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Thursday, August 5, 2010

Why Pediatricians Get So Worked Up About Juice...

"...You know fifty years ago..."

If you ever hear me say this line during a visit to the office, it probably means that I am getting on my soapbox about pediatric obesity. Fifty years ago kids drank water and milk and the occasional sugary drink, meaning an 8-oz bottle of Coke, not the "medium" 32-oz behemoth of today.

Every pediatrician has their particular pet peeve: sunscreen, sleep, developmental concerns, etc. Mine is pediatric obesity. I would estimate about 20% of the patients I see for well visits are either overweight or obese. Quite frankly, if your child can't read or gets a million ear infections a year, I get less passionate about that than I do kids drinking too much juice and watching too much TV. I have had 30 minute screaming matches with parents in Spanish over this.

Why do I care? When my patients graduate high school and leave me *sniff* this is pretty much the only thing that I can treat when they are four that will have a significant impact on their quality of life when they are 40. It makes me sad to have kindergartners with high cholesterol and signs of adult diabetes.

Inevitably, the culprits almost always boil down to either a) hours in front of the TV/PlayStation, or b) too much juice/soda/sweet tea.  Here is a chart I got from this website.

12 ounces of >>>>>>>  Coca-Cola Orange Juice Apple Juice Cherry Juice Grape Juice
Total carbohydrates 40 g 39 g 42 g 49.5 g 60 g
Carbs from sugar 40 g 33 g 39 g 37.5 g 58.5 g
Sugar (teaspoons) 10 tsp 8 tsp 10 tsp 9 tsp 15 tsp
Calories 145 165 165 210 240

Let's pick apple juice, since that is the most common and cheapest juice that most parents buy. BTW, all of these juices are 100% juice. None of that "juice drink" stuff or Lil' Hugs. In general stay away from any drink (or person) that has Lil' in it.

Two average-sized sippy cups of apple juice a day x seven days is 140 teaspoons of sugar in one week! Even if you water it down, that is between 50-70 teaspoons of sugar just from drinking. Imagine the dirty looks you would get from your loved ones if you let your child sit at a table with a cereal bowl and shovel spoonful after spoonful of sugar into their body. Makes you think twice. Grape juice is even more shocking.

And the TV. I have patients who watch more TV in a week than I spend working a full time job. My only exception to restricting TV/video games to no more than two hours a day is Wii. Wii is a pediatrician's best friend. Gets you up and moving. Unless you get Wii tennis elbow. True story.

Juice is not evil. I love juice. I am a former juice-aholic. But it is a treat. We went cold turkey last year and just stopped buying it all together. Water, milk and wine for the grown-ups. We may buy it for guests. That's it. We will drink juice or soda occasionally as treat when eating out and no one can come between the Kid and a coveted glass of pink lemonade at a restaurant (you could lose an arm). But we try our hardest to think before drinking a sugary drink.


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