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Health Studies

Bone Health

  • Calcium-fortified citrus juices provide 300-350 milligrams of calcium -- as much as a glass of milk -- which can help enhance calcium intake and reduce the risk for osteoporosis.
  • Potassium intake has been positively associated with bone health in middle-aged women (56, 57) and elderly men and women (58).
  • Elevated blood homocysteine concentrations recently have been associated with an increased risk for osteoporotic fracture in older individuals (59, 60).
Cancer

  • Consumption of citrus may be related to reducing the risk for certain types of cancers, including stomach, esophageal, and oro-pharyneal/laryngeal (48, 49).
  • Adequate folate intake may help reduce the risk for some cancers, including colon and cervical cancer (50, 51), and breast cancer (52), especially in those who have higher intakes of alcohol (53, 54).
  • Fresh citrus is a source of dietary fiber. Diets high in fiber may help reduce the risk of certain cancers, including those of the breast, pancreas, and colon/rectum (49).
General Health

  • Folate may be associated with reduced risk for depression, age-related dementia or Alzheimer's disease (30, 31).
  • Adequate vitamin C intake may help maintain eye health by reducing the risk for cataract and age-related macular degeneration (32-35).
  • Intake of at least two servings of citrus fruit per week -- specifically, oranges and tangerines -- was associated with reduced mortality in elderly men and women compared to those consuming citrus less than once per week (36).
  • Citrus can help adults achieve recommended intakes of vitamin C. Based on a national survey, adults achieving desirable intakes of vitamin C (that is, equal to or exceeding the Daily Value of 60 milligrams) on average consumed more than 5 daily servings of fruits and vegetables, of which at least one serving was citrus (37).
Heart Health

  • Including a glass of orange juice into the daily diet can help reduce the risk of stroke. In a study of over 114,000 men and women, an additional one serving per day of citrus juice resulted in a 25% reduced risk for stroke (1).
  • Studies show that a diet that includes orange juice can increase plasma vitamin C concentrations (2-6) and improve markers for oxidative stress (2, 4, 5) and inflammation (2, 3), which may reduce risk of heart disease.
  • Orange juice may help increase HDL, "good" cholesterol, and decrease the LDL-HDL ratio (6). Orange juice with added plant sterols may help improve cholesterol status by decreasing total and LDL cholesterol (7).
  • Orange juice is an excellent source of vitamin C. Adequate intake of vitamin C from food sources and/or adequate blood levels of vitamin C have been associated with a reduced risk for death due to heart disease (8-10).
  • Orange juice is a good source of potassium and is low in sodium. Adequate potassium intake has been shown to effectively lower blood pressure (11, 12) and reduce the risk for stroke (13-15). Doctors recommend getting potassium from foods rather than supplements.
  • Fresh citrus provides both soluble and insoluble fiber. Soluble fiber can help lower cholesterol and triglyceride levels, which may help reduce the risk of heart disease (16). Soluble and insoluble fibers may protect against cardiovascular disease by decreasing hypertension and normalizing blood glucose levels after a meal (17).
  • Orange juice is a good source of folate which can help lower blood homocysteine concentrations. Elevated blood homocysteine is an independent risk factor for heart disease. Diets that include orange juice have been shown to lower homocysteine concentrations in the blood (18, 19).
  • Orange juice contains a wide array of "phytonutrients" such as flavonoids, limonoids and carotenoids. These are naturally occurring compounds that can act as antioxidants to help scavenge free radicals. Phytonutrients found in citrus display anti-inflammatory and anticancer activities (20, 21). High intakes of flavonoids are associated with lower risk of cardiovascular disease or lower mortality from cardiovascular disease (22, 23).
  • Pink or red grapefruit and grapefruit juice contains lycopene, a powerful antioxidant that may help reduce the risk of cardiovascular disease and certain cancers, particularly prostate cancer (24, 25).
Immunity

  • One cup (8 ounces) of orange juice is a nutrient-dense beverage that provides more than 100% of the Daily Value (DV) for vitamin C, plus other important nutrients such as folate, vitamin B6, and carotenoids, that are needed to help the body maintain a healthy immune system (26, 27). A published summary of research studies suggests that vitamin C may have a modest effect on shortening the duration or lessening the severity of a cold if it is consumed before the onset of illness (28).
Pre-Natal

