A new study published today in the American Heart Association’s flagship journal Circulation reveals that drinking fruit juice and sugar-sweetened beverages from childhood through adulthood may be linked to an increased risk of developing high blood pressure as an adult. The research, which followed more than 25,000 participants for up to 25 years, underscores the lasting impact of early dietary habits on cardiovascular health.
“Dietary habits in early life can have lasting health consequences,” said senior study author Vasanti Malik, Sc.D., M.Sc., an associate professor and Canada Research Chair in Nutrition and Chronic Disease Prevention at the University of Toronto and an adjunct faculty member at the 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.”
High blood pressure can lead to serious conditions such as heart attack and stroke. While some risk factors cannot be changed, unhealthy lifestyle factors like poor diet can increase risk.
The analysis included participants from the Growing Up Today Study (GUTS), aged 9 to 16 at baseline. They reported their consumption of sugar-sweetened beverages (sodas, punches, lemonades, teas, sports drinks), fruit juice, and whole fruits via questionnaires every 1 to 4 years. The study found that those who drank two or more servings of sugar-sweetened beverages per day had a 52% higher risk of later developing high blood pressure compared to those who consumed 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, drinking 1.5 or more servings per day was associated with a 35% higher risk of high blood pressure compared to less than one serving a week. Each daily serving of orange juice was linked to a 20% higher risk, though the researchers noted potential misclassification of orange-flavored drinks with added sugars.
Importantly, the substitution analysis suggested that replacing a daily serving of sugary beverage with whole fruit could lower the risk of high blood pressure by 22%. Replacing fruit juice with whole fruit was associated with a 19% lower risk. Substituting sugary drinks with milk or water was linked to up to a 13% lower risk, while replacing fruit juice with milk or water showed no significant association.
“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.”
The findings align with the American Heart Association’s 2026 Dietary Guidance to Improve Cardiovascular Health, which notes that added sugar in beverages and foods should be minimized. Dr. Amit Khera, a volunteer expert with the Association, highlighted that the study’s focus on childhood provides a critical opportunity for prevention. “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 noted that non‑Hispanic Black and Hispanic American populations have the highest sugar-sweetened beverage intake, making these findings particularly relevant for those groups.
The study had limitations, including reliance on self-reported data and a predominantly white participant pool, which may limit generalizability. Nevertheless, the results reinforce the importance of early dietary interventions to reduce the burden of hypertension later in life.
