“The Fruit Juice Delusion”

From NY Times: The Fruit Juice Delusion

A recent commentary revisits the common misconception of fruit juice being healthy.

Key points:

  • “Americans drink a lot of juice…children consume on average 10 ounces per day, more than twice the amount recommended by the American Academy of Pediatrics.”
  • “One 12-ounce glass of orange juice contains 10 teaspoons of sugar.”
  • Eating whole fruit is “associated with a reduced risk of diabetes, drinking fruit juice is associated with the opposite.”
  • “Juice may also be a ‘gateway beverage’–[to drink] more soda in their school-age years
  • “There is no evidence that juice improves health…Parents should instead serve water and focus on trying to increase children’s intake of whole fruit.”

My take (borrowed from authors): “we have succeeded in recognizing the harm of sugary beverages like soda. We can’t keep pretending that juice is different.”

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8 Cups of Water: Weight Loss or Worthless?

A recent study: JMW Wong et al. JAMA Pediatr 2017; 17 e170012 (Thanks to Ben Gold for this reference)

Full Text Link: Effects of Advice to Drink 8 Cups of Water per Day in Adolesents with Overweight or Obesity: A Randomized Clinical Trial

Among 38 adolescents with overweight or obesity, participants were divided into a water group and a control group.  The water group received “well-defined messages about water through counseling and daily text messages, a water bottle, and a water pitcher with filters.”

Key findings:

  • The water group consumed 2.8 cups of water per day compared to 1.2 cups per day for the control group
  • The 6-month chnage in BMI z score was identical z= -0.1.

My take: Advice and behavioral supports to consume 8 cups of water per day are likely to fall short and do not seem to enhance weight loss.

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Normandy American Cementary

Better Hydration –Less Obesity?

Perhaps the Dos Equis’ guy’s slogan “Stay Thirsty My Friends” is not such great advice.

According to a study, summarized by NPR, inadequate hydration was associated with increased odds of obesity.  While an association does not prove causation, it adds another potential reason to drink plenty of water.

NPR Story: Thirsty? New Study Links Good Hydration with Slimmer Waistlines

Here’s an excerpt:

A new study published in the Annals of Family Medicineadds to the evidence that hydration may play a role in weight management.

“What we found was that people who were inadequately hydrated had increased odds of being obese,” says study author Tammy Chang of the Department of Family Medicine at the University of Michigan.

The study was based on data collected by a federal health survey, in which researchers had documented weight and height of participants. They also conducted urine tests to establish an objective measure of participants’ level of hydration.

Chang and her colleagues found the odds of being obese were 1.59 times higher for people who were not well-hydrated. And overall, they found that a lack of proper hydration was associated with higher body mass index.

On a neighborhood walk

On a neighborhood walk

Why We Should Not Worry That Much About Water Intake

A recent article in the NY Times rebuts the claim that so many kids are dehydrated: No, You Don’t Have to Drink 8 Glasses of Water a Day

An excerpt:

Prospective studies fail to find benefits in kidney function or all-cause mortality when healthy people increase their fluid intake. Randomized controlled trials fail to find benefits as well, with the exception of specific cases — for example, preventing the recurrence of some kinds of kidney stones. Real dehydration, when your body has lost a significant amount of water because of illness, excessive exercise or sweating, or an inability to drink, is a serious issue. But people with clinical dehydration almost always have symptoms of some sort….

This summer’s rash of stories was inspired by a recent study in the American Journal of Public Health. Researchers used data from the National Health and Nutrition Examination Survey from 2009 to 2012 to examine 4,134 children ages 6 to 19. Specifically, they calculated their mean urine osmolality, which is a measure of urine concentration. The higher the value, the more concentrated the urine…

But as people in this country live longer than ever before, and have arguably freer access to beverages than at almost any time in human history, it’s just not true that we’re all dehydrated.

Some of the key points:

  • Much of the research suggesting that there is an epidemic of under hydration is being funded by companies with a financial interest
  • Water is contained in both foods and other beverages
  • The research standard of urine osmalality >800 mOsm is not used clinically
  • There are no documented health advantages that have been identified in individuals who drink more fluid (except in those with documented history of kidney stones)

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Not Thirsty for Water

As noted in several previous posts (see below), many kids (and adults) would likely benefit from increased water consumption.  The pervasiveness of this problem was recently discussed in a recent (June 11th) USA Today article (“Researchers to kids: drink more water”), though experts disagree on whether mild water deficits are detrimental.

Here’s an excerpt:

The study, published Thursday by the American Journal of Public Health, found 54.5% of children ages 6 to 19 inadequately hydrated, at least by the standard set in the study.

The findings, based on one-time urine samples from more than 4,000 children, do not mean most children are seriously dehydrated…

The researchers considered a child inadequately hydrated if the concentration reached a level other studies have linked to sluggish thinking and mood changes.

They found boys and black children were more likely than girls and children of other races to have highly concentrated urine…

But … some experts …say most people can judge their fluid needs by thirst alone – and that fluids can come from any drink and many foods…

The study showed 22% of children drank no water.


Not drinking enough water



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Water -Often Missing from Diet

A recent NPR report indicates that a faction of scientists is pushing for a water icon to be added to the government’s MyPlate.

Here’s the link: Missing from MyPlate? Water

Here’s an excerpt:

“Consumption of sugary beverages is the leading contributor to added sugar in the American diet,” says Christina Hecht, senior policy adviser at the UC Nutrition Policy Institute and one of the water advocates. “If people could make that one change to drink water to quench their thirst instead of sugar beverages, that would solve a big piece of the problem.”

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Is Water The Best Beverage for Dieters? Maybe Not

According to a recent study in Obesity (2014; 22: 1415-21), during the first 12 weeks of a weight loss program water is not as helpful as non-nutritive sweetened drinks (eg. diet soda) when trying to lose weight (Thanks to Jeff Schwimmer for this reference).

The study describes the findings from the 12-week weight loss phase of a 1-year randomized, clinical trial to test the hypothesis that the amount of weight lost (12 weeks) and maintained (9 months) in a behavioral weight management program will be equivalent in participants consuming beverages containing non-nutritive sweetened beverages (NNS) compared to water.

  • Demographics: n=303, mean age ~48 years, 82% female, mean BMI 33
  • Design: “Participants randomized to the NNS beverage group were asked to consume at least 24 fluid ounces of NNS beverage per day and their water consumption was not restricted. An NNS beverage qualified if it had <5 kcal per 8 ounce-serving, was pre-mixed, and contained non-nutritive sweeteners.” Similarly, in the water group, individuals were instructed to consume at least 24 fluid ounces of water per day, and not drink any NNS beverages.
  • Results: “The two treatments were not equivalent with the NNS beverage treatment group losing significantly more weight compared to the water group (5.95 kg versus 4.09 kg; P < 0.0001) after 12 weeks. Participants in the NNS beverage group reported significantly greater reductions in subjective feelings of hunger than those in the water group during 12 weeks.”
  • Conclusion: “These results show that water is not superior to NNS beverages for weight loss during a comprehensive behavioral weight loss program.”

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