March 2019 Issue

Juicing Trends: Functional Varieties Diversify the Category
By Sherry Coleman Collins, MS, RDN, LD
Today’s Dietitian
Vol. 21, No. 3, P. 12

Several new launches of organic, cold-pressed, exotic, and functional juices are populating supermarket store shelves nationwide. Many of these products, which are sold online and in specialty health food stores, are being promoted as suitable replacements for whole fruits and vegetables. Companies claim their juices are full of antioxidants, vitamins, and minerals and that they promote gut health and help with detoxification.

Because of these claims, it’s important for dietitians to learn about the research and the products available to help clients and patients sort through them and make the most healthful choices.

Market Status
These new functional varieties and flavors have breathed new life into the category. Recently, juice consumption has been on the decline since health care professionals and organizations have warned consumers about sugar-sweetened beverages and developed guidelines about consumption of added sugars to help curtail the overweight and obesity epidemic and lower the rate of dental caries in children.1

“Beverages are one of the fastest-growing areas for innovation,” says Janet Helm, RDN, executive vice president and chief food and nutrition strategist at Weber Shandwick, a marketing firm in Chicago. “Consumers are seeking some form of discovery, and want new, interesting flavors. Juices can help satisfy this sense of discovery.”

Organic, Cold-Pressed, and Raw
These popular juices are distinguished from one another based on how they’re processed. Processing matters because high-temperature pasteurization, which is used to make some shelf-stable juice products, may reduce the number of available nutrients. High-pressure processing (HPP) appears to result in minimal loss.2

Here’s a list of some of the terms often seen in the marketplace to describe how juices are processed:

Organic: Juices labeled as organic include fruits and vegetables grown by farmers who don’t use “most conventional pesticides, fertilizers made with synthetic ingredients or sewage sludge, bioengineering, or ionizing radiation.”3

Cold-pressed or HPP: Cold-pressing or HPP entails processing juice using high pressure at low temperatures so heat doesn’t destroy the nutrients. The FDA describes HPP as using pressures of 30,000 to 45,000 psig (pounds per square inch gauge), which effectively kills pathogens and reduces the risk of foodborne illness. This process produces juice varieties with longer shelf lives than raw juice, but HPP products still require refrigeration.4

Raw: Juice labeled raw hasn’t been treated for pathogens via heat or pressure. Because it has a short shelf life and can present a risk of foodborne illness, especially in immunocompromised individuals, children, and pregnant women, raw juice must remain refrigerated.

Free Radical Fighters
In addition to touting these innovative processing methods, juice companies are claiming their juices are just as healthful as whole fruits and vegetables.

Whole fruits and vegetables are packed with a variety of biologically active compounds, such as vitamins, phytonutrients, and antioxidants, that may account for their heart-healthful, cancer-protective, immune-supporting effects. Therefore, the juice from these foods also should contain many of these same components, though some will be lost during processing when pulp and fiber are removed.

Often touted as superfoods, juices from dark-colored berries contain antioxidants such as anthocyanins and xanthones. Vitamins A, C, and E, also considered antioxidants, are naturally present in some juices and added to others. Antioxidants have been said to reduce oxidative damage to cells caused by free radicals produced during normal biochemical processes or due to exposure to environmental pollutants and harmful substances.5

Oxygen radical absorbance capacity (ORAC) is a measure of the antioxidant activity in a food. Dark-colored fruits and vegetables such as berries contain many antioxidants as measured by their high ORAC scores. However, the USDA removed its ORAC Database from the Nutrient Data Laboratory in 2012 because of the lack of evidence showing that the positive associations between fruits and vegetables and human health can be attributed specifically to the amount of antioxidants in a food.6

One juice company that uses ORAC as a measure of antioxidant activity to position them as powerful sources of antioxidants is Açaí Roots. The company’s website claims açaí berries have 500% more antioxidants than blueberries.7 The website also quotes an article from a popular health website that suggests açaí may improve cholesterol levels, help prevent cancer, and protect brain function, but includes a disclaimer stating the company doesn’t “claim that our products will have any of these effects as more research is still needed.”8

One small study on açaí juice that involved 12 subjects showed that consumption of açaí pulp over four weeks increased indicators of antioxidants in the blood of healthy women.9 But more research is necessary. An 8-oz serving of açaí juice contains 90 kcal, 3.5 g fat, and 1 g protein.

Pure Fruit Technologies sells Mangoxan mangosteen juice blend, made from mangosteen purée, pear, blueberry, red grape, red sour cherry, cranberry, and pineapple juices. The company claims mangosteen, a tropical fruit native to Southeast Asia, has powerful anti-inflammatory, immune-boosting, and energy-promoting properties, noting that the Mangoxan brand has twice the ORAC value of other mangosteen juices.10

In one small study funded by Vemma Nutrition Co, a manufacturer of mangosteen juice, 56 healthy adults drank Verve brand mangosteen juice daily for 30 days. Results showed increased antioxidants in their blood and reduced C-reactive protein, a measure linked to inflammation; researchers found no change in immune markers or kidney or hepatic function.11

An 8-oz serving of Mangoxan mangosteen juice blend contains 80 kcal and 24 g carbohydrate.

