title: Potential nutritional and economic effects of replacing juice with fruit in the diets of children in the United States.
abstract: OBJECTIVE
  To estimate the nutritional and economic effects of substituting whole fruit for juice in the diets of children in the United States.
  
  
  METHODS
  Secondary analyses using the 2001-2004 National Health and Nutrition Examination Survey and a national food prices database. Energy intakes, nutrient intakes, and diet costs were estimated before and after fruit juices were completely replaced with fruit in 3 models that emphasized fruits that were fresh, inexpensive, and widely consumed and in a fourth model that partially replaced juice with fruit, capping juice at recommended levels.
  
  
  METHODS
  A nationwide, representative sample of children in the United States.
  
  
  METHODS
  A total of 7023 children aged 3 to 18 years.
  
  
  METHODS
  Systematic complete or partial replacement of juice with fruit.
  
  
  METHODS
  Difference in energy intakes, nutrient intakes, and diet costs between observed and modeled diets.
  
  
  RESULTS
  For children who consumed juice, replacement of all juice servings with fresh, whole fruit led to a projected reduction in dietary energy of 233 kJ/d (-2.6% difference [95% CI, -5.1% to -0.1%]), an increase in fiber of 4.3 g/d (31.1% difference [95% CI, 26.4%-35.9%]), and an increase in diet cost of $0.54/d (13.3% difference [95% CI, 8.8%-17.8%]).
  
  
  CONCLUSIONS
  Substitution of juice with fresh fruit has the potential to reduce energy intake and improve the adequacy of fiber intake in children's diets. This would likely increase costs for schools, childcare providers, and families. These cost effects could be minimized by selecting processed fruits, but fewer nutritional gains would be achieved.
authors.affiliation: School of Public Health, University of Washington, Seattle, USA. pm491@medschl.cam.ac.uk
authors.forename: Pablo
authors.initials: P
authors.lastname: Monsivais
authors.forename: Colin D
authors.initials: CD
authors.lastname: Rehm
mesh_terms: D000293:Adolescent; D001628:Beverages / Q000191:economics; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D004043:Dietary Fiber; D002149:Energy Intake; D005638:Fruit / Q000191:economics; D006801:Humans; D018977:Micronutrients; D008962:Models, Theoretical; D009749:Nutrition Surveys; D009752:Nutritional Status; D014481:United States
chemical_list: D004043:Dietary Fiber; D018977:Micronutrients