A study spanning 25 years has found that individuals who consumed more sugar-sweetened beverages and fruit juice beginning in childhood had a significantly higher risk of developing high blood pressure as adults. The research, published today in the American Heart Association's flagship journal Circulation, analyzed data from more than 25,000 participants in the Growing Up Today Study (GUTS).
Participants 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 who consumed less than three servings a week. Each daily serving of soda was associated with a 23% higher risk, and each serving of sports drinks with a 36% higher risk. Among fruit juice consumers, those who drank 1.5 or more servings per day had a 35% higher risk compared to those who drank less than one serving a week. Notably, each daily serving of orange juice was linked to a 20% higher risk, though the researchers cautioned that some orange-flavored drinks with added sugars may have been misclassified as juice.
However, the study also offered encouraging findings: substituting a daily serving of sugary beverage with whole fruit was associated with a 22% lower risk of developing high blood pressure, and replacing fruit juice with whole fruit was linked to a 19% lower risk. Replacing sugary drinks with milk or water was associated with up to a 13% lower 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 and adjunct faculty 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.”
The analysis included participants aged 9 to 16 at baseline, followed for up to 25 years. Dietary intake was assessed using food frequency questionnaires, and high blood pressure was self-reported through follow-up questionnaires. The study controlled for overall diet quality, physical activity, and other lifestyle factors, and the associations remained significant.
Dr. Amit Khera, M.D., FAHA, vice-chair of the American Heart Association's dietary guidance writing committee, noted that “this study demonstrates that the total amount of fructose seems less important for the development of hypertension than the type of food where it is consumed.” He emphasized that “sugar-sweetened beverages and fruit juice relate to increased risk, while whole fruit does not.”
The findings highlight the importance of early dietary interventions. The American Heart Association's 2026 Dietary Guidance to Improve Cardiovascular Health recommends minimizing added sugars in beverages and foods. The study’s authors advise that fruit juice should be limited and always 100% fruit juice, while whole fruit should be emphasized over sugary beverages.
The study has limitations, including its observational nature, reliance on self-reports, and a predominantly white participant population, which may limit generalizability. Nonetheless, the results underscore the need for policies to reduce sugary drink consumption, such as taxes, improved school meal standards, and enhanced nutrition in federal assistance programs.
