UK schools should scrap break-time fruit juice – Royal College of Surgeons dental dean

By Ben Bouckley

- Last updated on GMT

Related tags Fruit juice Pasteurization Juice

The Royal College of Surgeons (RCS) has confirmed the accuracy of comments made by the dean of its dental faculty, urging that fruit juices be replaced with milk and water in UK schools during break times on dental health grounds.

Kathy Harley from the RCS told UK newspaper the Sunday Times​ earlier this month that half of five-year-olds seen by dentists had signs of wear, which she linked to enamel erosion caused by citrus fruits in particular.

She told the paper that schools should remove fruit juices (due to acid content) as a break time offering, and provide milk and water instead, which conflicts with the UK government’s Change4Life campaign, which 100% juice counts as one of five recommended daily fruit and vegetable portions.

An RCS spokeswoman confirmed the accuracy of Harley’s remarks, and said: “She advocates milk and water [at break times] with orange juice as a weekend treat. Milk and water is what is best [on dental health grounds], it’s strongly advisable.”

Media inaccuracies under fire

But the spokeswoman added that the headline of a later article published in The Mail​, entitled ‘How giving your children five-a-day can actually damage their teeth’ was inaccurate.

She told “We didn’t do an interview with The Mail, and the paper didn’t call us for comment at all. They took quotes from The Sunday Times, and at no point have Kathy or the RCS said that giving children ‘five a day’ was bad.”

“The article is about acid erosion on teeth, and the advice is to try and eat your fruits in one sitting, as opposed to eating them out the day, because continually eating them throughout the day has a ‘drip, drip’ effect on the teeth.”

BSDA defends fruit juice

A British Soft Drinks Association (BSDA) spokesman said that Harley’s comments regarding the removal of access to fruit juices during break times in schools “was not our view”​, and provided a more general statement responding to the Sunday Times​ piece.

“A glass of fruit juice can count as one of the five portions of fruit and vegetables we are all recommended to consume each day,” ​he said.

The BSDA said that its own December 2008 research showed that 93% of fruit juice was consumed with a meal, and if it was then it had no more effect on teeth than the rest of food consumed.

The spokesman added: “Any acid in the food or drink consumed can be buffered by saliva in the mouth. In addition, the vitamin C in fruit juice can help increase the uptake of minerals such as iron from foods that contain them, if the two are consumed together.”

Dentists also advised that drinking fruit juice via a straw reduced its impact on teeth, the BSDA said, before adding: “It is possible that extreme consumption habits might have some adverse impacts on dental health, but a dentist can give individual advice to a patient who might be affected in this way.”

Acidic, high sugar drinks

Judy More, pediatric dietician and member of the Infant Toddler Forum (ITF) said that fruit was best served to young children in pieces rather than as juice: “Fruit juices are a source of vitamin C, helping with the absorption of iron from plant-based foods,” ​she said.

“However, they are acidic, high-sugar drinks and can cause dental caries. The sugars in sweet foods and drinks are metabolized to acids by the bacteria in dental plaque.

More added: “These acids, along with the acid already present in drinks like fruit juices, squashes and fizzy drinks, cause demineralization or softening of the enamel.”

Fruit juice should be well diluted (one part juice to around 6-10 parts water), and should only be served in a glass, cup or beaker, rather than a bottle, More said.

“Sucking slowly on sweet drinks in a bottle increases the risk of tooth decay. Well diluted fruit juice, if given should be with meals and snacks, and 3-4oz or 100-120ml is about right as a single drink portion for 1-3 year olds,” ​she added.

“Water and milk are the only drinks that should be offered between meals and snacks.”

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