Childhood Consumption of Sugary Drinks and Fruit Juice Linked to Higher Adult Blood Pressure

A study spanning 25 years has found that consuming sugar-sweetened beverages and fruit juice during childhood and adolescence is associated with a higher risk of developing high blood pressure in adulthood. The research, published today in the American Heart Association’s journal Circulation, highlights the long-term consequences of early dietary habits.

“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 and adjunct faculty at Harvard T.H. Chan School of Public Health. “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.”

The analysis included over 25,000 participants from the Growing Up Today Study (GUTS), followed from ages 9 to 16 for up to 25 years. Participants reported their intake of sugar-sweetened beverages (sodas, punches, lemonades, teas, sports drinks), fruit juice, and whole fruits via food frequency questionnaires. Researchers estimated associations with self-reported high blood pressure diagnoses.

Key results 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 and sports drinks was associated with a 23% and 36% higher risk, respectively. Drinking 1.5 or more servings of fruit juice per day was linked to a 35% higher risk. Notably, each daily serving of orange juice was associated with a 20% higher risk, while apple and other juices showed no significant association.

The substitution analysis revealed that replacing a daily serving of sugary beverage with whole fruit could lower the risk of high blood pressure by 22%, and replacing fruit juice with whole fruit could lower risk by 19%. Substituting sugary drinks with milk or water was associated with up to a 13% lower risk, but no significant benefit was found for replacing fruit juice with milk or water.

“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.”

Amit Khera, M.D., FAHA, vice-chair of the American Heart Association’s dietary guidance writing committee, noted that this study adds new insights by focusing on childhood and emphasizing that the type of food matters more than total fructose. “There has been a misconception about fructose in general being harmful regardless of the source, and that fruit juices are beneficial for health. This study demonstrates that neither seems to be correct,” he said.

The study’s limitations include reliance on self-reports and a predominantly white cohort, so findings may not apply to other groups. The American Heart Association supports science-based policies to reduce sugary drink consumption, including taxes, improved school meal nutrition, and enhanced restaurant menu labeling. More information is available in the manuscript online and the Association’s news release on lifelong healthy eating.