• Daniel A Zaltz, Brian W Weir, Roni A Neff, and Sara E Benjamin-Neelon.
• Temerty Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address: daniel.zaltz@utoronto.ca.
• Am J Prev Med. 2025 Feb 1; 68 (2): 357365357-365.

IntroductionThe 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 U.S. early care and education settings between 2008 and 2020.MethodsEstimated 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 early care and education nested within studies, adjusting for potential confounders.ResultsThe sample consisted of 6,304 days of direct observation (90% aged 2 years or older, 51% female, 38% Black/African American) in 846 early care and education facilities (73% centers, 75% Child and Adult Care Food Program 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/d, increase fiber by 0.5-1.3 g/d, and have negligible impact on vitamin C and calcium. Replacing juice with whole fruit in early care and education would increase per-child daily food costs between $0.44 and 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.ConclusionsReplacing juice with whole fruit in early care and education would result in increased fiber intake and decreased sugar and calories. A policy to replace juice with whole fruit in early care and education 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 early care and education.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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