Pediatrics, journal of the American Academy of Pediatrics
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Elk Grove Village, IL 60007-1098

Dear Editor:

News reports on the research study by Jean A. Welsh et al. in the February 2005 issue of Pediatrics (Pediatrics 115:223-229), examining a possible connection between consumption of sweet drinks and overweight among low-income preschool children, make it appear that the authors are suggesting that juice should not be served to preschool children. Very clearly, this is not the study’s conclusion. The study concluded, “Reducing sweet drink consumption may be one strategy to manage the weight of preschool children” (emphasis added).

The U.S. Government and the majority of nutrition experts do not recommend or suggest that parents eliminate juice from the diets of young children. Rather, they counsel against over-reliance on fruit juice as a means of getting children to consume servings of fruit. The American Academy of Pediatrics, while recommending that parents ensure preschool and older children do not over-consume fruit juice, has indicated that fruit juices have a place in a balanced and varied diet for children over one year of age.

The new Dietary Guidelines for Americans 2005 underscore that calories from any source – food or beverage – contribute to weight, overweight, or obesity. Calories count, and thus, regarding juice beverages, parents must keep in mind that juice is not “zero calories.” Further, the Dietary Guidelines recommend that children as well as adults increase consumption of both fruits and vegetables and supports juice as part of overall dietary intake.

Fruit juices are important sources of nutrients such as vitamin C, B vitamins, folic acid, potassium, magnesium, and often calcium (fortified juices). The Dietary Guidelines notes that nutrients of concern for children include calcium, potassium, fiber, magnesium, and vitamin E. The population in the Welsh et al. study was low-income preschool children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The WIC Program has an outstanding role in delivery of targeted foods, including fruit juice, to improve nutrient intake and promote child growth and development.

For children, weight management or obesity prevention is an issue of dietary balance and appropriate physical activity. If a child is not overweight and is consuming balanced nutrients, appropriate amounts of fruit and vegetable juice in the diet is sound dietary advice. Fruit and vegetable juices can play a valuable role in ensuring that children meet new dietary recommendations for increased fruits and vegetables in the diet, and contribute to overall hydration. Further, children’s growth patterns are not linear. An overweight child at one health assessment may be a normal weight for height child by the next pediatric assessment or WIC evaluation. The study by Welsh et al. acknowledges the important link between food intake, physical activity and weight, and variability of childhood growth patterns, with 33 percent fewer children in the overweight cohort at follow up (one year).

The American Academy of Pediatrics, in line with its policy statement The Use and Misuse of Fruit Juice in Pediatrics, should seek opportunities to correct any misinterpretation that pediatricians, dietitians, or nutrition professionals should urge parents to eliminate fruit juice from the diets of preschool children.


Susan A. Ferenc, DVM, PhD
Executive Vice President and Chief Science Officer
Food Products Association