RT Journal A1 Monsivais P, Rehm CD T1 POtential nutritional and economic effects of replacing juice with fruit in the diets of children in the united states JF Archives of Pediatrics & Adolescent Medicine JO Archives of Pediatrics & Adolescent Medicine YR 2012 FD May 1 VO 166 IS 5 SP 459 OP 464 DO 10.1001/archpediatrics.2011.1599 UL http://dx.doi.org/10.1001/archpediatrics.2011.1599 AB Objective  To estimate the nutritional and economic effects of substituting whole fruit for juice in the diets of children in the United States.Design  Secondary analyses using the 2001-2004 National Health and Nutrition Examination Survey and a national food prices database. Energy intakes, nutrient intakes, and diet costs were estimated before and after fruit juices were completely replaced with fruit in 3 models that emphasized fruits that were fresh, inexpensive, and widely consumed and in a fourth model that partially replaced juice with fruit, capping juice at recommended levels.Setting  A nationwide, representative sample of children in the United States.Participants  A total of 7023 children aged 3 to 18 years.Main Exposures  Systematic complete or partial replacement of juice with fruit.Main Outcome Measures  Difference in energy intakes, nutrient intakes, and diet costs between observed and modeled diets.Results  For children who consumed juice, replacement of all juice servings with fresh, whole fruit led to a projected reduction in dietary energy of 233 kJ/d (−2.6% difference [95% CI, −5.1% to −0.1%]), an increase in fiber of 4.3 g/d (31.1% difference [95% CI, 26.4%-35.9%]), and an increase in diet cost of $0.54/d (13.3% difference [95% CI, 8.8%-17.8%]).Conclusions  Substitution of juice with fresh fruit has the potential to reduce energy intake and improve the adequacy of fiber intake in children's diets. This would likely increase costs for schools, childcare providers, and families. These cost effects could be minimized by selecting processed fruits, but fewer nutritional gains would be achieved.