A new study published in the American Heart Association's flagship journal Circulation reveals 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, which followed more than 25,000 participants for up to 25 years, underscores the lasting impact of early dietary habits on cardiovascular health.
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 was associated with a 23% higher risk, and sports drinks with a 36% higher risk. Those who drank 1.5 or more servings of fruit juice per day had a 35% higher risk compared to those who drank less than one serving a week.
Senior study author Vasanti Malik, Sc.D., M.Sc., an associate professor at the University of Toronto, noted, 'Dietary habits in early life can have lasting health consequences.' She emphasized the importance of early prevention as high blood pressure is emerging earlier in life. The American Heart Association's 2026 Dietary Guidance to Improve Cardiovascular Health advises minimizing added sugars in beverages and foods.
The substitution analysis offered promising insights: replacing a daily serving of sugary beverage with whole fruit was associated with a 22% lower risk of developing high blood pressure. Similarly, substituting fruit juice with whole fruit resulted in a 19% lower risk. Replacing sugar-sweetened beverages with milk or water was linked to up to a 13% lower risk. However, 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.' The study's findings were independent of overall diet quality, physical activity, and other factors.
American Heart Association volunteer expert Amit Khera, M.D., FAHA, noted that 'the total amount of fructose seems less important for the development of hypertension than the type of food where it is consumed.' He added that there is a misconception that fruit juices are beneficial for health, but this study shows otherwise. Khera also pointed out that the findings may be especially relevant for non-Hispanic Black and Hispanic American populations, who have the highest sugar-sweetened beverage intake.
The study used data from the Growing Up Today Study (GUTS), which included participants aged 9 to 16 at baseline. Dietary intake was assessed through food frequency questionnaires, and high blood pressure was self-reported. Limitations include the inability to prove cause and effect due to the observational nature and reliance on self-reports. The study population was predominantly white, so findings may not apply to other groups.
The American Heart Association advocates for policies to reduce sugary drink consumption, such as establishing taxes on sugary drinks and improving nutrition standards in school meals. These findings reinforce the importance of early dietary interventions to prevent high blood pressure and subsequent cardiovascular disease.
