Arsenic In Juice: How Concerned Should Parents Be?

"Some of the best-known brands in America have arsenic in their apple juice." When Dr. Mehmet Oz announced this on the September 13 episode of "The Dr. Oz Show," he set off a national controversy over the safety of apple juice -- a beverage long presented as one of America's classic kids' drinks.

Dr. Oz, a television personality and cardiothoracic surgeon, and his team conducted independent research on apple juice samples from five of the most popular juice makers -- Minute Maid, Mott's, Juicy Juice, Apple and Eve and Gerber. Of the 36 samples that Dr. Oz tested, 10 were reported to have higher levels of total arsenic than 10 parts per billion -- the level allowed in drinking water by the EPA. The FDA currently does not regulate arsenic in juice.

"No children are dying from acute toxicity from arsenic. The levels we're talking about are much lower than that. My concerns are about long-term effects, over years," Dr. Oz told ABC's "Good Morning America."

Some critics say Dr. Oz's presentation amounted to little more than fear mongering. One of the main things for which Dr. Oz has come under fire -- by the FDA and an array of high-profile medical professionals, including ABC's Senior Health and Medical Editor Richard Besser -- is that his research did not differentiate between organic and inorganic arsenic.

"Organic arsenic is not metabolized by the body and so it doesn't have the toxic potential of the inorganic form of arsenic," says Jerome Paulson, M.D., Director of the Mid-Atlantic Center for Children's Health & the Environment for the Child Health Advocacy Institute and chairperson of the American Academy of Pediatrics' Council on Environmental Health. "If the arsenic is in the body, but it's not really absorbed, or if it's absorbed but the arsenic is not free to interfere with processes for individual cells, then it's really pretty meaningless and is not going to harm a human being."

Still, HuffPost blogger and Chair of the Division of Anesthesiology, Critical Care Medicine and Pain Management at the Cleveland Clinic, Michael Roizen, M.D., expressed the attitude that he would rather be safe than sorry. "[I'm] getting apple juice made from organic apples in the U.S.A. until someone regulates the arsenic [in apple juice]," Dr. Roizen told The Huffington Post. He also said he applied this same principle to all produce listed on the Environmental Working Group's "Dirty Dozen" list, the 12 fruits and vegetables found by the nonprofit to have the highest levels of pesticide contamination.

So on a practical level, what is a concerned parent to do? And is arsenic really what we should be focusing on when it comes to issues of children's health and fruit juice? "Parents should limit juice consumption for a lot of other reasons, but not related to the presence of organic arsenic in juice," said Dr. Paulson. Here's what to know:

Risk #1: Childhood Obesity
One of the main concerns that medical professionals have with kids over-consuming fruit juice, comes from it having predominantly empty calories. Although 100 percent juice can be a good source of certain vitamins (especially if they are fortified), allowing children to drink too much, too often, doesn't bode well for the child's health.

Childhood obesity has been a hot button issue in the United States for a number of years. In the last 30 years, the obesity rates for children have nearly tripled, with 17 percent of children and teens ages 2 to 19 considered medically obese. Many children are, quite simply, consuming too many calories. As many fruit juices are marketed under the banner of good health, it's easy to forget that juice contains a lot of sugar naturally, and that many bottled juices and fruit drinks contain a significant amount of added sugars. And when it comes to calories, most juices aren't much better (if at all) than sodas. Many parents wouldn't allow their children to carry around a sippy cup of soda all afternoon -- so why juice?

"Parents are under the impression that somehow [juice is] better than soda," says Dr. Paulson. "It's a little better, but not enough. [Parents] really need to limit their children's intake of these sweet liquids just like other sweet liquids."

Risk #2: Poor Oral Health
The sugary content of fruit juice isn't just detrimental to kids' waistlines, but also to their teeth. According to WebMD, one of the major contributing factors to tooth enamel decay is the over-consumption of fruit drinks. "Our biggest concern with juice is that it has a high sugar content and also is very acidic. The combination definitely has an impact on teeth," says Dr. Rhea Haugseth, President of the American Academy of Pediatric Dentistry.

It is the acidity of the juice that becomes extremely problematic for children's oral health -- especially when kids are drinking it all day long. The bacteria that live in our mouths feed on sugar, producing even more acid. Dr. Haugseth described the "natural buffering" process that occurs to counteract the effects of this acidity. However, it takes about 20 minutes to become effective. Therefore, if a child is taking sips of juice frequently throughout the day, it's bad news. "[His or her] teeth are constantly being bathed in acid," Haugseth told The Huffington Post.

To counteract the negative oral health effects of juice, Dr. Haugseth suggests that parents cut juices' acidity by diluting it with some water -- especially when it comes to infants and toddlers -- as well as making sure that their kids only consume juice a few times a day.

Everything In Moderation
The lesson seems to be that parents should avoid giving their children too much of a good (and delicious) thing. "I don't say that parents should never offer their kids juices," says Dr. Paulson. "Occasionally they're fine and if [the kids] are otherwise eating a well-balanced diet that has a reasonable amount of calories in it, [and] juice is not their primary source of liquids, then fine. That's okay."

The American Academy of Pediatrics and the American Heart Association both recommend limiting children's intake of fruit juice to the following amounts:

  • Birth to 6 months: No fruit juice, except in cases where it is used as constipation relief
  • 6 months to 6 years: 4-6 ounces per day
  • 7 years and older: 8-12 ounces per day

And when all else fails, simply turn to old faithful -- tap water. All of the medical professionals to whom we reached out said that they recommend that parents encourage their children to hydrate the old-fashioned way, avoiding extra calories, extra environmental impact and extra toxins. "Tap water is among the most regulated of liquids in the United States," says Dr. Paulson.

And if you want to shake things up? Try adding a squeeze of lemon or a few fresh berries to that sippy cup.