from the world's big
Fruit juice can be twice as harmful as soda
No one should be drinking more than 8oz. a day. Here's why.
- A new study finds that the risk of all-cause mortality from over-consumption of fruit juice is significant.
- Other sugared beverages are still bad for you, but too much fruit juice is actually worse.
- Fructose, "real" or "natural," is still fructose and problematic.
While fruit juice largely retains its reputation as a healthy thing for kids to drink, it's not exactly news that it can contain just as much sugar as sugar-sweetened beverages (SSBs) like soda. Savvy parents and caregivers know it should be dispensed only in moderation. Along with all that sugar, of course, come beneficial vitamins, and previous research has linked the antioxidants and flavonoids in orange juice, in particular, to preventing cancer. (Not everyone agrees that the value of antioxidants has been proven.) In addition, brains of all ages consume the lion's share of a body's available sugar for energy.
Now, however, a study published in Jama Network Open from Emory University, the University of Alabama, and Cornell University, finds that the consumption of fruit juice more than doubles the risk of "all-around mortality" over SSBs.
Comparing oranges to orangesGiphy
The study was concerned with the effect of fruit-juice consumption on "all-around mortality." Earlier studies have examined the possible link between juice consumption and risk factors for coronary heart disease (CHD) such as dyslipidemia, diabetes, and obesity. So the current study's intent was to see whether or not juice consumption similarly increased the chance of mortality in general.
The data analyzed in the study was drawn from the nationwide REGARDS (REasons for Geographic And Racial Differences in Stroke) study and involved 13,440 adults with a mean age of 63.6. The cohort was 59.3 percent male/40.7 percent female, and 68.9 percent were non-Hispanic white. Seventy percent were technically overweight or obese.
REGARDS researchers re-interviewed subjects every 6 months until 2013, and mortality events were reported by family members and derived from private as well as public medical records. There were ultimately 1,000 all-cause deaths among participants, as well as 168 CHD-related deaths.
Subjects self-reported their previous year's consumption of SSBs — such as sodas, soft drinks, or fruit-flavored drinks — and naturally sweet 100 percent fruit juices. The possible responses ranged from "never" to "every day." They were also asked to report everything else they ate as a number of units or as portion sizes. The researchers then calculated the percentage of each participant's total energy (TE) consumption and the percentage of that was derived from SSBs or fruit juice. Official U.S. Dietary Guidelines, and those from the World Health Organization and the American Heart Association allowed the study's authors to classify these percentages as low (<5 percent), medium (5 – <10 percent), and high (≥10 percent).
Not so sweet
Image source: Collin, et al
On average, participants got 8.4 percent of their energy from SSBs and juice — that's just below the high-consumption threshold. After making adjustments for other cardiovascular risk factors, those who ingested above 10 percent of their energy from SSBs and fruit drinks had a 44 percent greater risk of CHD mortality and 14 percent of all-cause mortality. Looking at fruit juice alone, though, left researchers with their conclusion that each additional 12 ounces above 10 percent of your TE raises your overall risk of dying by a whopping 24 percent. By comparison, SSBs increase it by 11 percent.
Image source: molekuul_be / Shutterstock
The main issue seems to be the digestion of fructose when too much juice is consumed. The researchers suggest, "The metabolism of fructose, which is unique from all other sugars, occurs unregulated and almost exclusively in the liver. Fructose consumption is known to alter blood lipid levels, markers of inflammation and blood pressure, while high glucose consumption has been associated with insulin resistance and diabetes, independent of weight status." In a commentary accompanying the study, experts from Harvard's T.H. Chan School of Public Health note that "Although the sugar in 100 percent fruit juices is naturally occurring rather than added, once metabolized, the biological response is essentially the same."
What to do about this information
Image source: Roxana Bashyrova/Shutterstock
Other research has shown that a moderate level of juice consumption may lower one's risk of CHD problems. At the same time, the high level of sugar in juice will continue to pose a threat as a potential trigger for weight gain, diabetes, fatty liver disease, and other serious health issues.
The guidelines of the American Academy of Pediatrics and the Dietary Guidelines for Americans recommend that juice intake be limited to:
- 4 to 6 ounces a day for children aged 1–6
- 8 ounces a day for children over 7, adolescents, and adults
In addition, the Academy recommends consuming only 100 percent fruit juice, without added sugar, in both standard beverages smoothies.
Join The Daily Show comedian Jordan Klepper and elite improviser Bob Kulhan live at 1 pm ET on Tuesday, July 14!
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."