Friday, August 1, 2014
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AAP proposes new 'action level' for inorganic arsenic in apple juice

Today, the U.S. Food and Drug Administration proposed a new "action level" for inorganic arsenic in apple juice of 10 parts per billion, the same level set by the Environmental Protection Agency for drinking water. The FDA tested hundreds of samples of apple juice for arsenic and found the overall level of arsenic is low. The FDA is proposing the new action level because a small proportion of samples had higher levels of arsenic. The FDA is not recommending any change in juice consumption and has emphasized that the data show it is safe for children and adults to drink apple juice.

AAP proposes new 'action level' for inorganic arsenic in apple juice

Today, the U.S. Food and Drug Administration proposed a new "action level" for inorganic arsenic in apple juice of 10 parts per billion, the same level set by the Environmental Protection Agency for drinking water. The FDA tested hundreds of samples of apple juice for arsenic and found the overall level of arsenic is low. The FDA is proposing the new action level because a small proportion of samples had higher levels of arsenic. The FDA is not recommending any change in juice consumption and has emphasized that the data show it is safe for children and adults to drink apple juice.

The AAP is reminding parents that it is not necessary to offer children any juice to have a well-balanced, healthy diet. For years, the AAP has recommended limited intake of all sweet beverages, including juice, to reduce the risk of poor nutrition, obesity and childhood cavities. If parents want to include juice in their children’s diet, juice should be limited to 4 to 6 ounces a day for children ages 1 to 6 years, and 8 to 12 ounces a day for children age 7 and older. Children should be encouraged to eat whole fruits to meet their recommended daily fruit intake.

The AAP has assembled resources to help members communicate about the FDA report with their patients. See here.

Parents are sometimes obsessed that children need juice; they do not. Two centuries ago, citrus juice was needed to prevent sailors from getting a horrible wasting disease called scurvy that developed if one ate only preserved food and no fresh fruits or vegetables, but today, most children’s diets have all the vitamin C they need. 

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Juice is essentially sugar water and has 12 or more calories in every ounce (20 oz of juice has about the same calories as a small hamburger).  Frequent exposure to sugars dissolved in liquids leads to dental cavities, loose stools and excess weight gain.  At this point, the arsenic in apple juice is not a large problem, but it emphasizes that being “all natural” does not necessarily make a food good for your child


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Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D. St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, M.D., Ph.D Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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