Thursday, July 15, 2010

What To Drink Part 1: What's Wrong with Juice?

I'm taking a break from the D to discuss all the hubbub about drinks lately.  Have you heard it?  There's a soda tax being debated by politicians.  There's also a stink about flavored (Read: sweetened) milk served in schools and whether or not sports drinks are good for everyone, even after exercise.  Even kombucha has been pulled from the shelves in most supermarkets.  And is fruit juice really healthy like we all thought?  Let's start sipping this topic!

What's Wrong with Juice?

You have probably already read my post Just Say No...To Juice?, but if you haven't now's your chance.  Basically, the problem with juice is that it is too concentrated--you just can NOT eat enough fruit to get the equivalent amount of sugar that is in juice--you'd get sick!  And don't kid yourself, fructose is a sugar, just like high fructose corn syrup, just like table sugar, just like stevia.  They all set things in motion in your body that prepare it for the highly concentrated burst of energy your body knows comes with sweet foods.  It doesn't matter if they are "zero" calorie or low glycemic, sugar and its various forms set the fat storage switch to ON, storing excess carbohydrate as fat.  And unfortunately, fructose isn't like glucose; it doesn't precipitate a surge of insulin that triggers leptin (the hunger hormone) to tell your brain you are full.  From my previous post:
The short story: there is a deadly cycle of fructose leading to fat storage and telling your brain you are still hungry.  For example, fructose has the opposite effect of glucose on the hypothalamus section of the brain controlling feeding behavior.  While blood glucose levels are sensed by the brain and signal a secession to eating, fructose bypasses this metabolic step and actually promotes food intake to continue instead of signaling an end to eating.  
Even the USDA agrees that juice isn't all the "healthy" it's cracked up to be.  In their new guidelines (new and NOT improved, unfortunately) here is their conclusion (page D1-23+) about juice: 
Limited and inconsistent evidence suggests that for most children, intake of 100 percent fruit juice is not associated with increased adiposity, when consumed in amounts that are appropriate for age and energy needs of the child. However, intake of 100 percent juice has been prospectively associated with increased adiposity in children who are overweight or obese. 
Can you say wishy-washy?  But the message stands: juice isn't the best beverage for everyone.  Especially kids.  While their activity levels may be through the roof, it's still not enough to burn those excess calories juice provides.  Keep reading for more on exercise.

But isn't juice made for kids safe?  Isn't it made with their needs in mind?  No.  Check out the worst "kids drink" from The Most Harmful Drinks in America:

Tropicana Tropical Fruit Fury Twister (1 bottle, 20 fl oz)
340 calories
0 g fat
60 g sugars
Sugar Equivalent: Two 7-ounce canisters Reddi-wip
Don’t let Tropicana’s reputation for unadulterated OJ lead you to believe that the company is capable of doing no wrong. As a Pepsi subsidiary, it’s inevitable that they’ll occasionally delve into soda-like territory. The Twister line is just that: a drink with 10 percent juice and 90 percent sugar laced with a glut of artificial flavors and coloring. You could actually save 200 calories by choosing a can of Pepsi instead.
Drink This Instead!
Honest Kids Tropical Tango Punch (1 pouch, 6.75 fl oz)
40 calories
0 g fat
10 g sugars

Um, I think I'll go with water instead.  Thanks!  But scroll through that list of Most Harmful Drinks for some eye-opening beverages you probably once enjoyed too!

Here's more on Tropicana Twister:
Product Details:
Flavored Juice Beverage from Concentrate. With Fruit Force energy releasing B Vitamins! Contains 10% juice.
Filtered Water, High Fructose Corn Syrup, Apple Juice Concentrate, Grape Juice Concentrate, Citric Acid, Pineapple Juice Concentrate, Natural Flavors, Ascorbic Acid (Vitamin C), Pectin, Cherry Juice Concentrate, Sodium Citrate, Red 40, Niacin and Pantothenic Acid.
Not only do you have concentrated natural fructose but added high fructose corn syrup.  Can you say diabetes in a bottle?  Still think juice is healthy?  Okay, you're probably thinking 100% juice is a world away from fruit punches and juice drinks.  Is it really?  Let's look into it. 