  • A glass of orange juice is a good source of folate. Adequate folate intake before and during pregnancy can help reduce the risk of having a baby with a serious birth defect of the brain and spine (e.g., spina bifida) (38, 39).
  • Vitamin C may play a role in a healthy pregnancy. Lower intakes or blood levels of vitamin C have been associated with lower birth weights and lengths (40), increased risk for gestational diabetes (41), elevated risk for premature membrane rupture (42), and pre-eclampsia (43).
School Performance

  • Including orange juice as part of a healthy breakfast every day for children and adolescents may help improve school performance and attendance (44-47).
References:

1 Joshipura KJ, Ascherio A, Manson JE, Stampfer MJ, Rimm EB, Speizer FE, Hennekens CH, Spiegelman D, Willet WC. Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA. 1999;282:1233-1239.
2 Sanchez-Moreno C, Cano MP, de Ancos B, Plaza L, Olmedilla B, Granado F, Martin A. High-pressurized orange juice consumption affects plasma vitamin C, antioxidative status and inflammatory markers in healthy humans. J Nutr. Jul 2003;133(7):2204-2209.
3 Sanchez-Moreno C, Cano MP, de Ancos B, Plaza L, Olmedilla B, Granado F, Martin A. Effect of orange juice intake on vitamin C concentrations and biomarkers of antioxidant status in humans. Am J Clin Nutr. 2003;78:454-460.
4 Harats D, Chevion S, Nahir M, Norman Y, Sagee O, Berry EM. Citrus fruit supplementation reduces lipoprotein oxidation in young men ingesting a diet high in saturated fat: presumptive evidence for an interaction between vitamins C and E in vivo. Am J Clin Nutr. 1998;67:240-245.
5 Johnston CS, Dancho CL, Strong GM. Orange juice ingestion and supplemental vitamin C are equally effective at reducing plasma lipid peroxidation in healthy adult women. Journal of the American College of Nutrition. 2003;22(6):519-523.
6 Kurowska EM, Spence JD, Jordan J, Wetmore S, Freeman DJ, Piche LA, Serratore P. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr. 2000;72:1095-1100.
7 Devaraj S, Jialal I, Vega-Lopez S. Plant Sterol-fortified orange juice effectively lowers cholesterol levels in mildly hypercholesterolemic healthy individuals. Arterioscler Thromb Vasc Biol. 2004;24:e25-e28.
8 Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M, Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994;139:1180-1189.
9 Pandey DK, Shekelle R, Selwyn BJ, Tangney C, Stamler J. Dietary vitamin C and ?-carotene and risk of death in middle-aged men. The Western Electric Study. Am J Epidemiol. 1995;142:1269-1278.
10 Sahyoun NR, Jacques PF, Russell RM. Carotenoids, vitamins C and E, and mortality in an elderly population. Am J Epidemiol. 1996;144:501-511.
11 Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? A meta-analysis of published trials. Journal of Hypertension. 1991;9:465-473.
12 He F, MacGregor G. Beneficial effects of potassium. British Medical Journal. 2001;323:497-501.
13 Ascherio A, Rimm EB, Hernan MA, Giovannucci EL, Kawachi I, Stampfer MJ, Willett WC. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation. 1998;98:1198-1204.
14 Bazzano LA, He J, Ogden LG, Loria C, Vupputuri S, Myers L, Whelton PK. Dietary potassium intake and risk of stroke in US men and women: National Health and Nutrition Examination Survey I Epidemiologic Follow-up study. Stroke. 2001;32:1473-1480.
15 Khaw KT, Barrett-Connor E. Dietary potassium and stroke-associated mortality: A 12-year prospective population study. New England Journal of Medicine. 1987;316:235-240.
16 Health Claims: Soluble fiber from certain foods and risk of heart diseases. Washington DC: US Food and Drug Administration; 2001.
17 Lupton JR, Turner ND. Dietary fiber and coronary disease: does the evidence support an association? Curr Atheroscler Rep. Nov 2003;5(6):500-505.
18 Kauwell GPA, Lippert BL, Wilsky CE, Herrlinger-Garcia K, Hutson AD, Theriaque DW, Rampersaud GC, Cerda JJ, Bailey LB. Folate status of elderly women following moderate folate depletion responds only to a higher folate intake. J. Nutr. 2000;130:1584-1590.