Boosting Gut Health
In addition to touting their products as high in antioxidants, juice companies are adding prebiotics, probiotics, and fiber to their juices and promoting them as beneficial to gut health. Since a primary criticism of fruit juice is its lack of dietary fiber, this could be a significant benefit for those who like to drink juice.

Juiceology is one company incorporating a blend of fiber and prebiotics to its product line.12 Boasting in excess of 30% DV for fiber per 15.2-oz bottle, the fiber comes from chicory and a proprietary blend from oats, barley, and brown rice. While a benefit to most, this high amount of fiber may be problematic for clients with irritable bowel syndrome and inflammatory bowel disease, who may be sensitive to the prebiotics, fiber, and sugar.

Depending on the variety, each serving varies in nutrient content from 140 to 220 kcal, 24 to 54 g carbohydrate, and 6 to 8 g fiber per bottle. The juices are fat-free, and most don’t contain protein, except for Green Elements and Mighty Red, each of which has 2 g.

Tropicana, a PepsiCo company, offers functional juices through a new product line called Tropicana Probiotics.13 Each product in the new line contains a variety of juice blends and 1 billion colony-forming units per serving of the lactic acid–producing probiotic Bifidobacterium lactis HN019. Although this particular bacterial strain has shown some potential in reducing inflammatory markers, more research is needed.14

Each 8-oz serving of Tropicana Probiotics provides 130 to 140 kcal and 30 to 32 g carbohydrate. The fat-free juices contain only a small amount of protein and fiber.

With regard to gut health, much is still unknown about what constitutes a healthy microbiota. Nevertheless, “the science supports that specific live probiotics, consumed in adequate amounts, can support a healthy digestive tract and a healthy immune system,” says Joan Salge Blake, EdD, MS, RDN, FAND, a clinical associate professor at Boston University and the author of Nutrition & You. Benefits are strain specific, so it’s important to know what type of bacteria is included in products that claim to improve gut health.

Detoxification
Juices that claim to detoxify the body by ridding it of accumulated toxins from food and the environment are growing in popularity. Juice cleanses aren’t new, but there are more options.

Good Cleansing is one particular company that sells three-, five-, and seven-day cleanses as raw juice, optional vegan soups, and cleansing herbs. The company’s website claims consumers will experience increased energy, weight loss of 7 to 20 lbs per week, an improved complexion, and “spiritual transformation.”15 It warns that the average American has 5 to 25 lbs of mucus plaque (thick sticky mucus build-up inside the gut from undigested food) that can be expelled by a cleanse enhanced with cleansing herbs. A literature search found no evidence to support these claims. Good Cleansing sells 10 varieties of raw, organic juice that’s shipped directly to consumers. The company recommends consuming six juices per day, which it claims provides 400 kcal total, followed by a healthful dinner.

Similarly, Jùs by Julie sells one- to five-day cleanses in the form of smoothies on its website and through Costco. The website claims that drinking its products can help the body eliminate toxins, reduce bloating, and result in glowing skin, and its cleanse “wipes away the evidence of junk food and unhealthy habits.”16 The company offers 18 different combinations of raw juice smoothies that vary widely in nutrient content.

Suja Juice sells a three-day juice cleanse on its website, at Whole Foods, and on Amazon. It claims the three-day juice cleanse will leave consumers feeling “refreshed” and “restored.”17

The Suja Juice three-day cleanse guide on the website includes a recipe for high-fiber overnight oats. The guide encourages eating raw fruits and vegetables (in addition to the juice), half an avocado, baked sweet potato, or broth-based soup if hungry during the cleanse. Suja Juice offers 12 different options of cold-pressed juice, some of which have added probiotics and spices, in addition to “wellness shots,” kombucha, and plant-based milk.

According to Atlanta-based Caroline Young, MS, RDN, LD, RYT, who works with clients struggling with disordered eating and eating disorders, “Adopting any kind of extremely restrictive dietary plan, such as a juice cleanse, without consuming actual food puts people at risk of developing GI issues, nutrient deficiencies, and serious mental health conditions like eating disorders. Even if the juicing period is short, it will not provide enough energy and/or nutrients to support a healthy physical or mental state for anyone.”

Regardless of the hype, there’s little research to support the health claims of juice cleanses. In fact, a 2014 critical review published in Journal of Human Nutrition and Dietetics concluded, “There is no compelling evidence to support the use of detox diets for weight management or toxin elimination.”18

Guidance for Clients
A recent study published in Neurology supports moderate consumption of fruit juice. Researchers found that long-term consumption of fruits and vegetables, along with a glass of orange juice each day, improved subjective cognitive function in elderly men.19

A review of National Health and Nutrition Examination Survey data showed that consumption of 100% juice (and milk) was associated with better diet quality in children aged 4 to 19.20 However, a study of postmenopausal women who drank 100% fruit juice found an increase in weight of 0.39 lbs over three years for every serving of juice consumed per day.21 These findings emphasize the importance of considering the individual needs of each client.

