Most Americans drink less juice than guidelines allow, study finds

Researchers found that Americans who drank 100% fruit juice had healthier diets, higher nutrient scores, and stayed within guideline limits, suggesting juice may help bridge nutritional gaps without pushing out whole fruit.

Study: Consumption of 100% Juice and Diluted 100% Juice Is Associated with Better Compliance with Dietary Guidelines for Americans: Analyses of NHANES 2017–2023. Image Credit: Elenia Photo  / Shutterstock

In a recent article in the journal Nutrients, researchers analyzed patterns of pure and diluted juice consumption in the United States across different groups to assess its relationship with diet quality. Their findings show most Americans consume well below the Dietary Guidelines for Americans (DGA) limits on juice intake. However, juice consumption was linked to better diet quality, including higher intake of fruit, whole grains, vitamin C, potassium, and calcium, and lower intake of added sugar, sodium, and saturated fat.

Background

The DGA recommendations for 2020–2025 advise limiting 100% fruit juice. Excessive intake may add unnecessary calories. Recommendations vary by age, from ½ cup daily for children aged 2–3 years to 1.25 cups for adult men. At least half of fruit intake should come from whole fruit to provide enough fiber.

Despite these guidelines, national surveys show that 100% juice consumption in the U.S. is low. Sugar-sweetened beverages (SSBs), which add calories without nutritional benefits, are consumed in much larger amounts, especially by children and young adults. Paradoxically, concerns about childhood obesity have been more strongly linked to 100% juice rather than SSB consumption, even though SSBs are consumed far more widely. While trends in SSB intake have been well studied, fewer U.S. studies have examined recent patterns of 100% juice or diluted juice intake.

Orange and apple juice remain the main sources of fruit juice, and past research has shown that juices can provide bioactive compounds and contribute positively to diet quality. Beverage patterns centered on juice and milk, for instance, were associated with healthier diets compared to SSB-heavy patterns.

About the study

Researchers used National Health and Nutrition Examination Survey (NHANES) 2017–2020 and 2021–2023 cycles to examine how juice intake varies by demographic and socioeconomic factors, and whether juice consumption is linked to better diet quality and reduced nutritional disparities, comparing intake to pediatric and DGA recommendations.

Their dataset included 4,086 children aged between 5 and 19, and 10,925 adults. NHANES collects dietary intake using two 24-hour recalls with a multi-pass method, where trained interviewers record all foods and beverages consumed, including amounts and eating occasions. The Food Patterns Equivalents Database (FPED) converted reported foods into standardized cup-equivalents for consistency with DGA food groups.

Participants were stratified by age, sex, ethnicity/race, and income-to-poverty ratio (IPR), which reflects household income relative to poverty thresholds. Beverage intake was grouped into six categories: low-calorie drinks, SSBs, 100% juice, diluted juice (practically nonexistent in consumption, without added sugar), water, and milk.

Two measures of dietary quality were used: the Healthy Eating Index 2020, a 100-point scale assessing adherence to the DGA, and the Nutrient Rich Food Index, which scores diets based on nine nutrients to encourage and three to limit (sodium, saturated fat, and added sugar).

Analyses estimated mean intakes, percentiles, and demographic differences using chi-square tests and generalized linear models, with adjustments for energy intake and survey weights. Compliance with DGA juice recommendations was also assessed by categorizing individuals’ daily juice intake. Whole fruit and juice consumption ratios were calculated to evaluate whether juice was displacing whole fruit.

Key findings

The analysis showed that only about one-quarter of participants consumed any 100% fruit juice (including diluted versions) over two recall days. Consumption was more common among younger children, older adults, lower-income groups, and specific ethnic/racial minorities, particularly Mexican American and non-Hispanic Black individuals.

Water was by far the most consumed beverage, followed by milk, SSBs, with juice contributing relatively little overall. Children in lower-income households tended to drink more 100% juice and less whole fruit compared with higher-income children, though diluted juice intake was slightly higher in wealthier groups.

Compliance with DGA limits was widespread: nearly 95% of participants consumed under 1 cup/day, and 88% consumed under ½ cup/day. Only a small fraction of young children exceeded age-specific recommendations. Importantly, juice intake did not appear to displace whole fruit at the population level. However, the average juice-to-whole fruit ratio was 0.4, within DGA guidance, and higher in lower-income groups and young children.

Consumers of 100% juice had significantly higher dietary quality scores. Both Healthy Eating Index and Nutrient Rich Food Index scores were greater among juice drinkers, reflecting higher intakes of fruit, whole grains, vitamin C, potassium, and calcium, and lower intakes of added sugar, sodium, and saturated fat. Vegetable intake differences were less consistent, and non-consumers scored slightly higher for dairy.

Conclusions

This study highlights that 100% fruit juice consumption in the U.S. is generally low and well within DGA limits, with only a small minority exceeding recommended amounts. Notably, juice consumption was linked with higher-quality diets overall, indicating that it may substitute for less nutritious beverages such as SSBs rather than displacing whole fruit.

Strengths include nationally representative data and robust measures of dietary quality; however, limitations include reliance on self-reported 24-hour recalls, potential misreporting among children, and the cross-sectional design, which precludes causal inference.

In conclusion, while the DGA emphasizes limiting juice, these findings suggest that modest juice consumption supports diet quality and may help reduce disparities in fruit intake. The authors stress that the economic cost of meeting DGA fruit recommendations is a major barrier and argue that affordability and accessibility of whole fruit should be central in future guidelines.