When it comes to fruit consumption, apples are the first choice for children in the US, accounting for almost a fifth of their fruit intake. However, more than a third of children's fruit intake comes from a less healthy source - fruit juices. This is according to the results of a new survey published in the journal Pediatrics.

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The new research found apples are the most common whole fruit consumed by children ages 2-19.

It is well established that fruits and vegetables are an important part of a healthy diet for both adults and children, with studies showing that consuming more of these may help reduce the risk of stroke, heart disease, obesity and some cancers.

According to the 2010 Dietary Guidelines for Americans, children and adolescents ages 2-18 years should eat one to two cups of fruit daily. However, a 2014 report from the Centers for Disease Control and Prevention (CDC) found that around 60% of children do not meet these recommendations.

Kirsten A. Herrick, PhD, from the National Center for Health Statistics at the CDC, and colleagues set out to gain a better understanding of what fruits children and teenagers consume, as well as the sociodemographic factors that may influence fruit consumption among this population.

The team used 2011-12 data from the National Health and Nutrition Examination Survey (NHANES) to assess the total fruit intake of 3,129 children ages 2-19. As part of the survey, children were required to report all foods they had consumed over the past 24 hours.

Using the Food Patterns Equivalents Database and the What We Eat in America 150 food groups, the researchers calculated children's intake of whole fruit, fruit juices and mixed fruit dishes.

Apples make up 18.9% of children's total fruit intake

On average, the researchers found that the children consumed around 1.25 cups of fruit each day.

Fast facts about apples
  • There are around 7,500 apple producers in the US
  • Around 67% of the apple crop in the US is for fresh whole consumption, while the remainder is used for processed apple products, such as juice
  • Apples are rich in antioxidants, flavonoids and fiber and have been linked to reduced risk of cancer, hypertension, diabetes and heart disease.

Learn more about apples

Whole fruits - which have the greatest health benefits - made up 53% of children's total fruit consumption, while 100% fruit juices made up 34% of total fruit intake. Juices with lower fruit content and mixed fruit dishes made up the remaining 11%.

Almost half of total fruit consumption was dominated by apples, apple juice, citrus juice and bananas, with apples alone contributing to 18.9% of total fruit intake.

On analyzing fruit intake by age, the team identified significant differences between those ages 2-5 years and 6-11 years.

For example, they found 22.4% of total fruit intake among those ages 6-11 was from apples, while apples only contributed to 14.6% of total fruit intake for those ages 2-5. However, the opposite was true for apple juice, contributing to 8.8% of total fruit consumption for those ages 6-11 and 16.8% for those ages 2-5.

The team also identified differences in fruit intake between racial and ethnic groups. For example, more than half of total fruit intake came from whole fruits among white, Asian and Hispanic children, while whole fruits contributed to around 43% of total fruit intake among black children.

High fruit juice intake a concern

While the findings suggest children are on their way to meeting fruit intake recommendations - consuming around 1.25 cups of fruit daily - health experts say it is worrying that more than a third of total fruit intake comes from fruit juices, a less healthy source.

Fruit juices have developed a bad reputation in recent years. In February 2014, Medical News Today reported on a study published in The Lancet claiming fruit juices are just as unhealthy as sugary drinks, while a more recent study suggests fruit juices are a major contributor to dental erosion.

"While fruit juice may be a convenient and child-preferred source of fruit in the diet, parents should try to use whole fruit to meet intake guidelines," Laura Gearman, a pediatric dietitian at the University of Minnesota, told Forbes. "Whole fruits provide the benefit of fiber over 100% fruit juices and do not contain added sugar, fat or sodium, which other fruit-containing foods may have."

By providing insight into the types of fruits children are consuming and the sociodemographic factors that influence their fruit intake, these findings may help guide strategies to improve fruit consumption among this population.

Gearman adds:

"The good news is children are eating some fruit. We need to work on shifting intakes to be 100% from whole fruits, rather than some from fruit juices. Given the popularity of a few fruits among children - apples, banana, melon - it seems we could also work on having a wider variety of fruits more easily accessible to children."

In March last year, MNT reported how consumption of fruits and vegetables has increased among students after the US Department of Agriculture guidelines on school lunches were updated in 2012. The guidelines stated that schools should improve the nutritional quality of their meals.