Reality Check: Kids' Fruit Juices

The nation’s biggest fast-food eateries have replaced soft drinks with juices in kids’ meals over the last few months, and by doing so they have rekindled the debate over sugar in the American diet.

The move by Burger King, McDonald’s and Wendy’s is part of a new effort by fast-food chains to improve the quality of their offerings in response to growing demands by consumers, activists and dietitians concerned about the obesity epidemic and the health of American children.

Up to one out of every five children in the U. S. is overweight or obese, and this number is continuing to rise. Overweight children are at higher risk of becoming overweight adolescents and adults, putting them at risk of developing chronic diseases such as heart disease and diabetes.

But the criticism directed at fast-food restaurants hasn’t gone away. The problem: the apple juice option that replaces the soft drinks at many of these popular eateries contain 20 grams of sugar per container.

Many are also offering low-fat chocolate milk and fat-free milk instead of the soft drinks. Dietitians generally say that having these options is at least an improvement over only providing a soft drink with a kids’ meal — although a child-size soda has about as many grams of sugar as the juice.

Juices and Sugar
What are parents to do? Dietitians and family physicians agree that parents should be more mindful of the sugar content in their kids’ diet overall. And they don’t have to get them kids’ meals at all. Juices marketed for children often contain as much sugar as soft drinks, but many brands offer “low sugar” options. Parents should read labels carefully.

“Parents need to pay close attention to their children’s diet at home and at restaurants to control sugar, especially if their kids are overweight and not very active,” said Javier Hiriart, M.D., a Baptist Health Medical Group internist and pediatrician at the Family Medicine Center West Kendall Baptist Hospital. “Fast-food restaurants should not be a regular stop for parents and their kids, but more of a once-in-a-while thing.”

Sugary soft drinks are a top source of calories in children’s diets and have been found to be big contributors to obesity, Dr. Hiriart says.  A can of soda can have 40 grams of sugar, which is like eating 10 teaspoons of sugar  or 10 packets of sugar. The percentage of obese children ages 6–11 years, in the U.S. jumped from 7 percent in 1980 to nearly 18 percent in 2012, according to the Centers for Disease Control and Prevention. Meanwhile, the percentage of adolescents, ages 12–19 years, who were obese increased from 5 percent to nearly 21 percent over the same time frame, says the CDC.

 ‘Added Sugar’ and Obesity
The amount of “added sugar” in the diets of Americans has become a high-profile issue recently, with more books, documentaries and clinical studies chronicling how sugar has contributed to obesity and heart disease rates.

Added sugars are defined as sugars and syrups that are added to foods or beverages when those items are processed or prepared. These include common ready-to-eat cereals, candy, cookies, sodas and a range of other food products that are packaged or canned. Added sugar also includes those sugar packets you open to sweeten your coffee or tea.

“It can be confusing to parents shopping for their families at the grocery, with so many processed foods containing added sugars,” says Dr. Hiriart, who advises parents to consult a dietitian, if necessary, with the help of their primary care physician or pediatrician to help clear up the confusion.

Carbohydrates provide your body with the glucose, or blood sugar, it needs to function properly. But there are two types of carbohydrates: complex and simple. Foods rich in complex carbohydrates and fiber are called good carbohydrates. Simple carbohydrates include foods with added sugars and are called bad carbohydrates.

“Once you start reading the food label, you might be surprised to find how many of your food choices are high in sugar and may contain artificial ingredients,” says Natalie Castro, Baptist Health South Florida’s chief wellness dietitian. “The best way to reduce your sugar intake is to eat ‘real food.’ Real food refers to items that are as minimally processed as possible.”

‘Added Sugar’ Recommendations
The American Heart Association has set guidelines for the amount of added sugar considered acceptable for a healthy diet for both adults and children. It is recommended that adult men not exceed 37.5 grams of sugar per day. Adult women should limit their intake to 25 grams of sugar. Here are the guidelines for children:

  • Children ages 4 to 8 should consume no more than about 12.5 grams per day of added sugar;
  • For preschool children eating a 1,200 to 1,400-calorie diet, added sugar should not exceed about 16.7 grams per day.
  • Pre-teen and teenagers should limit their intake to between 21 and 33 grams of sugar per day.
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