Projected impact of replacing juice with whole fruit in early care and education.

Introduction: The purpose of this study was to simulate potential changes in dietary intake and food costs by replacing juice with whole fruit among children ages 1 - 5 years attending US early care and education (ECE) settings between 2008-2020.

Methods: Estimated mean changes in daily intake of calories, sugar, fiber, calcium, vitamin C and overall food costs under plausible scenarios of replacing juice with whole fruit. Researchers fit hierarchical regression with children nested within ECE nested within studies, adjusting for potential confounders.

Results: The sample consisted of 6,304 days of direct observation (90% ages 2 years or older, 51% female, 38% Black/African American) in 846 ECE facilities (73% centers, 75% Child and Adult Care Food Program (CACFP) participants). Replacing juice with whole fruit would reduce energy intake by 8.2 - 27.3 kcal/day, reduce sugar by 3.4 - 5.6 g/day, increase fiber by 0.5-1.3 g/day, and have negligible impact on vitamin C and calcium. Replacing juice with whole fruit in ECE would increase per-child daily food costs between $0.44 - 0.49, representing an increase from 3.8% for juice to approximately 9.8% - 10.7% for whole fruit as a percent of total food costs.

Conclusions: Replacing juice with whole fruit in ECE would result in increased fiber intake and decreased sugar and calories. A policy to replace juice with whole fruit in ECE would likely cause an increased daily food cost and given the potential broad benefit of this dietary intervention, there may be reason to expand funding within nutrition assistance programs in ECE.