January 2024
Blog | OJ vs Coca Cola: a dietitian's response to the furore
By Megan Bridger
Share post:Read time: approx 1 mins
Online messages around nutrition are becoming a minefield to navigate. It is becoming increasingly more confusing to separate fact from fiction and know what we should be fuelling our minds and bodies with.
Recently, a clip of well-known media spokespeople Professor Tim Spector and Dr Rangan Chatterjee was circulating online, in which they touched on the subject of ultra-processed foods. In this clip it was suggested that drinking orange juice is as bad as drinking Coca-Cola. Orange juice was coined as an ultra-processed foods and headlines have been created suggesting that we should be drinking it as a treat. But what is an ultra-processed food? Is orange juice in this category and should you be drinking it? I want to unpick the fact from the fiction, share why context is key and where you should be going for trustworthy nutrition advice.
The claim
In the short clip shared on Instagram, the view was shared that it would be preferable for people to drink Coca-Cola instead of orange juice because you would be consuming it knowing that it was a “naughty treat”. Orange juice was claimed to be an ultra-processed food that should “come with a health warning”. It was argued that orange juice is an ultra-processed food that has been packaged and promoted as a health food and that the sugar spikes experienced can lead to type 2 diabetes, heart disease and potentially certain types of cancers.
The issue
There are several issues with this clip. Firstly, the demonisation of foods as “good” and “bad”. Whilst it is true that there are a myriad of evidence demonstrating the positive/ negative impacts different nutrients and foods may have on the body we need to remember that food is more than fuel and we eat for enjoyment too. Optimising consumption of whole foods, fibre containing foods and a diet rich in fruit and vegetables and reducing consumption of high fat, sugar, salt foods is not poor advice, but food choice is more complex than this and this is something that has not seemingly been considered within this short clip.
Grouping foods as good and bad can have a negative impact on our relationship with food and lead to feelings of guilt when consuming these “bad” foods. For those predisposed to disordered eating this sends a negative message on how they should be controlling their diet and leads the risk of following episodes of restrictive diets followed by periods of binging.
Secondly, when segments of longer recordings are used in this way, the media can latch on to create misleading and often confusing headlines. The takeaway from this short clip, for some, could simply be if I am going to drink something ‘bad’, I may as well have Coca-Cola over orange juice. Or perhaps the takeaway would be that orange juice is bad for our health and should not be consumed at all. This is a very narrow view of a much more nuanced topic. When short segments of a bigger piece are taken out of context misleading messages can be created.
The other issue is the blurred line between public health messages and the rise of personalised nutrition approaches. Evidence can be used by policy makers to make suggestions on what should constitute a healthy, balanced diet for the general population. UK healthy eating guidelines state that fruit juice or smoothies should be limited to no more than 150mls per day (this would look like one small glass or around 1/3 of a pint glass), we should be aiming to eat 5 portions of fruit and vegetables, 30g of fibre (you can see examples of fibre content of foods here) and 6-8 glasses of fluid - “water, lower-fat milks, lower-sugar or sugar-free drinks and tea and coffee all count.” However, if we take a personalised nutrition approach there may be instances where we would recommend foods such as fruit juice to support micronutrient intake and perhaps even increase weight.
Another example may be in sport nutrition where carbohydrate needs are higher than that of the general population. For example, in elite football, there is evidence to suggest players should be consuming 8g carbohydrate per kg body weight the day before a match and post-match to be meeting 1g carbohydrate per kg body mass per hour for 4 hours. Meeting this via wholefoods alone may not always be practical or comfortable for the athlete. This is where fruit juice, which can be quickly broken down and absorbed, may support. A good source of iron is red meat, iron that comes from animal sources is referred to as haem-iron and is more readily absorbed than plant-based sources. However, there are good sources of iron from plant-based foods such as beans, lentils and dark green vegetables such as spinach and kale we call these sources ‘non-haem iron’. To support the absorption of iron from these plant sources it is often suggested to consume them alongside a source of vitamin C.
