A new study published in the American Heart Association's flagship journal Circulation reveals that consuming sugar-sweetened beverages and fruit juice during childhood and adolescence may significantly increase the risk of developing high blood pressure in adulthood. The research, which followed over 25,000 participants for up to 25 years, underscores the long-term health consequences of early dietary habits.
Senior study author Vasanti Malik, Sc.D., M.Sc., an associate professor at the University of Toronto, emphasized that "dietary habits in early life can have lasting health consequences." High blood pressure is increasingly being diagnosed at younger ages, making early prevention critical. The condition can lead to serious health events such as heart attack and stroke, according to the American Heart Association.
The analysis included participants from the Growing Up Today Study (GUTS), aged 9 to 16 at baseline. Researchers assessed intake of sugar-sweetened beverages (sodas, punches, lemonades, teas, and sports drinks), fruit juice, and whole fruits through food frequency questionnaires. Participants were followed from 1996 to 2021, with blood pressure diagnoses self-reported through 2021.
Key findings showed that those who drank two or more servings of sugar-sweetened beverages per day had a 52% higher risk of developing high blood pressure compared to those consuming less than three servings a week. Each daily serving of soda was associated with a 23% higher risk, and sports drinks with a 36% higher risk. For fruit juice, consuming 1.5 or more servings per day increased risk by 35%. Specifically, each daily serving of orange juice was linked to a 20% higher risk, though apple and other juices did not show a significant association. The researchers noted potential misclassification of orange-flavored drinks with added sugars as orange juice.
However, the study also offered encouraging news: substituting a daily serving of sugary beverages with whole fruit was associated with a 22% lower risk of high blood pressure, and replacing fruit juice with whole fruit reduced risk by 19%. Replacing sugar-sweetened beverages with milk or water lowered risk by up to 13%, though no significant benefit was found for replacing fruit juice with milk or water.
These associations were independent of overall diet quality, physical activity, and other factors. Malik advised limiting sugar-sweetened beverages, noting that "fruit juice intake may be harmless at low levels yet harmful at higher intake levels." She emphasized that any fruit juice should be 100% juice and consumed in moderation, with whole fruit preferred.
The study aligns with the American Heart Association's 2026 Dietary Guidance to Improve Cardiovascular Health, which calls for minimizing added sugars. Dr. Amit Khera, vice-chair of the dietary guidance writing committee, noted that the findings challenge misconceptions about fruit juice being beneficial. "This study demonstrates that neither sugar-sweetened beverages nor fruit juice are harmless, while whole fruit is protective," he said.
The study population was predominantly white (96%), but Dr. Khera pointed out that non-Hispanic Black and Hispanic populations have the highest intake of sugar-sweetened beverages, making these findings especially relevant for those groups. The American Heart Association advocates for policies such as taxes on sugary drinks, improved nutrition standards in schools, and enhancements to the Supplemental Nutrition Assistance Program (SNAP) to reduce consumption.
Limitations of the study include reliance on self-reported dietary intake and blood pressure diagnoses, and the inability to establish cause and effect. Nonetheless, the findings provide strong evidence that early dietary choices have lasting cardiovascular implications. The full manuscript is available online.
