© 2011 Roy Benaroch, MD
“Why do pediatricians hate juice so much? It’s not completely junk like soda. I think kids should have some juice, but my pediatrician says it’s no good for them.”
You’re right: I’ll bet if you survey pediatricians, 4 out of 5 will say “No!” to juice. (There’s always that 5th one, the weirdo who doesn’t prefer sugarless gum and thinks car seats are for sissies. Ignore him.) Why has juice gotten such a bad rap?
Let’s look at the cold facts, comparing fruit juice to Coca-cola:
The main ingredient in both is water.
The second ingredient in both is sugar. Sugar from juice is almost all fructose, and sugar from soda is….all fructose (from high fructose corn syrup.) It’s the same. Fructose is fructose, whether from juice or from an extract from corn syrup.
12 oz of Coca-cola has 140 calories, all of which are from fructose. It has no other nutritional value.
12 oz of orange juice has 170 calories, all of which are from fructose– in fact, there is more fructose sugar in OJ than in soda, as reflected in the higher calories. 12 ounces of apple juice has about 160 calories. All, again, fructose.
OJ does contain plenty of vitamin C, well over a day’s worth in one serving. But vitamin C deficiency is not seen in the USA, ever, except perhaps in cases of mental illness and neglect. There is also a bit of vitamin A in OJ, probably 10% of the RDA in one serving. OJ and other juices provide some folate, an important B vitamin, that’s also available from many other sources, including all fortified grains.
So: juice has more calories, more sugar, and some vitamins C, A, and folate that your child is probably getting from other sources. Nutritionally, it’s similar enough to soda that you might as well think of it as soda. I do.
Some OJ is fortified with Calcium and Vitamin D, and those nutrients are deficient in many children. There are more-healthful sources (like skim milk—it has protein, potassium, phosphorus, vit A, vit D, and calcium in a very bioavailable form.) But if Junior is anti-milk, OJ w/ Calcium to me seems like one reasonable alternative.
Which brings us back to the original question: Why are pediatricians so down on juice? We have to look at The Big Picture. There really is only one nutritional problem in the United States, one problem that is much more common than all other nutritional problems combined. It’s not vitamin C deficiency, or folate deficiency, or any other deficiency. It’s an excess. An excess of calories. When you think about it, the only nutritional problem we commonly see is obesity. Kids getting too many calories are far, far more common than any sort of lack of vitamins. So when a pediatrician thinks about the best advice to give families about feeding their children, we’re first and foremost trying to think of ways to prevent and treat obesity. Sure, there are plenty of slender kids out there, and for those kids some juice (or some soda) really wouldn’t hurt. But many of them have overweight siblings, and many of them will end up fighting with overweight when they’re older. So it really is better for most families to not encourage any kind of extra calories from soda or juice.
To put it another way: I struggle to try to help families with overweight kids every single day. I’ve yet to see a single child with health problems from juice deficiency. So I’m sticking to my guns. Stay away from juice.
The Pediatric Insider 
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