Are Fruit and Juice Interchangeable?

No.  But the USDA thinks so.  In their Food Pyramid, one serving of fruit is one cup of fruit OR one cup of fruit juice.  Here is just a few reasons why this is bad:
  • The Sugar
We already discussed the sugar content of juice far exceeds that of whole fruit.  Would it surprise you that it also EXCEEDS that of SODA?  According to this chart from Hooked on Juice comparing 100% fruit juice to Coca-cola, apple juice, grape juice, and cherry juice all EXCEED the total teaspoons of sugar, total carbohydrate, and total calories of Coca-cola in the same 12oz serving (and OJ wasn't lagging far behind).  OMG, I have to say it again, it is so shocking: juice has more sugar than soda!
  • The Fat
But juice is zero fat, you say?  Once absorbed by your digestive tract, fructose goes to the liver, where it replenishes energy stores.  Any excess energy is converted into fat (don't kid yourself, you are NOT using all that energy).  Conversion of excess fructose into triglycerides elevates the fatty acids circulating in your blood, necessitating fat storage.   And fructose is more readily metabolized into fat than glucose, so it's the bad-est of the bad.  We also know that elevated triglycerides are associated with cardiovascular disease.  And you don't have to be obese to have a heart attack--those pesky triglycerides can accumulate in anyone, thick or thin.  
  •  The Metabolic Derangement
Metabolic syndrome leading to diabetes, heart disease, and stroke is associated with insulin resistance and these signs: abdominal obesity, elevated triglycerides, impaired fasting glucose, high blood pressure, low HDL, fatty liver, elevated uric acid, and systemic inflammation (amongst others).  Fructose intake is related to each of those and insulin resistance itself.  While the amount of fructose you ingest needs to be substantial for these problems to surface, do most of us really know how much we are consuming?  Most people on a processed diet are getting fructose from multiple sources since it is the sweetener of choice among manufacturers.  All those sources can DEFINITELY add up.  If you are on a whole foods diet, you are definitely much safer.  But why drink juice then if you can have the whole fruit and get so many more benefits (i.e. fiber, vitamins, minerals) from going to the source?
  • The Risk of Cancer  
Inflammation may be a precursor to some cancers, and since we have already established that fructose can lead to inflammation, it follows that high fructose consumption can set the stage for cancer.  For example, this study illustrates the fructose-cancer link and even found that juice intake had a significant association with pancreatic cancer.    

Not only does fructose set up the right conditions, but it also provides the fuel for the fire.  Ever hear the saying "cancer loves sugar"?  According to research like this, cancer cells have a sweet tooth too.  Cancer cells require amino acids and glucose for cell growth.  And fructose is converted into glucose in the liver.  If you starve your body of sugar, cancer cells will still force your body to produce its own sugar, BUT you aren't feeding the cancer, either.  That is why some cancer therapy diets focus on the elimination of all sources of sugar.  In combination with medical treatment, it can be very successful.  So fight cancer with your diet, don't feed it.  Pretty revolutionary!  
  • The Hunger
Fructose by-passes the normal metabolic step turning off your hunger; instead, it just makes you hungrier.  It may even break your appetite control mechanism by inducing leptin (the hormone that tells your brain you're full) resistance.   
  • The Ease of OD
It is quicker and easier to drink calories than to eat them, so you can easily go overboard on juice. 
  • The Processing
Processed juice loses its nutritional value, especially its quantity of vitamin C, with exposure to high temperature, exposure to light (through clear containers), and long shelf life.  
  • The Damage to your Teeth
Juice can lead to cavities, just like any other sugar.  For example, "bottle caries" are cavities that result from letting children suck on bottles (of juice or milk) while sleeping. 
  • The Waste
It's wasteful.  Think of all the packaging required for an apple or orange or even a container of berries.  Now compare that with a box/can/carton/bottle of juice.  Think of all the oil required to process fruit into juice, create the packaging, package the juice, and transport it.  Which has more environmental impact?
    Is a cup of juice still a cup of fruit?

