A new study published in the American Heart Association's flagship journal Circulation reveals that drinking fruit juice and sugar-sweetened beverages from childhood through adulthood may increase the risk of developing high blood pressure later in life. The research, which followed over 25,000 participants for up to 25 years, found that those who drank two or more servings of sugary beverages per day had a 52% higher risk of high blood pressure compared to those who consumed less than three servings a week. Similarly, participants who drank 1.5 or more servings of fruit juice daily had a 35% higher risk.
“Dietary habits in early life can have lasting health consequences,” said senior study author Vasanti Malik, Sc.D., M.Sc., an associate professor at the University of Toronto. “High blood pressure is also emerging earlier in life, with growing rates being seen in younger adults, in children and adolescents, which highlights the importance of early detection and prevention.” High blood pressure can lead to serious conditions such as heart attack and stroke, and while some risk factors cannot be changed, unhealthy lifestyle factors like poor diet can be modified.
The analysis included participants from the Growing Up Today Study (GUTS), aged 9 to 16 at baseline, who reported their dietary intake through food frequency questionnaires. Researchers estimated associations of total fructose and specific beverages with self-reported high blood pressure diagnoses. Among sugary drink subtypes, each daily serving of soda and sports drinks was associated with a 23% and 36% higher risk, respectively. For fruit juice, each daily serving of orange juice was linked to a 20% higher risk, though apple and other juices showed no significant association.
The substitution analysis provided actionable insights: replacing a daily serving of sugary beverage with whole fruit was associated with a 22% lower risk of high blood pressure, and replacing fruit juice with whole fruit resulted in a 19% lower risk. Substituting sugary drinks with milk or water was associated with up to a 13% lower risk. “Sugar-sweetened beverages, such as soda and sports drinks, which are often marketed as somewhat healthy, should be limited,” Malik said. “Fruit juice intake may be harmless at low levels yet harmful at higher intake levels. They should always be 100% fruit juice, and even so, consumed only in moderation. Whole fruit should be emphasized over sugary beverages.”
American Heart Association volunteer expert Amit Khera, M.D., FAHA, noted that these findings add new insights by focusing on childhood behaviors and the importance of the source of fructose. “There has been a misconception about fructose in general being harmful for cardiovascular health regardless of the source, and that fruit juices are beneficial for health. This study demonstrates that neither seems to be correct,” Khera said. He also highlighted that non‑Hispanic Black and Hispanic American populations have the highest sugary beverage intake, making these findings particularly relevant for those groups. The American Heart Association advocates for science-based policies to reduce sugary drink consumption, including taxes, improved school meal standards, and enhanced nutrition in programs like SNAP.
The study's limitations include reliance on self-reports and the inability to prove cause and effect. The findings may not apply to diverse populations, as the cohort was mostly non-Hispanic white. Nevertheless, the research underscores the long-term cardiovascular risks associated with early consumption of sugary beverages and fruit juice, emphasizing the need for early dietary interventions.