While there’s likely no danger in consuming fruit juice as part of a healthful diet, there’s little evidence to support the idea that it confers superior health benefits over eating a variety of whole fruits and vegetables. “The main problem with the juice trend is the magical thinking,” Helm says. “Juices won’t speed your metabolism and melt fat away. Juices are not detoxifying. Your body does a good job of that on its own.”

The 2015–2020 Dietary Guidelines for Americans state that individuals can meet up to one-half of the recommended servings of fruit with 100% fruit juice, limited to 4 to 6 oz for young children.22 Whether fruit juices are considered exotic or more familiar, or whether or not they have functional ingredients and added nutrients, moderation is key when it comes to consumption.

— Sherry Coleman Collins, MS, RDN, LD, is president of Southern Fried Nutrition Services in Atlanta, specializing in food allergies and sensitivities, digestive disorders, and nutrition communications. Find her on Twitter, Instagram, and Facebook as @DietitianSherry, via the Southern Fried Girlfriends podcast, and at www.southernfriednutrition.com.

References
1. Bleich SN, Vercammen KA, Koma JW, Li Z. Trends in beverage consumption among children and adults, 2003-2014. Obesity. 2018;26(2):432-441.

2. Barrett DM, Lloyd B. Advanced preservation methods and nutrient retention in fruits and vegetables. J Sci Food Agric. 2012;92(1):7-22.

3. Organic production/organic food: information access tools. US Department of Agriculture, National Agricultural Library website. https://www.nal.usda.gov/afsic/organic-productionorganic-food-information-access-tools. Updated October 2018. Accessed January 9, 2019.

4. Guidance for industry: juice HACCP hazards and controls guidance first edition. US Food and Drug Administration website. https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/juice/ucm072557.htm. Updated September 20, 2018. Accessed January 9, 2019.

5. Antioxidants. Mayo Clinic website. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428. Published February 7, 2017.

6. Oxygen radical absorbance capacity (ORAC) of selected foods, release 2 (2010). US Department of Agriculture, Agricultural Research Service website. https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/nutrient-data-laboratory/docs/oxygen-radical-absorbance-capacity-orac-of-selected-foods-release-2-2010/. Updated August 13, 2016. Accessed January 9, 2019.

7. Our berries. Açaí Roots website. https://acairoots.com/our-berries/. Accessed January 9, 2019.

8. Health benefits. Açaí Roots website. https://acairoots.com/health-benefits/. Accessed January 9, 2019.

9. Barbosa PO, Pala D, Silva CT, et al. Açai (Euterpe oleracea Mart.) pulp dietary intake improves cellular antioxidant enzymes and biomarkers of serum in healthy women. Nutrition. 2016;32(6):674-680.

10. Mangoxan mangosteen fruit juice health benefits & properties. Pure Fruit Technologies website. https://www.purefruittechnologies.com/benefits-of-mangosteen. Accessed January 9, 2019.

11. Xie Z, Sintara M, Chang T, Ou B. Daily consumption of a mangosteen-based drink improves in vivo antioxidant and anti- inflammatory biomarkers in healthy adults: a randomized, double-blind, placebo-controlled clinical trial. Food Sci Nutr. 2015;3(4):342-348.

12. About. Juiceology website. http://www.purejuiceology.com/#about. Accessed January 9, 2019.

13. Products. Tropicana website. https://www.tropicana.com/products. Accessed January 9, 2019.

14. Bernini LJ, Simão ANC, de Souza CHB, et al. Effect of Bifidobacterium lactis HN019 on inflammatory markers and oxidative stress in subjects with and without the metabolic syndrome. Br J Nutr. 2018;120(6):645-652.

15. Good Cleansing website. https://www.goodcleansing.com. Accessed January 12, 2019.

16. Blended is better. Jùs by Julie website. https://www.jusbyjulie.com/pages/blended-is-better. Accessed January 12, 2019.

17. Suja Organic. Suja 3-day cleanse: user guide. https://cdn.sujajuice.com/wp-content/uploads/2018/12/3-day-cleanse-program.pdf. Accessed January 12, 2019.

18. Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2014;28(6):675-686.

19. Yuan C, Fondell E, Bhushan A, et al. Long-term intake of vegetables and fruits and subjective cognitive function in US men. Neurology. 2019;92(1):e63-e75.

20. Maillot M, Rehm CD, Vieux F, Rose CM, Drewnowski A. Beverage consumption patterns among 4-19 y old children in 2009-14 NHANES show that the milk and 100% juice pattern is associated with better diets. Nutr J. 2018;17(54):54.

21. Auerbach BJ, Littman AJ, Krieger J, et al. Association of 100% fruit juice consumption and 3-year weight change among postmenopausal women in the in the Women’s Health Initiative. Prev Med. 2018;109:8-10.

22. US Department of Health and Human Services. Dietary Guidelines for Americans 2015–2020: chapter 1: key elements of healthy eating patterns. https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns/. Published January 6, 2016. Accessed January 9, 2019.