    What about Juice for Energy-Refueling after Exercise? 

    Short answer: it's not ideal.  There are much better means.  Juice and fructose in general isn't a great post-workout (PWO) energy refuel because, according to Robb Wolf:
    Fructose has a nasty habit of up-regulating hepatic GLUCOSE uptake. So not only does the fructose preferentially fill liver glycogen, spuring fat gain, but it partitions glucose into the same fate. Hence my PWO meal of chicken breasts and yams.
    and in his Post WO Nutrition post:
    Fruit should be used sparingly in this meal if one is focused on optimized glycogen repletion as fructose refills liver glycogen first, and once liver glycogen is full we up-regulate the lipogenic activity of the liver and start down the road towards fat gain and insulin resistance. 
    And don't think you could actually burn off that Jamba Juice smoothie or that you are just replenishing your energy after a workout.  Unfortunately, exercise alone is NOT enough to burn the calories you consume.  Science Daily just reported on the EarlyBird Diabetes Study on children in the UK that shows "physical activity had no impact on weight change."  The article suggests that physical activity plays LITTLE IF ANY role in childhood obesity.  If active little kids can't burn off their poor diets with exercise, think us adults have a chance?

    TIME magazine ran a piece a year ago called Why Exercise Won't Make You Thin.  Basically, we tend to reward ourselves after working out or feel like we have a free pass to eat poorly the rest of the day.  And exercise may create an energy deficit that makes us hungry, which is counter-productive to weight loss goals.  Their conclusion:
    In short, it's what you eat, not how hard you try to work it off, that matters more in losing weight. 
    Of course, I totally disagree with the article's attack on exercise, but the message still stands.  Exercise must go hand in hand with NUTRITION to get the results you seek.  Exercise is NECESSARY and leads to a fitter, healthier you, but don't think it alone can determine your health.  And we certainly can't use exercise as an excuse to eat poorly.  Maybe it works for Top Chef host Padma, who can spend her life in the gym and doesn't mind looking skeletal, but it's NOT for most of us.  We need exercise AND a healthy diet.  The base of OUR pyramid is nutrition: 

    So Why Is Juice Still Being Served in Schools?

    Almost NO one sees juice as a problem!  It still has the healthiness glaze about it.  Juice is still thought of as a health food drink.  And with Jamba Juice stepping up to offer its smoothies in school just as sodas are being banned left and right, it's no wonder juice is still the "healthy" alternative.  Unfortunately, as we discussed above, that is NOT the case.  Kids (and adults) are much better off eating the whole fruit, NOT drinking the juice.  Juice should be the last ditch effort to suck down some vitamins when you are in a serious bind--NOT the daily accompaniment to our meals.  

    The good news?  Legislation is moving that will limit juice consumption at daycare facilities in California and North Carolina.  At least some people are connecting the dots between childhood obesity and too much sugar, even from a supposedly "benign" source like juice.   And more and more schools are banning sugared drinks, which gets rid of the sugared juices too.  But not the 100% juices.  Why don't we make whole fruits more available and exchange those servings of fruit juice for the real thing?

    And for all of our concerns over proper hydration, what is wrong with water?  Why can't kids use the water fountains?  For all the toxicity and contamination fears with tap water, there are just as many with the cultivation and processing of juice.  I'd rather drink the water. 

    Why does it really matter in the whole scheme of things?