19 Brouwer IA, van Dusseldorp M, West CE, Meyboom S, Thomas CM, Duran M, van het Hof KH, Eskes TK, Hautvast JG, Steegers-Theunissen RP. Dietary folate from vegetables and citrus fruit decreases plasma homocysteine concentrations in humans in a dietary controlled trial. J Nutr. Jun 1999;129(6):1135-1139.
20 Silalahi J. Anticancer and health protective properties of citrus fruit components. Asia Pacific J Clin Nutr. 2002;11(1):79-84.
21 Manthey JA, Grohmann K, Guthrie N. Biological properties of citrus flavonoids pertaining to cancer and inflammation. Curr Med Chem. Feb 2001;8(2):135-153.
22 Mennen LI, Sapinho D, de Bree A, Arnault N, Bertrais S, Galan P, Hercberg S. Consumption of foods rich in flavonoids is related to a decreased cardiovascular risk in apparently healthy French women. J Nutr. Apr 2004;134(4):923-926.
23 Hertog MG, Feskens EJ, Hollman PC, Katan MB, Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet. Oct 23 1993;342(8878):1007-1011.
24 Arab L, Steck S. Lycopene and cardiovascular disease. Am J Clin Nutr. Jun 2000;71(6 Suppl):1691S-1695S; discussion 1696S-1697S.
25 Rao AV, Agarwal S. Role of antioxidant lycopene in cancer and heart disease. J Am Coll Nutr. Oct 2000;19(5):563-569.
26 Scrimshaw, N. and J. SanGiovanni (1997). "Synergism of nutrition, infection, and immunity: an overview." Am J Clin Nutr 66:464S-477S.
27 Calder, P. (2002). "The immune system: a target for functional foods?" British Journal of Nutrition 88:S165-S176.
28 Douglas, R., H. Hemila, R. D'Souza, E.B. Chalker, B. Treacy (2004). "Vitamin C for preventing and treating the common cold." The Cochrane Database of Systematic Reviews Issue 4, No. CD000980.
30 Reynolds EH. Folic acid, ageing, depression, and dementia. Bmj. Jun 22 2002;324(7352):1512-1515.
31 Snowdon DA, Tully CL, Smith CD, Riley KP, Markesbery WR. Serum folate and the severity of atrophy of the neocortex in Alzheimer disease: findings from the Nun study. Am J Clin Nutr. Apr 2000;71(4):993-998.
32 Valero MP, Fletcher AE, De Stavola BL, Vioque J, Alepuz VC. Vitamin C is associated with reduced risk of cataract in a Mediterranean population. J Nutr. Jun 2002;132(6):1299-1306.
33 Taylor A, Jacques PF, Chylack LT, Jr., Hankinson SE, Khu PM, Rogers G, Friend J, Tung W, Wolfe JK, Padhye N, Willett WC. Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr. Mar 2002;75(3):540-549.
34 Jacques PF. The potential preventive effects of vitamins for cataract and age-related macular degeneration. Int J Vitam Nutr Res. May 1999;69(3):198-205.
35 Jacques PF, Chylack LT, Jr., Hankinson SE, Khu PM, Rogers G, Friend J, Tung W, Wolfe JK, Padhye N, Willett WC, Taylor A. Long-term nutrient intake and early age-related nuclear lens opacities. Arch Ophthalmol. Jul 2001;119(7):1009-1019.
36 Fortes C, Forastiere F, Farchi S, Rapiti E, Pastori G, Perucci CA. Diet and overall survival in a cohort of very elderly people. Epidemiology. Jul 2000;11(4):440-445.
37 Taylor CA, Hampl JS, Johnston CS. Low intakes of vegetables and fruits, especially citrus fruits, lead to inadequate vitamin C intakes among adults. Eur J Clin Nutr. Jul 2000;54(7):573-578.
38 Berry RJ, Li Z, Erickson JD, Li S, Moore CA, Wang H, Mulinare J, Zhao P, Wong LY, Gindler J, Hong SX, Correa A. Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med. Nov 11 1999;341(20):1485-1490.
39 Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet. Jul 20 1991;338(8760):131-137.
40 Lee BE, Hong YC, Lee KH, Kim YJ, Kim WK, Chang NS, Park EA, Park HS, Hann HJ. Influence of maternal serum levels of vitamins C and E during the second trimester on birth weight and length. Eur J Clin Nutr. Oct 2004;58(10):1365-1371.
41 Zhang C, Williams MA, Frederick IO, King IB, Sorensen TK, Kestin MM, Dashow EE, Luthy DA. Vitamin C and the risk of gestational diabetes mellitus: a case-control study. J Reprod Med. Apr 2004;49(4):257-266.
42

