Nutritional Disorders Telehealth Network Project

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Elimination of Juice/Empty Calories

Eliminate the dietary practice of excess fruit juice
Background Education for Providers
Typically, children will have an easier time drinking calories than eating them (e.g., whole milk, formula). Fruit juice or sugar sweetened beverages are often associated with obesity or excess weight gain in children. However, in the undernourished patient, most notably infants and toddlers, it can have an opposite effect. With an underweight patient the general goal is to maintain a healthy diet while increasing the calorie intake. Beverages such as fruit juice will increase caloric intake; however, many of these calories come from the added sugar. It is important to remember that the nutritional quality of the foods remains important. 
Any caloric beverage provided between meals may decrease a child’s appetite at mealtimes. Providing high calorie beverages and fruit juices between mealtimes should be avoided in order to improve intake at mealtimes.   Children should be given no more than 8 ounces of fruit juice per day, and other high calorie beverages should be made available for the child to drink with their meals. If children are thirsty between mealtimes, they should be encouraged to drink water. Often when children say they are hungry between mealtimes, it may often be a sign of thirst. Families may inquire about increasing fruit juice intake, which should be limited and could be avoided as this offers little nutritional benefit for the underweight or undernourished child. 
Instructions for Provider
  • Prevent and control access to fruit juice. Prevent ad lib or grazing drinking patterns of juice or sugar sweetened beverages.
  • Only provide and encourage water to drink between scheduled meal and snack times. 
  • Limit total fruit juice intake to less than 8 ounces per day.
  • Provide alternative choices for high calorie beverages that can be provided to children at mealtimes, such as PediaSure, formula, or whole milk.
Supplemental Materials
© 2015 Medical College of Wisconsin
Page Updated 04/15/2014