Health & Nutrition | Health Updates

Health Updates - Research

Disclaimer: The following includes a compilation of select study results or other reference information regarding the relationship between citrus consumption or nutrient intake and various diseases or other health conditions. This compilation may not necessarily represent a review of the entire body of literature for the topic(s) addressed.

General Health

One serving of 100 percent orange or grapefruit juice is more nutrient dense – that is, has more nutrients per calorie - than many commonly consumed 100% fruit juices such as apple, grape, pineapple, and prune.¹
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.²
A study of over 1,800 Japanese Americans residing in King County, Washington reported that consuming fruit and vegetable juices three times or more per week was associated with a 76% reduced risk for Alzheimer’s disease compared to consuming juices less often than weekly.³
A study in nine healthy females reported that the consumption of grapefruit juice reduced the risk of calcium oxylate crystallization and kidney stone formation in urine.⁴
A pilot study reports that inclusion of fresh grapefruit or grapefruit juice as part of the usual diet in obese individuals may have beneficial effects on weight loss and insulin sensitivity.⁵
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.⁶
Adequate vitamin C intake may help maintain eye health by reducing the risk for cataract and age-related macular degeneration.^7,8,9,10
Folate may be associated with reduced risk for depression, age-related dementia or Alzheimer’s disease.^11,12

Heart Health

A study of women and men in the Nurses’ Health Study and Health Professionals’ Follow-up Study found that highest consumption of citrus fruit juice was associated with a 25% reduced risk for ischemic stroke compared to lowest consumption.¹³
Studies in animals and humans report that consuming grapefruit or grapefruit juice may have positive effects on blood lipid levels.^{14,15,16,17,18} The flavonoid naringin, found in grapefruit, may play a role in these associated effects.^17,19,20
Findings from the Iowa Women’s Health Study indicate that in the highest intake group for grapefruit there was a 15% reduced risk for coronary heart disease mortality compared to the lowest intake group.²¹
A study in men residing in Northern Ireland or France reported that the highest intake of citrus fruit was associated with a 36% reduced risk for an acute coronary event.²²
Studies show that a diet that includes orange juice can increase plasma vitamin C concentrations^{23,24,25,26,27} and improve markers for oxidative stress^23,25,26 and inflammation,^23,24 which may reduce risk of heart disease.
Orange juice may help increase HDL, "good" cholesterol, and decrease the LDL-HDL ratio. Orange juice with added plant sterols may help improve cholesterol status by decreasing total and LDL cholesterol.²⁷
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.^29,30,31
Orange juice is a good source of potassium and is low in sodium. Adequate potassium intake has been shown to effectively lower blood pressure^32,33 and reduce the risk for stroke.^34,35,36 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.³⁷ Soluble and insoluble fibers may reduce the risk of cardiovascular disease by supporting healthy blood pressure and moderating blood glucose levels after a meal.³⁸
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.^39,40
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 appear to display anti-inflammatory and anti-cancer activities.^41,42 High intakes of flavonoids are associated with lower risk of cardiovascular disease or lower mortality from cardiovascular disease.^43,44

Cancer

In some studies, the consumption of higher levels of citrus fruits and juices has been associated with a lower risk of certain types of cancer.⁴⁵
A meta-analysis of observational studies found that citrus fruit consumption was associated with a 62% decreased risk for oral cancer.⁴⁶
A prospective study in almost 500,000 participants of the National Institutes of Health-AARP Diet and Health Study reports that consumption of citrus fruit was associated with a protective effect against esophageal squamous cell carcinoma.⁴⁷
A multicenter case-control study of men residing in Europe who had laryngeal or hypopharyngeal cancer reported that the highest intake level of citrus fruit was associated with a 60% reduced risk for the development of second primary tumors compared to the lowest intake level.⁴⁸
A case-control study in Uruguay reported that compared to the lowest consumption, highest consumption of citrus fruit was associated with over 70% reduced risk for squamous cell carcinoma of the esophagus.⁴⁹
In a population-based case control study in eastern Nebraska, the highest intake of citrus fruit and juices was associated with a significantly reduced risk for esophageal adenocarcinoma compared to lowest intake.⁵⁰
A case-control study in northern Italy found that individuals with the highest intake of citrus fruits had a 58% reduced risk for squamous cell cancer of the esophagus compared to the lowest intake. Citrus appeared to be especially beneficial in individuals with higher alcohol intakes.⁵¹
Findings from the Nurses’ Health Study indicate that the intake of higher levels of citrus fruit and juice was associated with a reduced risk for adenomas of the distal colon or rectum in women who had not previously been diagnosed with adenomas.⁵²
A population-based case-control study conducted in Hawaii reported a 50% reduced risk for lung cancer in individuals with the highest intake of white grapefruit compared to lowest intake.⁵³
A study of over 42,000 men in the Health Professional’s Follow-Up Study reported that the highest consumption of citrus juice was associated with a reduced risk for oral premalignant lesions compared to lowest intake.⁵⁴
Adequate folate intake may help reduce the risk for some forms of cancer.^{55,56,57,58,59}
Pink and Ruby Red grapefruit contain lycopene, a carotenoid that is not converted to vitamin A in the body, but has been associated with decreasing the risk of prostate cancer.⁶⁰

Immunity

One cup (8 ounces) of orange juice is a nutrient-dense beverage that provides at least 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.^61,62
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.⁶³

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. According to data from the 1999-2002 National Health and Nutrition Examination Survey, only 43% of men and 38% of women met the daily Adequate Intake (AI) recommendation for calcium. In the U.S., 10 million individuals are estimated to already have osteoporosis ⁶⁴ and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis.⁶⁵
100% orange juice is a good source of potassium that may help your body fight osteoporosis by helping to neutralize acidity that could lead to loss of calcium from bone. Potassium intake has been positively associated with bone health in middle-aged women ^66,67 and elderly men and women.⁶⁸
Elevated blood homocysteine concentrations have been associated with an increased risk for osteoporotic fracture in older individuals.^69,70
Magnesium may play an important role in bone health and diets rich in fruits and vegetables can optimize the intake of micronutrients required for bone health.⁷¹

Pre-Natal

An 8-ounce glass of orange juice is a good source of folate. Folate is essential for growth and development. It plays a key role in DNA formation and cell division, helps guard against one form of anemia, and may help reduce the risk of birth defects of the brain and spinal cord, known as "neural tube defects."
To help reduce the risk of someday having a baby with a neural tube defect, all women capable of becoming pregnant need to get 400 micrograms of the synthetic form of folate, folic acid, every day while consuming food folate from a varied diet.⁷² Have a glass of orange juice to help increase the folate in your diet.
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,⁷³ increased risk for gestational diabetes,⁷⁴ elevated risk for premature membrane rupture,⁷⁵ and pre-eclampsia.⁷⁶

School Performance

Regular breakfast consumption for children and adolescents may help improve school performance and attendance.^77,78,79,80 Orange or grapefruit juice is a great addition to a healthy breakfast.

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