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Study: Fruit juice availability reduces milk, whole fruit consumption in high schools

Research examining register data at three low-income high schools found that healthier options are taken less frequently when fruit juices are present on the cafeteria line.

The presence of fruit juice on the cafeteria line has a corrosive effect on the selection of healthier options such as milk, whole fruit, a la carte bottled water and, not surprisingly, a la carte 100-percent juice, according to a study published in the Journal of Nutrition Education and Behavior.

The study found that when fruit juice is made available as part of a reimbursable meal, about 8.6 percent fewer milks and about 8.8 percent fewer whole fruits are chosen than when the juice is unavailable. In addition, having the juice on the cafeteria line reduces a la carte sales of bottled water by about 12 percent and 100-percent fruit juice by 16 percent.

The study, “Juice Displaces Milk and Fruit in High School Lunches,” was conducted by researchers Rebecca Boehm, Margaret Read and Marlene Schwartz for the Rudd Center for Food Policy and Obesity at the University of Connecticut. It examined cafeteria register data over the course of the 2013-2014 school year from three unnamed Northeastern high schools participating in the USDA’s Community Eligibility Provision (CEP) program, meaning all students were eligible to receive free school meals.

All had closed campuses at lunch and none had vending machines on the premises at the time of the study. Total combined enrollment at the time was 4,614.

The impact of the difference is in the amount of nutrients lost to students who choose the fruit juice over the other options, the study authors argue.

An 8-ounce serving of 1 percent milk has 102 calories, 12.7 grams of sugar, 2.9 micrograms of vitamin D, 305 milligrams of calcium and 366 milligrams of potassium, they note, whereas an equal amount of 100-percent apple juice has 114 calories, 24 grams of sugar, no vitamin D, 20 milligrams of calcium and 250 milligrams of potassium. Plus, they add, 1 cup of fruit has 1.1 to 5.1 grams of fiber whereas juice contains no fiber.

“In light of the nutritional deficiencies documented for US adolescents, on balance, milk and fruit are more nutrient-dense choices than juice,” they suggest.

In their notes on implications for research and practice, the study authors recommend that further research be done on the impact of the availability of juices on consumption of entrees as their research did not measure food waste to see if the students were eating less of the food they took. They also suggest doing research similar to theirs on schools with demographic profiles different from the one they studied to see if the results they found are replicated with other populations.

“If further research confirms that juice displaces milk and fruit in the school meal, the role of juice in the program may warrant reevaluation,” they conclude. “A policy to further limit juice availability frequency or serving sizes, or to remove it from schools entirely, may help children stay below the American Academy of Pediatrics juice consumption limit. Simultaneously, this could increase milk and fruit consumption among US children when they eat lunch at school.” Alternatively, they suggest, “[b]ehavioral economics interventions such as Smarter Lunchroom Movement strategies could be used to promote milk, fruit, and water over juice without removing juice from school meals altogether.”

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