A new study spanning 25 years has found that individuals who consumed more sugary 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, highlights the long-term health 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 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.”
The analysis included more than 25,000 participants from the Growing Up Today Study (GUTS), who reported their dietary intake via food frequency questionnaires from childhood through adulthood. Participants 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. Among sugary drink subtypes, each daily serving of soda and sports drinks was associated with a 23% and 36% higher risk, respectively.
Fruit juice consumption also posed risks. Those who drank 1.5 or more servings of fruit juice per day had a 35% higher risk of developing high blood pressure compared to those who drank less than one serving a week. For orange juice specifically, each daily serving was associated with a 20% higher risk.
However, the study also found that substituting one serving per day of sugary beverages with whole fruit was associated with a 22% lower risk of high blood pressure. Replacing fruit juice with whole fruit resulted in a 19% lower risk. Substituting sugar-sweetened beverages with milk or water was associated with up to a 13% lower risk.
“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. American Heart Association volunteer expert Amit Khera, M.D., FAHA, commented, “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, so sugar-sweetened beverages and fruit juice relate to increased risk, while whole fruit does not.”
The study's limitations include reliance on self-reported data and a predominantly non-Hispanic white participant population, which may affect generalizability. Nonetheless, the researchers emphasize the importance of early intervention. For more information on reducing sugary drink intake, visit the American Heart Association's Rethink Your Drink resource.
