New study reveals the positive contribution of 100% fruit juice to the diets of European adults and children

Is overconsumption of fruit juice making our sugar intakes too high as some commentators suggest? Not according to a new study published in the journal, Nutrition Research Reviews [1].

The study, by Dr Janette Walton and Dr Laura Kehoe from Munster Technical University, Cork, analysed national dietary studies from across Europe to determine how much fruit juice people are actually drinking and what this popular beverage contributes to the diet. This is what we learnt from the new research:

1.     Fruit juice is not overconsumed

Focusing on the data for 100% fruit juice, which never contains added sugars, the average adult consumer drinks just over 130 grams a day while children of school-age drink just over 100 grams a day. Average intakes for adults and children are well within the 100-200 ml guidance given on daily serving sizes in several European countries indicating that fruit juice is not overconsumed.

Intakes are lower when the overall population, including non-consumers is considered. It is important to look at both metrics since dietary guidelines for sugar apply to the whole population while recommendations for typical servings of fruit juice apply to individuals.

2.     The proportion of fruit juice consumers varies widely

Adult consumers make up 29-90% of the population depending on the country with the highest proportion of consumers seen in Sweden and the lowest seen in France and Finland. For younger school-aged children, consumers ranged from 26-67% with the lowest proportion in Sweden and the highest seen in France and Italy. For teenagers, 22-71% drank fruit juice with the lowest proportion again seen in Sweden and the highest in Italy.

3.     Nutrient contribution

Fruit juice is a well-known source of vitamin C. Indeed, a recent study found that a typical 150ml glass of orange juice – regardless of whether it is home-squeezed or purchased from a supermarket – contains more than 90% of the European recommendation for vitamin C [2].

The new study from Walton and Kehoe found that up to 26% of vitamin C was provided by regular fruit juice consumption. Vitamin C is important for normal immune function and increases iron absorption from the diet. Across the lifecycle, the contribution of fruit juice to daily vitamin C intakes ranged from 4-20% in infants; 6-26% in children; 8-20% in teenagers; 8-19% in adults; and 6-19% in older adults.

Fruit juice also provided 2-4% of daily potassium intakes, a nutrient which supports normal blood pressure. The European Food Safety Authority highlighted in 2022 that potassium intakes are far too low in Europe [3], in part due to low fruit intakes. Hence, fruit juice may complement policies to boost fruit consumption.

Finally, fruit juice provided 1-7% to daily folate intakes, a B vitamin which supports maternal tissue growth during pregnancy. Intakes of folate are too low in women of childbearing age according to expert bodies such as the UK Food Standards Agency. Folate has also been provided to reduce tiredness and fatigue and contributes to normal psychological function.

4.     Only 1-2% of calories come from fruit juice

Some media reports suggest that fruit juices are high in calories, but this isn’t true. A typical 150ml glass of orange juice contains just 62 kcal. The new study found that fruit juices in Europe contribute 1-3% of daily energy intakes in infants, and 1-2% in other age categories. For a typical 2000 kcal diet, the Reference Intake for an adult, this equates to just 20-40 kcal a day. As a comparison, this would be the same calorie content of 8 orange segments. Hence, it is implausible that a typical daily glass of fruit juice could be linked to obesity.

5.     Contribution of fruit juice to sugars is much lower than estimated

A previous report from the European Food Safety Authority estimated that fruit juices provide 15-50% of free sugar intakes across Europe depending on the country and age group [4]. For specific age groups, including consumers and non-consumers, the average contribution of fruit juices to free sugars in Europe was estimated to be 20% in school-aged children,18% in teenagers and 13% in adults.

In the new study from Walton and Kehoe, the overall contribution of fruit juice to free sugar intakes was 2-14%. For the specific age groups mentioned above, the average contribution to school-aged children was 10%, for teenagers 12% and for adults 10%.

Why the discrepancy? In the national surveys of several countries, 100% fruit juices are not categorised separately but are placed in food groups with nectars, olives, apple sauce or smoothies. This makes it impossible to determine the sugar contribution of 100% fruit juice. The report by EFSA included surveys which combined fruit juices, vegetable juices and nectars. In contrast, and consistent with good research practice, the Walton and Kehoe study only included surveys which reported 100% fruit juices as a separate category.

It is important to examine fruit-based drinks separately as nectars contain added sugars and can be reformulated. This is not the case for 100% fruit juices as the sugars come directly from the fruits used in the juicing process. Current EU regulations state that sugar cannot be added or removed from fruit juice.

6.     What is the role of fruit juice in the diet?

The authors of the new study concluded that there is an “important role of fruit juice in the context of vitamin C intakes in population groups with little contribution to energy intakes” while highlighting “the importance of targeting sugar reduction strategies for discretionary/’top-shelf’ foods which are not recommended in food based dietary guidelines and, unlike fruit juice, where reformulation is legally possible”.

A final point raised “questions surrounding the categorisation of fruit juice in research related to associations with health [which] may have implications for the development of population-based nutrition policies with respect to FJ consumption and dietary guidance”. Future national surveys should report 100% fruit juice as a separate category of consumption so we can be clear how much is being consumed by Europeans and the contribution made to energy, free sugars and micronutrient intakes.

References

1. Walton J & Kehoe L (2024) Current perspectives and challenges in the estimation of fruit juice consumption across the lifecycle in Europe. Nutrition Research Reviews, in press. https://pubmed.ncbi.nlm.nih.gov/38356367/ 

2. Salar FJ et al. (2024) Comparison of vitamin C and flavanones between freshly squeezed orange juices and commercial 100% orange juices from four European countries. International Journal of Food Sciences and Nutrition, in press. https://pubmed.ncbi.nlm.nih.gov/38230429/

3. European Food Safety Authority (2022) Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. EFSA Journal https://www.efsa.europa.eu/en/efsajournal/pub/7259  

4. European Food Safety Authority (2022) Tolerable upper intake level for dietary sugars. https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2022.7074