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Age of Juice Introduction and Cardiometabolic Outcomes in Middle Childhood
Priscilla K Clayton1, Diane L Putnick1, Ian R Trees1
1Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.
Insights
Introducing juice before six months of age is linked to increased blood pressure and heart rate in children. Early juice consumption may negatively impact cardiovascular health later in childhood.
Area of Science:
- Pediatric Health
- Cardiovascular Health
- Nutrition Science
Background:
- The American Academy of Pediatrics advises introducing juice after 12 months.
- Juice consumption is associated with childhood obesity and cardiometabolic risk.
Purpose of the Study:
- To investigate the relationship between the age of juice introduction and cardiometabolic outcomes in middle childhood.
Main Methods:
- Parents reported juice introduction age for 524 children (8-10 years old).
- Measured anthropometry, blood pressure (BP), and pulse wave velocity (PWV).
- Analyzed plasma lipids, hemoglobin A1c (HbA1c), and C-reactive protein (CRP) in a subset.
Main Results:
- Children introduced to juice before 6 months had higher systolic BP, heart rate, and mean arterial pressure compared to those introduced at ≥12 months.
- No significant differences were found in anthropometry, lipids, HbA1c, or CRP levels.
Conclusions:
- Early infant juice introduction is associated with elevated systolic BP, heart rate, and mean arterial pressure in middle childhood.
- This finding highlights potential long-term cardiovascular implications of early juice consumption.
Background:
The American Academy of Pediatrics recommends juice introduction after 12 months of age. Juice consumption has been linked to childhood obesity and cardiometabolic risk.
Objectives:
To examine the prospective relationship between the age of juice introduction and primary and secondary cardiometabolic outcomes in middle childhood.
Methods:
Parents reported the age of juice introduction on Upstate KIDS questionnaires completed between 4 and 18 months. The quantity and type of juice introduced were not measured. Anthropometry, blood pressure (BP), and arterial stiffness by pulse wave velocity (PWV) were measured for 524 children (age, 8-10 y) at study visits (2017-2019). Age- and gender-adjusted z-scores were calculated using the Centers for Disease Control and Prevention reference for anthropometrics. Plasma lipids, hemoglobin A1c (HbA1c), and C-reactive protein (CRP) in a subset of children were also measured (n = 248). Associations between age at juice introduction (categorized as <6, 6 to <12, ≥12 months), and outcomes were estimated using mean differences and odds ratios, applying generalized estimating equations to account for correlations between twins.
Results:
Approximately 18% of children were introduced to juice at <6 months, 52% between 6 and <12 months, and 30% ≥ 12 months of age. Children who were introduced to juice before 6 months had higher systolic BP (3.13 mmHg; 95% confidence interval [CI]: 0.52, 5.74), heart rate (4.46 bpm; 95% CI: 1.05, 7.87), and mean arterial pressure (2.08 mmHg; 95% CI: 0.15, 4.00) compared with those introduced ≥12 months after covariate adjustment including sociodemographic factors and maternal prepregnancy body mass index. No adjusted differences in anthropometry, lipids, HbA1c, and CRP levels were found.
Conclusions:
Early juice introduction during infancy was associated with higher systolic BP, heart rate, and mean arterial pressure in middle childhood. This trial was registered at clinicaltrials.gov as NCT03106493 (https://clinicaltrials.gov/study/NCT03106493?term=upstate%20KIDS&rank=1).
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