You may have noticed the carbohydrate fearing headline stating that - "One small glass of juice a day raises cancer risk, " yesterday. Do you know when you’ve been tangoed?

This is based upon the study by Chazelas et al (Chazelas et al 2019) and being used to justify the swathe of dogmatic headlines in the press.Apart from the study being based on food questionnaires (mean food log was 5.6 days over 5 years hardly conclusive) which are not reliable indicators of actual consumption, the authors suggest that the mechanisms that might drive the association are as follows.

1.    Excessive sugar consumption could contribute to obesity driven mechanisms. There's no doubt that excess carbohydrate, fat and protein contribute to obesity when an EXCESS of calories are consumed (and the other multifactorial issues associated with obesity.

2.    Sugar from juice contributes to increased glycaemic load and inflammation. This point doesn't add up because many fruit juices have a low glycaemic load, associated with anti- inflammatory responses (polyphenols, vitamin c, capacity to lower endotoxins, improve blood sugar regulation and cholesterol levels). Many grains have higher glycaemic loads and index than juices. So is this really a valid argument?

Of the 101, 000 or so participants the increased risk associated with sugary drinks was found in those who exercised less. In an important factor, if you combine over consumption and decreased activity. Another point that the authors suggest on sugary drinks is that additives to sweetened beverages like sodas could also contribute to risk. Indeed a valid point.

It starts with a hint of truth and a headline or meme tends to become written in folklore, the myth of the carbohydrate rich food churning out death in its path. These small, half or even quarter truths often disappear when you scratch beneath the surface. That’s why I actively encourage carbohydrate and specifically carbohydrate consumption in my programs. Even most people I have met rarely chug down large amounts of fruit juices in isolation and even if glycemic index\load were an issue, when you consume carbohydrate rich foods with proteins and fats, these concepts are somewhat irrelevant.

Orange juice (or any juices) is one of those foods that still seems to be getting a bad rap but many people who demean its nature often fail to look at the studies that have shown it to be protective. You might have heard...but the sugar levels or but it’s acidic. Just take a look at the tabloid’s permanent vilification of the simple juice drink, which is based on half-truths of small increased risk with limited data. To play devil’s advocate, there’s no doubting that some people with less money available have been seduced into purchasing more junk food. It’s cheap, it’s filling and it’s full of sugar, vegetable oils, preservatives, GMOs, fillers, emulsifiers, additives like flavouring, enhancers, gums and much more. Yet still, the sugar is the demon in this list. Not even the pollution that’s shown to increase cancer, heart diseases, diabetes and neurodegenerative diseases, it’s still sugar and even if you drink fruit juice, it’s the sugar that will kill you.

So, with that in mind let’s consider what a simple food like orange juice could do to hasten, I’m sorry I meant prevent neurological and metabolic decline. Let’s first add some context. It should be no surprise that if you just drink large amounts of juice on their own, without balancing their ability to enter the blood stream with fats and or proteins, it isn’t going to be as beneficial. This is also why throwing large amounts of sweetened fizzy drinks down one’s neck can be problematic. The Glycemic index becomes redundant when you add another food into the mix, therefore drinking fruit juices with fats and proteins helps to normalise blood sugar responses in isolation. So why orange juice? Here are just a couple of reasons

Orange juice decreases inflammation

Eating a variety of foods has the capacity to increase inflammatory and damaging agents like endotoxin. Endotoxin or lipopolysaccharides is well known to increase in high fat and carbohydrate meals, especially so when fibrous poorly digested foods are consumed. High fat diets also induce endotoxin, and this is well known to induce intestinal hyperpermeability or the more well-known leaky gut syndrome. Consumption of orange juice appears to significantly reduce the levels and effects of inflammation induced by endotoxin (Ghanim et al., 2010) . Unfortunately, many foods are often kept stable longer with additives like carrageenan and gums, which also promote increased endotoxin.

