhea, doctors now recommend that children take electrolyte rehydration solutions, such as Pedialyte, and avoid apple juice.
Another place to avoid juice is in a bottle. When children drink juice from a bottle, teeth are in constant contact with sugary liquids, wreaking havoc with dental health. According to Burton Conrod, a Sydney, N.S. dentist and president-elect of the Canadian Dental Association, children who spend a lot of time with a bottle in their mouth - whether lying down or walking around - are at risk of suffering from severe tooth decay (unless, of course, that bottle is filled with water). Thus it is better to drink juice from a bottle, cup, sippy cup or juice box in a single sitting rather than throughout the day, to limit the contact time between teeth and sweet fluids.
The best place for babies to get their first taste of juice is from a cup. That's what Darlynn Harmison of Bourget, Ontario chose to do with her six-month-old daughter. "Courtney was still nursing exclusively and I figured, `Why introduce a bottle, then take it away?' " she says. "Besides, I had read about the risk of dental caries with a juice bottle."
Harmison started Courtney with diluted apple juice since she didn't want her daughter's palate to become accustomed to the sweetness of full-strength juice. (The CPS says it's fine to offer pure, undiluted fruit juice to babies, but does not recommend introducing diluted or undiluted juice until a baby is six months old.)
Now Courtney is 18 months old, and her mother limits her juice intake to four ounces (125 mL) a day. "I fill her sippy cup every day, and if she doesn't finish it when it's served, she can finish it later," explains Harmison. "But I'll always offer her water or milk first. I know that there's vitamin C in her juice, but I'd rather she got more nutrients from whole fruit."
The only time Harmison will break down and offer extra juice to her daughter is during a heat wave. "When it's really hot out and the temperature is up in the 30s, I do get concerned about dehydration," she says. "If juice is all she'll take, that's what I'll give her."
Since most juice hounds complain loudly when parents try to cut back, it's wise to do so gradually, perhaps over a month. Reduce the actual serving size, too, or consider diluting it. Juice from concentrate is easier to water down (without kids noticing) than juice from a can. When a dedicated juice-drinker witnesses his beverage getting a shot of water from a faucet, the success rate is sure to plummet. But if you dilute canned juice and store it in a pitcher, who's to know? Another trick for children over three is to serve one or two frozen-juice ice cubes in a glass of water. You can jazz up the cubes by adding a slice of strawberry or a few blueberries.
Of course, it makes better sense to serve juice judiciously, right from the get-go. If kids under two get a cup in a high chair, then wandering with bottles is prevented. If you instill some structure, such as, "We only serve it at breakfast" or "Here's your daily juice snack," then the all-day habit never starts.
Donna Green of Toronto remembers when her daughter, Stella, was two and a confirmed juice-aholic. "When she was hungry, Stella would much rather drink something sweet than eat food. So I started a no-juice policy during mealtimes to ensure a balanced meal."
It worked. Stella, now nine, is still an avid drinker. "The difference nowadays is that if she's hungry, she'll take a steamy bowl of soup over a glass of juice, hands down. She's kicked the habit, so to speak."
By Madeleine Greey
There was a time when my son seemed to have only two words in his vocabulary: "No!" and "Juice!" Both words tumbled out of his two-year-old mouth with the same sense of dire urgency. When Nicholas awoke, it was "Juice!" Mid-morning, it was "Juice!" And so on throughout each busy day. I found myself pouring little plastic cups of juice like a mindless robot, until one day I stopped to take stock. My cute little juice-aholic was knocking back more than 24 ounces of the sweet stuff a day. No wonder his other favourite word came my way every time I asked him to sit down and eat.
Juice, like many good things, is best in moderation. Too much of it can lead to a surprising array of problems. The wake-up call for many health-care professionals was a study, published in a 1994 issue of Pediatrics, revealing that excessive juice consumption in toddlers could actually lead to failure to thrive, or growth deficiencies.
Less extreme, but still worrisome to many parents, is the relationship between juice drinking and picky eating. This phenomenon has been witnessed in detail by William Wilkoff, author of Coping with a Picky Eater, who points to a problem he calls "the juice deception."
"Juice is better than soft drinks," writes Wilkoff, "but it is easy to get too much, particularly in a bottle, and it displaces important nutritious components of the child's diet.... In my pediatric nutrition clinic days, more often than not, I would find toddlers were drinking way too much juice - sometimes as much as 24 ounces a day."
That amount far exceeds the Canadian Paediatric Society (CPS) recommendation that children from six to 24 months drink no more than four to six ounces (125 to 200 mL) a day, and children two to 12 years old drink no more than eight to 12 ounces (250 to 375 mL) a day. In other words, parents should limit juice intake to two servings daily.