    We are getting fatter as a species.  Childhood obesity is at an all-time high.  If there was nothing to lose from downing a little sugar, then there wouldn't be an issue.  But there is.  There is our future to lose.  If we set our kids up with solid nutrition and nutritional knowledge NOW, we are giving them the best legacy we can provide.  Give them a love and appreciation for real food, whole food, and slow food that doesn't come out of a box, can, carton, or bottle.  

    Bottom line: Use water to hydrate and use whole fruit to get your juice!  To start on this process, try weaning yourself off juice by watering it down.  The less you rely on sugar, the better your system and health will be and the more you will appreciate sweetness in moderation.

    Keep reading the on-going series for more about the best beverages!

    Next up: What's Wrong With Milk?

    Fructose, Insulin Resistance, and Metabolic Dyslipidemia


    1. Wow. What an awesome dissection of what makes juice so evil. It makes me even more happy (after reading this) that both my daughters "prefer" and request water over juice in most instances. Juice is flavored sugar water. That's it. Eat the whole fruit and at least get something from it other than fructose. Great post, great blog.

    2. Thanks, Eric! I appreciate the feedback! Glad your daughters aren't addicted to juice as so many children are today. The whole fruit has so much more to offer!

      Have you been successful with implementing a paleo-style diet at home in other ways? I am always interested in hearing more success stories and stories of people on their own ever-evolving journeys with nutrition. Thanks again!
      Best wishes,

    3. Hey Kristy!
      WOW!!! I just found your site this morning... this is AWESOME!! I love what you're doing, what you're teaching, how you're living it, and how you're backing everything up with solid support and research! Love, love, love it!! I'll be visiting often and sending people your way!
      Thanks for doing what you're doing!

    4. Thank you so much for the gracious feedback, Dr. Mom! I hope the information I gather and present helps more parents find a healthy path for their families! Thanks again!
      Best wishes,
      Kristy A.

    5. Nice writeup! It makes sense to avoid the juice..

      However, it's hard to argue with results, and if you look at guys like, Jay Kordich, or Jack Lalane, who look great for their age, and have gone overboard on the juicing for *decades*, makes you think, how can it be that unhealthy?

      Sure exercise/genetics will play a role, but maybe there's more to it. Perhaps there's antioxidants/enzymes that are better absorbed when juiced... I don't know. I do juice kale/beets/radishes together, and haven't seen any problems yet(knock, knock, knock.)

      Finally, what about those drink mixes where they've dried fruits/vegetables and you just add water? Google 'New Chapter Berry Greens', or 'NewGreens Berry Fusion' as examples. But it's interesting, those products contain tons of fruits, yet no sugar.. which I'm not sure how that can be done!

    6. Thank you for your comment, Enliteneer! I agree that there are benefits to fruit and veggies for their antioxidants, vitamins, and minerals, but I believe the best way to get those are through eating the whole food. As Robb Wolf has said before, real food trumps manufactured/engineered food any day. I'd personally rather rely on whole, real foods to get what I need as much as possible.

      That being said, taking vitamin, mineral, and fish oil supplements (which I do) are a slippery slope because while beneficial, they are definitely compromising the whole "nutrition from real food" stance... I guess all in all we live a life of compromises and just need to evaluate each one!

    7. WELL very nice and detailed post. tons of information.

    8. This really is a fantastic post! I think what spelled it out so clearly to me was the amount of fruit you would have to eat to get that amount of juice with the same amount of you said, you would get sick. I stopped drinking juice several years ago because of the sugar...however, you're right, there is still a misconception that since fruit=healthy juice must be healthy as well.

    9. You're an idiot. When you drink fruit juices that are 100% juice, the sugars aren't the same as what's in pop. When you pick juices that are filled with sugar, that's obviously not healthy. But when you choose juices from fruit, there isn't a problem unless you go overboard.

    10. Um, they're both fructose so they are digested by the body the same way--through the liver and not only spike blood sugar but lead down the path to triglicerides and fat accumulation. Basic nutritional biology. This is nothing new. Thanks for commenting!