Orange juice attenuates metabolic dysfunction

 “ Despite media concern, daily orange juice consumption did not result in adverse metabolic effects, despite providing additional dietary sugars. Data from epidemiological and in vitro studies suggest that orange juice (OJ) may have a positive impact on lipid metabolism. “ (Simpson, Mendis, & Macdonald, 2016)

During times of stress, under eating or consuming foods low in carbohydrates the response is to liberate energy from stored fats in the form of triglycerides. As metabolism becomes compromised high levels of triglycerides are known to be present in blood sugar dysregulation. There’s much in the press to suggest that sugar from fruit juice consumption increases cardiac risk but there are many studies that suggest otherwise, with the observed effect being reduced triglycerides and cholesterol (Aptekmann & Cesar, 2013). The cardiac protective factors aren’t limited to orange juice alone, pomegranate and other juices also seem to offer similar results (Moazzen & Alizadeh, 2017)

Orange juice decreases carcinogen production

A very relevant and protective mechanism of orange juice (and others) and fruit peel consumption is the decreased risk of gastrointestinal cancers (Xu, Song, & Reed, 1993). Nitrates and nitrates are naturally occurring compounds found in a variety of foods. Nitrates are often used in preservatives and sodium nitrites are ubiquitous in preserved meats and have a significant relationship between cancers in many of the mucosal areas including the mouth, bowel and lungs.. Nitrates have been implicated in not just intestinal and stomach cancers but increasingly thyroid cancers (Hernández- Ramírez et al., 2009). This occurs through increases in N-nitroso compounds (NOC) which increase the capacity of cell mutation but there are extensive studies that show many classes of NOC inhibitors which include vitamin e and vitamin C that negate that risk.

Of course, for optimal effects, ensuring adequate protein and fats are consumed will always be beneficial. We’ve known that compromised blood sugar and insulin responses are rarely to do with consuming carbohydrates. Unless excessive eating and obesity are the association, there’s plenty more relevant relationships such as environmental pollutants and other stressors that show a clear effect on all aspects of metabolism and increased metabolic disease. Yet many people seem intent on shooting the messenger and vilifying protective carbohydrates such as fruit juice.

References: 

 1.    Aptekmann, N. P., & Cesar, T. B. (2013). Long-term orange juice consumption is associated with low LDL-cholesterol and apolipoprotein B in normal and moderately hypercholesterolemic subjects. Lipids in Health and Disease. https://doi.org/10.1186/1476-511X-12-119

2.   Chazelas Eloi, Srour Bernard, Desmetz Elisa, KesseGuyot Emmanuelle, Julia Chantal, Deschamps Valérie et al. Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort BMJ2019; 366 :l2408

3.    Ghanim, H., Sia, C. L., Upadhyay, M., Korzeniewski, K., Viswanathan, P., Abuaysheh, S., … Dandona, P. (2010). Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin increase and toll-like receptor expression. American Journal of Clinical Nutrition. https://doi.org/10.3945/ajcn.2009.28584

4.    Hernández-Ramírez, R. U., Galván-Portillo, M. V., Ward, M. H., Agudo, A., González, C. A., Oñate-Ocaña, L. F., … López-Carrillo, L. (2009). Dietary intake of polyphenols, nitrate and nitrite and gastric cancer risk in Mexico City. International Journal of Cancer. https://doi.org/10.1002/ijc.24454

5.    Moazzen, H., & Alizadeh, M. (2017). Effects of Pomegranate Juice on Cardiovascular Risk Factors in Patients with Metabolic Syndrome: a Double-Blinded, Randomized Crossover Controlled Trial. Plant Foods for Human Nutrition. https://doi.org/10.1007/s11130-017-0605-6

6.    Simpson, E. J., Mendis, B., & Macdonald, I. A. (2016). Orange juice consumption and its effect on blood lipid profile and indices of the metabolic syndrome; A randomised, controlled trial in an at-risk population. Food and Function. https://doi.org/10.1039/c6fo00039h

7.    Xu, G. P., Song, P. J., & Reed, P. I. (1993). Effects of fruit juices, processed vegetable juice, orange peel and green tea on endogenous formation of N-nitrosoproline in subjects from a high-risk area for gastric cancer in Moping County, China. European Journal of Cancer Prevention. https://doi.org/10.1097/00008469-199307000-00007