Childhood consumption of fruit juice and sugary drinks linked to higher adult hypertension risk

Drinking fruit juice and sugar-sweetened beverages regularly from childhood through adulthood is associated with a higher risk of developing high blood pressure later in life, according to a long-term study published in the American Heart Association journal Circulation (newsroom.heart.org).

Researchers analyzed data from 25,749 participants in the Growing Up Today Study (GUTS), who were ages 9 to 16 at enrollment (about 55% female and 96% non-Hispanic White). Participants completed food frequency questionnaires periodically over up to 25 years, reporting intake of sugar-sweetened beverages (such as sodas, fruit punches, lemonades, iced teas, and sports drinks), fruit juice, whole fruits, and other items, along with lifestyle factors. High blood pressure diagnoses were self-reported. The median age at the end of follow-up was 36 years (hsph.harvard.edu).

Participants who consumed two or more 12-ounce servings of sugar-sweetened beverages per day had a 52% higher risk of later high blood pressure compared with those who consumed fewer than three servings per week. Among subtypes, each daily serving of soda was linked to a 23% higher risk and each daily serving of sports drinks to a 36% higher risk (newsroom.heart.org).

For fruit juice, those drinking 1.5 or more 8-ounce servings per day had a 35% higher risk than those drinking less than one serving per week. Each daily serving of orange juice was associated with a 20% higher risk, while apple and other juices were not; researchers noted possible misclassification of orange-flavored drinks with added sugars (sciencedaily.com).

The associations held after accounting for overall diet quality, physical activity, and other factors. Total fructose intake from all sources was not linked to higher risk in the same way, and whole fruit intake showed no association with increased hypertension risk (newsroom.heart.org).

Substitution analyses indicated that replacing one daily serving of a sugar-sweetened beverage with whole fruit was associated with a 22% lower risk of high blood pressure. Replacing fruit juice with whole fruit was linked to a 19% lower risk. Replacing sugar-sweetened beverages with milk or water was associated with up to a 13% lower risk, while replacing juice with milk or water showed no significant change (hsph.harvard.edu).

“Dietary habits in early life can have lasting health consequences,” said senior author Vasanti Malik, Sc.D., of the University of Toronto and 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.” She advised limiting sugar-sweetened beverages and consuming 100% fruit juice only in moderation, while emphasizing whole fruit (newsroom.heart.org).

American Heart Association expert Amit Khera, M.D., noted that the findings underscore the importance of childhood behaviors for adult risk and that the source of fructose matters more than total amount, with beverages linked to risk but whole fruit not. He observed that the predominantly White study population means findings may be particularly relevant for groups with higher sugary drink intake, such as non-Hispanic Black and Hispanic Americans (sciencedaily.com).

Limitations include the observational design, which cannot prove causation; reliance on self-reported diet and diagnoses; and limited generalizability beyond the study demographics. The AHA recommends minimizing added sugars in beverages and foods as part of cardiovascular health guidance (newsroom.heart.org).