Should you choose Coca-Cola, orange juice or neither?
To begin answering this question we need to understand what is meant by the term ultra-processed food.
Under NOVA definition (see full document here), 100% orange juice would not be ultra-processed. In fact, it would come under the unprocessed or minimally processed category. If it was not 100% orange juice and contained added sugar, sweeteners of flavour that is where it would start to become more processed.
Coca-Cola on the other hand comes under the ultra-processed category. The EPIC study has provided evidence that suggests a high consumption of ultra-processed foods can increase the risk of certain types of cancer and cardiometabolic diseases. However, products such as infant formulas also come under the ultra-processed category. For mothers who cannot or choose not to exclusively breastfeed infant formulas would be required to support the normal healthy development of infants but the stamp of “ultra-processed” is being used by the media to scaremonger when a holistic approach needs to be taken when considering food choice.
In 2015, the Scientific Advisory Committee on Nutrition (SACN) published their report on Carbohydrates and Health. Within this report it was suggested that adults reduce their consumption of free sugars to so that they do not exceed more than 5% of total dietary energy because of the impact over consumption has on dental hygiene and total energy consumption. Suggesting that to decrease consumption of free sugars would mean you may be less likely to exceed your energy requirements. The term “free sugar” includes sugar “added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices.” So, by definition orange juice would be a source of free sugars, as would Coca-Cola. The World Health Organisation (WHO) would also corroborate this message about reducing intake of free sugars. Alongside this, adults in the UK on average are not meeting the 30g/ day fibre recommendation, consuming whole fruits over juices would support meeting the recommendation for fibre so it would be suggested consuming whole fruits over relying on juices to meet your 5 a day would be preferable.
However, orange juice does contain vitamin C and can still be useful for some in supporting to meet the 5-a-day recommendation and micronutrient intake. The term ‘treat’ does not support a healthy relationship with food and so whether you choose to include orange juice, Coca-Cola or both in your diet the message should be that they can both be consumed as part of a healthy balanced diet and that it is overall diet quality which counts.
How do I navigate health advice online?
Sound advice when seeing claims online is to go back to the original source so that you can put the quotes into context. The clip around orange juice and Coca-Cola was a snippet of a longer 20-minute podcast. Within the full podcast the Professors discuss how different people may respond to foods in different ways in regard to their blood sugar spikes. From putting the snippet of comparing orange juice to Coca-Cola, I don’t think the message is drink coke instead of orange juice but it is to be aware of health claims made on food, and prioritise whole, minimally processed foods as a more general rule of thumb.
I think a more helpful message instead of “do not drink orange juice” would be that orange juice may support some individuals in meeting their 5-a-day and acting as source of vitamin C when kept to 150mls per day alongside whole fruits and vegetables and as part of a healthy balanced diet. There is not a one size fits all when it comes to nutrition but any message that demonises a particular food or food group should be considered more deeply than the surface claim.
Furthermore, dietitians are the only nutrition professionals regulated by law who assess, diagnose, and treat nutritional problems. If seeking nutrition advice reach out to an appropriately qualified nutrition professional such as a Registered Dietitian (RD) or Registered Nutritionist (RNutr).
Learn more about nutrition, and how it contributes to health and wellbeing in our Dietetics MSc (Pre-registration) course (subject to HCPC approval) or find out more about our courses across our School of Health.
For further information:
Fruit and vegetables - how to get five-a-day (bda.uk.com)
Fibre (bda.uk.com)
References:
SACN Carbohydrates and Health Report - GOV.UK (www.gov.uk)
Ultra-processed foods,diet quality, and health using the NOVA classification system - (UN Report)
Reducing free sugars intake in adults to reduce the risk of noncommunicable diseases (who.int)
The Eatwell Guide - NHS (www.nhs.uk)
Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study (ScienceDirect)
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