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Review
. 2017 Apr;139(4):e20162454.
doi: 10.1542/peds.2016-2454. Epub 2017 Mar 23.

Fruit Juice and Change in BMI: A Meta-analysis

Brandon J Auerbach  1   2 , Fred M Wolf  2   3   4 , Abigail Hikida  4   5   6 , Petra Vallila-Buchman  7 , Alyson Littman  2   5   6 , Douglas Thompson  8 , Diana Louden  9 , Daniel R Taber  7 , James Krieger  10   4   7
Affiliations
Review

Fruit Juice and Change in BMI: A Meta-analysis

Brandon J Auerbach et al. Pediatrics. 2017 Apr.

Abstract

Context: Whether 100% fruit juice consumption causes weight gain in children remains controversial.

Objective: To determine the association between 100% fruit juice consumption and change in BMI or BMI z score in children.

Data sources: PubMed, Embase, CINAHL, and Cochrane databases.

Study selection: Longitudinal studies examining the association of 100% fruit juice and change in BMI measures were included.

Data extraction: Two independent reviewers extracted data using a predesigned data collection form.

Results: Of the 4657 articles screened, 8 prospective cohort studies (n = 34 470 individual children) met the inclusion criteria. Controlling for total energy intake, 1 daily 6- to 8-oz serving increment of 100% fruit juice was associated with a 0.003 (95% CI: 0.001 to 0.004) unit increase in BMI z score over 1 year in children of all ages (0% increase in BMI percentile). In children ages 1 to 6 years, 1 serving increment was associated with a 0.087 (95% confidence interval: 0.008 to 0.167) unit increase in BMI z score (4% increase in BMI percentile). 100% fruit juice consumption was not associated with BMI z score increase in children ages 7 to 18 years.

Limitations: All observational studies; studies differed in exposure assessment and covariate adjustment.

Conclusions: Consumption of 100% fruit juice is associated with a small amount of weight gain in children ages 1 to 6 years that is not clinically significant, and is not associated with weight gain in children ages 7 to 18 years. More studies are needed in children ages 1 to 6 years.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart of studies for inclusion in the systematic review and meta-analysis.
FIGURE 2
FIGURE 2
Forest plot of change in BMI z score per 1 serving/day increment of 100% fruit juice consumed in children (not adjusted for total energy intake). The time period denotes the time over which each study reported the change in BMI z score. Although 2 studies reported time periods of BMI z score change >1 year, the effect size (ES) may be interpreted as the change in BMI z score per 1 serving/day increment of 100% fruit juice consumed over ∼1 year. Horizontal lines denote 95% CIs; solid diamonds represent the point estimate of each study. Gray boxes behind the solid diamonds represent the fixed-effects study weight. Open diamonds represent pooled estimates. The I2 and P values for heterogeneity are shown. Only 6250 of 8950 children in the study by Shefferly et al were included in the meta-analysis (see the Results section).
FIGURE 3
FIGURE 3
Forest plot of change in BMI z score per 1 serving/day increment of 100% fruit juice consumed in children (adjusted for total energy intake). Time period denotes the time over which each study reported the change in BMI z score. Although 2 studies reported the time period of BMI z score change ≠1 year, the effect size (ES) may be interpreted as the change in BMI z score per 1 serving/day increment of 100% fruit juice consumed over ∼1 year. Horizontal lines denote 95% CIs; solid diamonds represent the point estimate of each study. Gray boxes behind the solid diamonds represent the fixed-effects study weight. Open diamonds represent pooled estimates. The I2 and P values for heterogeneity are shown.
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