"Parents have a tendency to offer juice more often than not," says Toronto dietitian Lorry Chen. "Kids love juice and will ask for it, again and again. Most parents aren't even aware that overconsumption is an issue. They think it's nutritious... so why not offer it all the time?"
That's the catch: Juice is nutritious. Most varieties are excellent sources of vitamin C. Depending on the type, juice can also supply folate, potassium - even vitamin A and calcium. It's fat-free, easy to digest, has no additives and is all natural.
Yet despite all of its attributes, juice is high in calories and does fill up tiny tummies quickly. If your little guy is feeling satiated from a juice bottle, chances are he won't want his Pablum. If babies and toddlers are filling up on the sweet liquid, they might routinely refuse solid foods, which may lead to anemia.
There's another concern. Too much juice - especially apple or pear juice - can sometimes lead to watery stools or toddler's diarrhea. Different than infectious diarrhea, toddler's diarrhea occurs when too much sorbitol and fructose enter the digestive tract. "These sugars are not broken down easily in a young child's digestive system," explains Doris Yuen, chairperson of the CPS Nutrition Committee, "and as a result, water actually leaks into the gut, causing diarrhea."
The other type of diarrhea - caused by gastrointestinal infections - can be compounded, warns Yuen, if a child drinks juice. While the old school of medical thought was to prescribe "clear fluids" for gastrointestinal infections and flu-related diarrhea, doctors now recommend that children take electrolyte rehydration solutions, such as Pedialyte, and avoid apple juice.
Another place to avoid juice is in a bottle. When children drink juice from a bottle, teeth are in constant contact with sugary liquids, wreaking havoc with dental health. According to Burton Conrod, a Sydney, N.S. dentist and president-elect of the Canadian Dental Association, children who spend a lot of time with a bottle in their mouth - whether lying down or walking around - are at risk of suffering from severe tooth decay (unless, of course, that bottle is filled with water). Thus it is better to drink juice from a bottle, cup, sippy cup or juice box in a single sitting rather than throughout the day, to limit the contact time between teeth and sweet fluids.
The best place for babies to get their first taste of juice is from a cup. That's what Darlynn Harmison of Bourget, Ontario chose to do with her six-month-old daughter. "Courtney was still nursing exclusively and I figured, `Why introduce a bottle, then take it away?' " she says. "Besides, I had read about the risk of dental caries with a juice bottle."
Harmison started Courtney with diluted apple juice since she didn't want her daughter's palate to become accustomed to the sweetness of full-strength juice. (The CPS says it's fine to offer pure, undiluted fruit juice to babies, but does not recommend introducing diluted or undiluted juice until a baby is six months old.)
Now Courtney is 18 months old, and her mother limits her juice intake to four ounces (125 mL) a day. "I fill her sippy cup every day, and if she doesn't finish it when it's served, she can finish it later," explains Harmison. "But I'll always offer her water or milk first. I know that there's vitamin C in her juice, but I'd rather she got more nutrients from whole fruit."
The only time Harmison will break down and offer extra juice to her daughter is during a heat wave. "When it's really hot out and the temperature is up in the 30s, I do get concerned about dehydration," she says. "If juice is all she'll take, that's what I'll give her."
Since most juice hounds complain loudly when parents try to cut back, it's wise to do so gradually, perhaps over a month. Reduce the actual serving size, too, or consider diluting it. Juice from concentrate is easier to water down (without kids noticing) than juice from a can. When a dedicated juice-drinker witnesses his beverage getting a shot of water from a faucet, the success rate is sure to plummet. But if you dilute canned juice and store it in a pitcher, who's to know? Another trick for children over three is to serve one or two frozen-juice ice cubes in a glass of water. You can jazz up the cubes by adding a slice of strawberry or a few blueberries.
Of course, it makes better sense to serve juice judiciously, right from the get-go. If kids under two get a cup in a high chair, then wandering with bottles is prevented. If you instill some structure, such as, "We only serve it at breakfast" or "Here's your daily juice snack," then the all-day habit never starts.
Donna Green of Toronto remembers when her daughter, Stella, was two and a confirmed juice-aholic. "When she was hungry, Stella would much rather drink something sweet than eat food. So I started a no-juice policy during mealtimes to ensure a balanced meal."
It worked. Stella, now nine, is still an avid drinker. "The difference nowadays is that if she's hungry, she'll take a steamy bowl of soup over a glass of juice, hands down. She's kicked the habit, so to speak."
posted by Chommar at 2:18 PM
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