Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2066-2075 (doi:10.1542/peds.2006-1117)
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ARTICLE

Fruit Juice Intake Predicts Increased Adiposity Gain in Children From Low-Income Families: Weight Status-by-Environment Interaction

Myles S. Faith, PhDa,b, Barbara A. Dennison, MDc,d, Lynn S. Edmunds, MS, RDe and Howard H. Stratton, PhDf

a Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
b Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
c Bureau of Health Risk Reduction, Division of Chronic Disease Prevention and Adult Health, New York State Department of Health, Albany, New York
d Research Institute, Bassett Healthcare, Cooperstown, New York
e Division of Nutrition, New York State Department of Health, Albany, New York
f Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York

OBJECTIVE. Our goal was to test the hypothesis that increased fruit juice intake and parental restriction of children's eating are associated with increased adiposity gain and whether exposure to nutritional counseling predicted reduced adiposity gain among children.

PATIENTS AND METHODS. A sample of parents or guardians of children aged 1 to 4 years who attended 1 of 49 Special Supplemental Nutrition Program for Women, Infants, and Children agencies in New York State were surveyed in 1999 or 2000 (N = 2801). The survey addressed children's dietary intake, parental feeding practices, and parental exposure to nutritional counseling messages to increase fruit, vegetable, and low-fat milk intakes. Each child's height and weight were measured approximately every 6 months for up to 48 months. A prospective cohort design was used in which survey variables were the predictors and the outcome was change in children's adiposity, defined as change in age- and gender-standardized BMI per month (ie, BMI z-score slope).

RESULTS. Controlling for gender and ethnicity, the relationship between juice intake and adiposity gain depended on children's initial overweight status. Among children who were initially either at risk for overweight or overweight, increased fruit juice intake was associated with excess adiposity gain, whereas parental offerings of whole fruits were associated with reduced adiposity gain. Each additional daily serving of fruit juice was associated with an excess adiposity gain of 0.009 SD per month. Feeding restriction was greater among parents whose children were initially at risk for overweight or overweight compared with those at a healthy weight. Parental exposure to nutritional messages was not associated with reduced child adiposity gain.

CONCLUSION. This study supports the Institute of Medicine recommendations to reduce fruit juice intake as a strategy for overweight prevention in high-risk children.

Key Words: obesity • child nutrition • feeding behavior • primary prevention • ethnic groups • fruit

Abbreviations: WIC—Special Supplemental Nutrition Program for Women, Infants, and Children • IOM—Institute of Medicine

Accepted Jul 27, 2006.




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