Longitudinal evaluation of 100% fruit juice consumption on BMI status in 2-5-year-old children

Abstract

Background: Obesity in childhood is related to multiple lifestyle factors. Our objective was to evaluate the relationship between consumption of 100% fruit juice and weight status over time among pre-school children.

Methods: We used linear and logistic multivariable regression to evaluate body mass index (BMI) z-score and overweight/obese status as a function of 100% fruit juice intake for 8950 children examined at ages 2, 4 and 5 years as part of the Early Childhood Longitudinal Study-Birth Cohort, a representative sample of the United States.

Results: Cross-sectional analysis at ages 4 and 5 years showed no difference in the prevalence of overweight and obesity between consistent juice drinkers and inconsistent/non-drinkers. Longitudinal analysis found that children who drank 100% juice consistently at age 2 years had greater increases in BMI z-score by age 4 years than infrequent/non-drinkers (P < 0.0001), a difference driven by lesser increases in height z-score (P = 0.0003) and slightly greater increases in weight z-score (P = 0.0550) among consistent juice drinkers over the 2 to 4 year time period. Additionally, consistent juice drinkers at age 2 had higher odds of becoming overweight by age 4 (adjusted odds ratio 1.30; CI 1.06-1.60). These differences in growth parameters were not noted between ages 4 and 5 years.

Conclusions: Drinking 100% fruit juice regularly at age 2 is associated with higher odds of becoming overweight between 2 and 4 years. Paediatricians and parents can discourage excessive fruit juice consumption as part of a larger effort to avoid unhealthy gain in BMI in young children.

Keywords: fruit juice; obesity; sugar; weight gain.

Figure 1. Change in BMI-z-score over time for regular juice drinkers vs. infrequent/non-drinkers

A. BMI-z-scores at age 2 years and 4 years for children drinking ≥1 serving of juice daily (vs. <1) at age 2. B. BMI-z-scores at 4 years and 5 years for children drinking ≥1 serving of juice daily (vs. <1) at 4 years. All values adjusted for race/ethnicity, socio-economic status and maternal BMI. # p<0.001 for longitudinal change in BMI-z for daily juice drinkers vs. non-drinkers; * p<0.01 for cross-sectional BMI-z for daily juice drinkers vs. infrequent/non-drinkers using linear regression.