Approximately 24% of the population consumed 100% OJ on either of the days when a 24 hour recall was taken. Males consumed more 100% OJ, both as a percentage of consumers and in amount. The percent of consumers was similar to that of children
. Per capita UI consumption was 50.3 ml/d; however the UI for consumers was 210.0 ml/d. Unlike children, where there is a specific recommendation for consumption of 100% FJ
, there is no recommendation for consumption of 100% FJ by adults, other than “the majority of the fruit recommended should come from whole fruits, including fresh, canned, frozen, and dried forms, rather than from juice”
The rationale for limiting 100% FJ intake is that it lacks fiber and can contribute to excess energy consumption when consumed in excess
. A modeling study, commissioned by the 2005 Dietary Guidelines Advisory Committee
 suggested that dietary fiber was lower when whole fruit was removed from the diet, which led to the recommendation that intake of no more than one-third of fruit servings should come from 100% FJ and two-thirds should come from whole fruit. However, this study and others
[1–4, 52] have shown that either consumers of 100% FJ had higher intakes of dietary fiber than non-consumers or there was no difference in fiber consumption between the groups. Since 100% FJ is low in dietary fiber, it suggests that other higher fiber foods, including whole fruit, are consumed by consumers of 100% FJ; this was shown not only in this study of 100% OJ consumers, but has been shown in other studies as well
[1, 2, 52].
As expected, 100% OJ consumers had increased intake of nutrients typically found in 100% OJ (i.e. vitamin C, folate, and potassium). Consumers were also less likely to have intakes below the EAR for vitamins A, B-6, and C; folate; and magnesium than non-consumers. The reduction in the percentage of the population with inadequate intakes of these nutrients associated with 100% OJ consumption indicates the value of consuming a nutrient dense beverage
. Mean potassium UI was also higher in consumers than non-consumers and the percentage of the population above the AI was higher. This is an important finding since potassium was identified as a nutrient of public health concern
. To our knowledge this is the first report studying the association between the consumption of 100% OJ and nutrient adequacy in adults using the recommended UI procedures.
Diet quality, as measured by HEI-2005, was approximately 10% higher in 100% OJ consumers. While the increase was due in part to the increase in whole fruit and FJ consumption, consumers also had a higher UI of whole grains. Although intake of total fruit, whole fruit, and FJ was higher in 100% OJ consumers, overall intake from the fruit food groups was low. Despite extensive, coordinated public health campaigns by government, industry, and others
, fruit consumption in adults remains low
. Since a 236.6 ml serving of 100% OJ counts as part of the recommendation for the fruit group, moderate consumption of 100% OJ can help individuals meet fruit intake recommendations.
The potential association of consumption of 100% FJ and weight in children has been debated in the literature for more than a decade
[1, 2, 5–8, 57–62]; however, less is known about this relationship in adults. Participants in the Nurses’ Health Study II with a higher consumption of 100% FJ had a larger weight gain than those with lower fruit 100% FJ consumption, although the amounts and types of 100% FJ consumed, and specific covariates used in the analyses, were not clear
. Another study
 showed that self reported BMI was lower in consumers of 100% FJ. Ours was the first study that used a nationally representative adult population that showed consumers of 100% OJ had a lower BMI than non-consumers. These findings are important since 100% OJ has the highest per capita consumption
 among the juices and therefore has the potential to be an important component of the diet. Clinical studies that incorporated high levels of 100% OJ (750 ml
 or 500 ml
) as an intervention have reported no increases in weight or other anthropometric measures over the course of the study.
Total cholesterol levels and LDL-C levels were both significantly lower in consumers of 100% OJ than non-consumers. Compounds found in 100% OJ, including hesperidin, naringin, or limonoids or their circulating aglycone forms, have been shown to lower total or LDL-C in animal models
[63, 64]. It was hypothesized that these compounds may have inhibited 3-Hydroxy-3-methyl-glutaryl coenzyme A reductase and increased the expression of LDL-C receptors in the liver, a mechanism similar to statins. These compounds have also been shown to reduce the net secretion of apolipoprotein B, which in turn may help inhibit cholesterol ester synthesis
Orange juice, at higher intake amounts (750 ml) has also been shown to lower LDL-C and raise HDL-C in a randomized clinical trial of hypercholesterolemia individuals
. Although the present study did not look separately at individuals with hypercholesterolemia, it did show that a more realistic consumption of 100% OJ was associated with reduced total cholesterol and LDL-C levels. It is not clear why there was no difference shown between HDL-C levels between 100% OJ consumers and non-consumers, as may have been suggested by clinical trials; the response may be dose-dependent or dependent on continual consumption. There was a 23% lower risk of low HDL-C levels in males only.
Consumption of 100% OJ was associated with a 21% lower risk of obesity in men and women. This was similar to the findings of Pereira and Fulgoni
 that looked at the risk of obesity and consumption of 100% FJ in participants of NHANES 1999-2004. They also showed a significantly lower risk of metabolic syndrome, whereas this study showed a lower risk in males only. That study showed a much higher intake of 100% FJ, compared with the intake of 100% OJ only; but there were also other differences in the population, since they showed, for example that consumers were more likely to be female. Our study showed that 100% OJ consumers were more likely to be males. Consumption differences of 100% FJ in adults need to be studied further.
Strengths of this study include that it encompassed a large nationally representative sample achieved through combining several sets of NHANES data releases. The study also uses the NCI method to assess UI and the percentage of the population below recommended levels in 100% OJ consumers and non-consumers, as well as adjustment for numerous covariates including physical activity.
Twenty-four hour dietary recalls have several inherent limitations. Participants relied on memory to self-report dietary intakes; therefore, data were subject to non-sampling errors, including underreporting of energy and examiner effects. Respondents may not have differentiated between 100% OJ or a fruit drink/ade. Confusion over these beverages has been reflected in several studies that assessed a combined 100% FJ and juice drink or sweetened FJ category
[66–69]. The use of AI cannot be used to determine the prevalence of inadequate intake in a group. Rather, if the mean intake of a group is at or above the AI, and the variance of intake in the group of interest is similar to the variance of intake used in the population originally used to set the AI, the prevalence of inadequate nutrient intakes is likely to be low
. Finally, since causal inferences cannot be drawn from NHANES analyses, and due to multi-collinearity of diet, foods other than 100% OJ may have contributed to differences in nutrient intake of the participants.