Siega-Riz AM, Promislow JH, Savitz DA, Thorp JM, Jr., McDonald T. Vitamin C intake and the risk of preterm delivery. Am J Obstet Gynecol. Aug 2003;189(2):519-525.

43 Zhang C, Williams MA, King IB, Dashow EE, Sorensen TK, Frederick IO, Thompson ML, Luthy DA. Vitamin C and the risk of preeclampsia--results from dietary questionnaire and plasma assay. Epidemiology. Jul 2002;13(4):409-416.
44 Powell C, Grantham-McGregor S, Elston M. An evaluation of giving the Jamaican government school meal to a class of children. Hum Nutr Clin Nutr. 1983:381-388.
45 Murphy JM, Pagano ME, Nachmani J, Sperling P, Kane S, Kleinman RE. The relationship of school breakfast to psychosocial and academic functioning: cross-sectional and longitudinal observations in an inner-city school sample. Arch Pediatr Adolesc Med. Sep 1998;152(9):899-907.
46 Meyers AF, Sampson AE, Weitzman M, Rogers BL, Kayne H. School Breakfast Program and school performance. Am J Dis Child. 1989;143:1234-1239.
47 Kleinman RE, Hall S, Green H, Korzec-Ramirez D, Patton K, Pagano ME, Murphy JM. Diet, breakfast, and academic performance in children. Ann Nutr Metab. 2002;46 Suppl 1:24-30.
48 Baghurst K. The Health Benefits of Citrus Fruits. Report to Horticulture Australia Ltd.: CSIRO Health Sciences and Nutrition; June 2003 2003.
49 Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington DC: World Cancer Research Fund/American Institute for Cancer Research; 1997.
50 Rampersaud GC, Bailey LB, Kauwell GP. Relationship of folate to colorectal and cervical cancer: review and recommendations for practitioners. J Am Diet Assoc. Sep 2002;102(9):1273-1282.
51 Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Ann Intern Med. Oct 1 1998;129(7):517-524.
52 Shrubsole MJ, Jin F, Dai Q, Shu XO, Potter JD, Hebert JR, Gao YT, Zheng W. Dietary folate intake and breast cancer risk: results from the Shanghai Breast Cancer Study. Cancer Res. Oct 1 2001;61(19):7136-7141.
53 Zhang S, Hunter DJ, Hankinson SE, Giovannucci EL, Rosner BA, Colditz GA, Speizer FE, Willett WC. A prospective study of folate intake and the risk of breast cancer. Jama. May 5 1999;281(17):1632-1637.
54 Sellers TA, Kushi LH, Cerhan JR, Vierkant RA, Gapstur SM, Vachon CM, Olson JE, Therneau TM, Folsom AR. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. Jul 2001;12(4):420-428.
55 Code of Federal Regulations; Title 21, Volume 2; 21 CFR101.72. U.S. Government Printing Office, http://www.cfsan.fda.gov/~lrd/cf101-72.html
56 New S, Robins S, Campbell M, Martin J, Garton M, Bolton-Smith C, Grubb D, Lee S, Reid D. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr. 2000;71:142-151.
57

New S, Bolton-Smith C, Grubb D, Reid D. Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr. 1997;65:1831-1839.

58 Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr. Apr 1999;69(4):727-736.
59 vanMeurs J, Dhonukshe-Rutten R, Pluijm S, vanderKlift M, deJonge R, Lindemans J, deGroot L, Hofman A, Witteman J, vanLeeuwen J, Breteler M, Lips P, Pols H, Uitterlinden A. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med. 2004;350:2033-2041.
60 McLean R, Jacques P, Selhub J, Tucker K, Samelson E, Broe K, Hannan M, Cupples L, Kiel D. Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med. 2004;350:2042-2049.
 

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