Have you ever met a kid that didn't like sweets? I'm guessing not. Honestly you probably have a better chance at spotting Big Foot playing miniature golf or watching a unicorn flying through a rainbow. Kids don't kind of like sweets they love them! Although kids are great at devouring sweet treats they aren't very good at regulating their intake of them. It usually takes a tummy ache before they start to slow down on their own. Until they reach that age where they know what's good and what isn't good for them they'll need their parents to regulate their diet, especially as it comes to their sugar intake.

Monitoring sugar intake isn't reserved for Halloween night though. Sugar can sneak its way into a diet through many other forms other than candy bars. One place parents often overlook their child's sugar intake is the juice they drink. The sugars found in juices (primarily sucrose, glucose, fructose, and sorbitol) can have adverse health effects when consumed in excessive quantities. Too much sugar can lead to malnutrition (over nutrition and under nutrition), contribute to tooth decay or cause teeth staining. In addition to tooth decay there could be some other rather unpleasant effects from over consumption of juice including diarrhea, flatulence and abdominal distention.

The American Academy of Pediatrics updated their fruit juice intake guidelines in 2017 for the first time since 2001. What they say might just have you adjusting your child's juice intake. Let's take a closer look at the following:

- What constitutes a juice?
- Are all juices equal?
- What's a healthy portion?
- What's the best time of the day for juice?
- Our final take.

What constitutes a juice?

As it turns out just having a picture of fruit on the bottle label doesn't mean the bottle contains fruit juice. Buyer beware. In order for a beverage to be labeled as fruit juice the US Food and Drug Administrates requires that the contents are 100% fruit juice. That's a pretty straightforward requirement.

If the juice was reconstituted from concentrate the labeling needs to clearly state that fact. Reconstituted from concentrate just means that the water was removed for shipping purposes and then re-added for final packaging/bottling. Reconstituted fruit juice makes it easier for the producer because frozen products will keep longer.

If a beverage has less than 100% fruit juice the label is required to list the percentage of contents that are fruit juice as well as include a descript term such as "beverage", "drink", or "cocktail". The majority of juice drinks contain between 99% and 10% juice and added sweeteners, colors, flavors, and sometimes fortifiers like Vitamin C or calcium. Once again the bottle labeling must indicate the presence of these items.

The takeaway here is that you need to spend a minute reading the entire label so you know exactly what's in the bottle. Don't settle for the prettiest label.

Are all juices equal?

The short answer is No. As we mentioned earlier one giveaway on the front of the bottle is the products name. If it includes terms such as "beverage", "drink", or "cocktail" it means the product isn't 100% fruit juice. Beyond that the front label generally will only help you determine the primary fruit or fruit blend. In order you really understand how one juice stacks up against another you have to compare the details on the back of the label.

The amount of sugar a juice contains is going to be determined by the type of fruit that's used and any additional sweetening the manufacturer adds. Here's some general sugar and calorie information for the more common fruit juices. To put this list into perspective 8 oz of soda has around 26 grams of sugar.

Based on 8oz	Sugar (g)	Calories
Apple Juice, Unsweetened	24.0	112
Grape Juice	36.0	152
Orange Juice	20.8	112
Pomegranate Juice	32.0	136
Tangerine Juice	24.8	104

Another important item to make note of is if the product is unpasteurized or not. Unpasteurized juice products could potentially contain pathogens such as E. coli or salmonella. These pathogens can cause serious illnesses and should be given to children cautiously, if at all. The AAP recommends that the consumption of unpasteurized juice products should be strongly discouraged in infants, children, and adolescents. The majority of juices sold in the US however are not unpasteurized. On one hand this means you're less likely to inadvertently pick up an unpasteurized juice but on the other hand you might be more inclined to assume the juice is pasteurized. Take the time to inspect the label carefully, especially when the juice if your child. Their sensitive immune system is more susceptible to attack.

One final thing to consider is that the AAP recommends that grapefruit juice be avoided when a child is taking a medication that is metabolized by CYP3A4. This abbreviation represents a "an important enzyme in the body, mainly found in the liver and in the intestine. It oxidizes small foreign organic molecules (xenobiotics), such as toxins or drugs, so that they can be removed from the body." If your child is taking a medication and consuming juice you may want to contact your physician and/or pharmacist to ask about any potential interactions between the two. The flavonoids contained in the juice your child is drinking may decrease the activity of several enzymes and transport proteins that are an essential part of certain medications.

What's a healthy portion?

That largely depends on the age of your child. Lets look at the age groups and portions the AAP has identified. If your child is suffering from dehydration or diarrhea though the quick answer is no juice. Juice shouldn't be used as a treatment in either of those circumstances.

The AAP recommends that infants 6 months and younger should only drink human milk or formula when human milk isn't an option. Optimally juice should not be introduced into the diet of infants before 12 months of age unless clinically indicated.

The AAP recommends that toddlers, 1 through 3 years of age, should be limited to 4 ounces/day. Furthermore the AAP recommends that you avoid using bottles or sealed cups that will allow your child to drink juice throughout the day.

The AAP recommends that small children, 4 through 6 years of age, should be limited to 4 to 6 ounces/day.

The AAP recommends that older children and adolescents, 7 through 18 years of age, should be limited to 8 ounces/day. One 8 ounce serving equates to one cup of the recommended 2 to 2.5 cups of fruit servings per day. Eating whole fruit can make up the balance of the daily recommending servings. One added benefit to eating whole fruit is the intake of fiber. Unless the juice you consume has pulp in it there's likely no fiber in it.

What's the best time of the day for juice?

Although there isn't a definitive answer to this question the best time might be the middle of the day. What works for one child might not work as well for others so be willing to experiment a little to see what works best for your child. Take into consideration their general mood (before & after) and their willingness/ability to nap. You have to find the balance between their health and your sanity.

There are a couple of reasons why the middle of the day might prove to be the best time. Starting the day out with a dose of sugar might be compounding their sugar intake if their breakfast food has a relatively high amount of sugar in it already. Take notice of the sugar content in their food and balance that with their juice intake. Ending the day with juice just before bedtime could result in a very challenging end of the day where you're much more tired then your child. Your child might end up putting you to bed instead.

In addition to the time of the day you should also consider the duration of time your child is allowed to have juice. It's usually a good idea to limit juice intake to just mealtime rather than let your child nurse a bottle of juice for hours a time. If your child has juice all the time that constant inflow of sugar will increase the chances of having tooth issues. On top of that the constant availability of juice could have them turning their noses up when you try to substitute their sweet nectar with something much more bland like water or milk.

Our final take.

What can be considered a healthy amount of fruit juice depends on the type of juice and the age of your child. The amount of sugar varies from juice to juice and healthy portion sizes should be determined by the age of your child. You should also consider replacing some of your child's juice intake with whole fruit that will provide them with the benefit of fiber intake.