Drinking fruit juices not much better than drinking sugary drinks

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Most folks know that sugary drinks aren’t healthy, but a new study finds fruit juices are not much better. In fact, consuming them regularly may help shorten your life, Medical Xpress reports researchers say.

“Older adults who drink more sugary beverages, which include fruit juice as well as sodas and other sugar-sweetened beverages, may be at risk of dying earlier,” said study author Jean Welsh. She is an associate professor at Emory University School of Medicine in Atlanta.

“Efforts to decrease consumption of sodas and other sugar-sweetened beverages should also include fruit juices, and these efforts need to include adults as well as children,” Welsh said.

For the study, Welsh and her colleagues collected data on 13,440 men and women, average age 64, who were part of a large stroke study from 2003 to 2007. Among these participants, 71% were obese or overweight. The participants were asked how many sugar-sweetened drinks they consumed. Over an average of six years, 1,168 of the participants died.

The researchers found that those who drank the most sugar-sweetened beverage – including 100% fruit juice – had higher odds of dying during the study, compared with those who drank the least of these. Moreover, each additional 12-ounce drink increased the risk even more.

In the US, about half of the population consumes at least one sugar-sweetened drink per day, said Dr Marta Guasch-Ferre, a research scientist in the department of nutrition at Harvard TH Chan School of Public Health, in Boston. “Most people are aware that sodas and other sugar-sweetened beverages – including soft drinks, fruit punch and energy drinks – are associated with weight gain and adverse health effects. But fruit juices are still widely perceived by many as a healthier option,” Guasch-Ferre said. Evidence has shown that sugar-sweetened drinks are tied to an increased risk for diabetes, heart disease and obesity, she added. The evidence is less clear for fruit juice.

Whole juice contains some nutrients, and that may be beneficial for health, but they also contain relatively high amounts of sugar from natural sources, Guasch-Ferre explained. Although fruit juices have been associated with an increased risk of diabetes and heart disease, whole fruits have not, she said.

Current recommendations suggest drinking no more than 4 to 6 ounces of juice per day, Guasch-Ferre said. “Although fruit juices are not as harmful as sugar-sweetened beverages, consumption should be moderated in both children and adults, especially for individuals who attempt to control their body weight,” said Guasch-Ferre, who co-authored an accompanying journal editorial.

Fruit-based smoothies are commonly seen as healthier options. However, their ingredients can vary substantially and there is limited research on their health effects, she said. In addition, smoothies are usually very high in calories and so aren’t recommended as daily beverages. Vegetable juice is a lower-calorie alternative to fruit juice, but may contain a lot of salt.

“The current evidence suggests that water should be the preferred beverage, and the intake of other beverages such as tea or coffee, without sugar and creamers, should be chosen in place of sugar-sweetened drinks,” Guasch-Ferre advised.

Abstract
Importance: Research has linked sugar-sweetened beverage (SSB) consumption to coronary heart disease (CHD) risk, but the role of nutritionally similar fruit juice and the association of these beverages with mortality risk is unknown.
Objective: To assess the association of SSBs and 100% fruit juices, alone and in combination (sugary beverages), with mortality.
Design, Setting, and Participants: This cohort study is a secondary analysis of data obtained from 30 183 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The REGARDS study was designed to examine modifiers of stroke risk. Enrollment took place from February 2003 to October 2007, with follow-up every 6 months through 2013. Overall, 30 183 non-Hispanic black and white adults 45 years and older were enrolled in the REGARDS study. Those with known CHD, stroke, or diabetes at baseline (12 253 [40.6%]) and those lacking dietary data (4490 [14.9%]) were excluded from the current study, resulting in a sample size of 13 440. Data were analyzed from November 2017 to December 2018.
Exposures: Sugar-sweetened beverage and 100% fruit juice consumption was estimated using a validated food frequency questionnaire and examined using categories of consumption that align with recommended limits for added sugar intake as a percentage of total energy (TE; <5%, 5%-<10%, and ≥10%) and 12-oz serving increments.
Main Outcomes and Measures: All-cause and CHD-specific mortality were determined from cause of death records and family interviews and adjudicated by a trained team. Multivariable adjusted hazard ratios (HRs) were estimated using regression models.
Results: Overall, 13 440 participants had a mean (SD) age of 63.6 (9.1) years at baseline, 7972 (59.3%) were men, 9266 (68.9%) were non-Hispanic white, and 9482 (70.8%) had overweight or obesity. There were 1000 all-cause and 168 CHD-related deaths during follow-up (mean [SD] follow-up, 6.0 [1.8] years). Mean (SD) sugary beverage consumption was 8.4% (8.3%) of TE/d (4.4% [6.8%] TE/d from SSBs; 4.0% [6.8%] TE/d from 100% fruit juice). Among high (≥10% of TE) vs low (<5% of TE) sugary beverage consumers, risk-adjusted HRs were 1.44 (95% CI, 0.97-2.15) for CHD mortality and 1.14 (95% CI, 0.97-1.33) for all-cause mortality. Risk-adjusted all-cause mortality HRs were 1.11 (95% CI, 1.03-1.19) for each additional 12 oz of sugary beverage consumed and 1.24 (95% CI, 1.09-1.42) for each additional 12 oz of fruit juice consumed. In risk-adjusted models, there was no significant association of sugary beverage consumption with CHD mortality.
Conclusions and Relevance: These findings suggest that consumption of sugary beverages, including fruit juices, is associated with all-cause mortality. Well-powered and longer-term studies are needed to inform their association with CHD mortality risk.

Authors
Lindsay J Collin; Suzanne Judd; Monika Safford; Viola Vaccarino; Jean A Welsh

Medical Xpress report
JAMA Network Open abstract


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