Juiced? 
We have been juicing fruits for a long time.  Here’s a short summary. Wine is fermented grape juice – the fermentation  process is a way of preserving the fruit– and it looks like we’ve been  making it for about 8000 years. Archeologists have found that the people  living at Gadachrili Gora and a nearby village 20 miles south of  Tbilisi, Georgia, were the world’s earliest known vintners—producing  wine on a large scale as early as 6000BC. Now skip a few millenia.  Lemonade became popular in the 1500s, and orange juice in the 1700s and  we preserved them by adding sugar (sucrose) which in the right amount  inhibits bacterial growth (a good thing). Louis Pasteur’s pasteurization  process (1864) preceded the development of fresh (unfermented) 100%  fruit juices in 1868. In 1930, the first commercial juicing machine was  invented and around this time electric refrigeration became affordable.  Home juicing became popular in the USA in the 1970s, thanks to  affordable home juicers.
 
 
Today, people enjoy 100% fruit juice worldwide and  it’s a nutritious choice as the analysis of commercial unsweetened  orange juice shows. (And if you are wondering why orange juice rates  five stars while a whole orange picked straight from the tree only rates  4½, it’s because Australia’s star rating system currently uses  different algorithms for solid foods and for beverages)
 
 
The American Dietary Guidelines  consider 1 cup (240ml) of 100% fruit juice as being equivalent to one  serve of fruit, but they also recommend that at least half our  recommended serves of fruit should come from whole fruit, which  generally contains more dietary fibre and less calories.
What  about the sugars? The carbohydrate in fruit and fruit juice is in the  form of sugars (fructose, glucose and sucrose principally). Some people  point out that fruit juices can provide nearly as much sugars as some  sugar sweetened beverages, which nutrition epidemiological studies have  associated with weight gain and risk of type 2 diabetes. Do 100% fruit  juices pose the same risk? Fortunately, there is now a relatively large  body of evidence that can help answer this important question.
Auerbach and colleagues  investigated the association of 100% juice consumption with body mass  index (BMI) in prospective cohort studies of children. The overall  conclusion was that while consumption of 100% fruit juice is associated  with a small amount of weight gain in children ages 1 to 6 years, the  amount is not clinically significant. (Controlling for total energy  intake, they reported that one 180–240ml (6–8oz) serve of 100% fruit  juice a day is associated with a 0.087 unit increase in BMI in children  aged 1 to 6 years, but not in children aged 7 to 18 years.) Similarly, systematic reviews of the evidence in adults show no detrimental effects of consuming moderate amounts of 100% fruit juice.
Murphy and colleagues  investigated the effect of 100% fruit juice on blood glucose and  insulin levels in randomised controlled trials which included a range of  people including those who were overweight/obese and/or had diabetes.  They found that 100% fruit juice had no significant effect on fasting  blood glucose, fasting blood insulin or HbA1c. The overall conclusion  was that 100% fruit juices have a neutral effect of on glycemic control,  and they noted that these findings were consistent with findings from  observational studies suggesting that consumption of 100% fruit juice is  not associated with increased risk of developing type 2 diabetes.
Sugars  (e.g., glucose, fructose and sucrose) and other fermentable  carbohydrates (i.e. maltodextrins and starches), provide food for oral  bacteria, which lower our plaque and salivary pH, and in turn promote  tooth demineralization. This is the main reason why the World Health  Organisation recommends we limit our consumption of free sugars to less  than 10% of energy – 100% fruit juices are a source of free sugars.  However, most of the studies that make up the evidence base for the WHO  guideline are based on added sugars – not juices. So, what does the  evidence say about 100% fruit juice?
A recent clinical trial by Issa and colleagues  found that a range of solid and juiced fruits (e.g. apples, oranges,  grapes and tomatoes) could contribute to tooth demineralisation, but  there were no significant differences between solid and juiced foods. A  review by Touger-Decker and van Loveren  found that many factors in addition to free sugars affect the risk of  tooth decay, including the form of food or fluid, the duration of  exposure, nutrient composition, sequence of eating, salivary flow,  presence of buffers, and your personal oral hygiene. In particular, they  noted that polyphenols such as tannins in cocoa, coffee, tea, and many  fruit juices may reduce the cariogenic potential of foods and drinks. In  addition, in a series of experiments in young adults that included  fruits and juices (e.g. apples/juice, dates, bananas, orange juice,  raisins), Edgar and colleagues  found that while juices had a higher acidic potential than whole  fruits, they only moderately increased risk compared to sugar-sweetened  beverages and confectionery, which conferred a high risk. In summary,  100% fruit juices are not as likely to cause tooth decay as  sugar-sweetened beverages or confectionery.
So,  overall, the evidence we currently have supports the American Dietary  Guidelines allowance of up to 1 cup of 100% juice a day as part of a  healthy balanced diet.
 
  
Alan Barclay, PhD is a consultant dietitian.  He worked for Diabetes Australia (NSW) from 1998–2014 . He is  author/co-author of more than 30 scientific publications, and  author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).
Contact: You can follow him on Twitter or check out his website.
1 June 2018
PERSPECTIVES WITH DR ALAN BARCLAY
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