A long-term study published today in the American Heart Association's flagship journal Circulation found 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, adds to growing evidence that early dietary habits have lasting cardiovascular consequences.
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 subtypes, each daily serving of soda was linked to a 23% higher risk, and sports drinks to a 36% higher risk. Fruit juice also posed risks: those who drank 1.5 or more servings per day had a 35% higher risk than those who drank less than one serving a week. Notably, each daily serving of orange juice was associated with a 20% higher risk.
However, the study also offered promising substitution strategies. Replacing a daily serving of sugary beverage with whole fruit was associated with a 22% lower risk of developing high blood pressure, while replacing fruit juice with whole fruit resulted in a 19% lower risk. Substituting sugary drinks with milk or water was linked to up to a 13% lower risk, though replacing fruit juice with milk or water showed no significant benefit.
“Sugar-sweetened beverages, such as soda and sports drinks, which are often marketed as somewhat healthy, should be limited,” said senior study author Vasanti Malik, Sc.D., an associate professor at the University of Toronto. “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 are particularly relevant given rising rates of high blood pressure in younger populations. The study's participants were aged 9 to 16 at enrollment, with a median age of 36 by the end of follow-up. The analysis was based on data from the Growing Up Today Study (GUTS), which included offspring of participants from the Nurses' Health Study II. Diet was assessed using food frequency questionnaires, and blood pressure was self-reported.
American Heart Association volunteer expert Amit Khera, M.D., noted that the study highlights the importance of early prevention. “This study demonstrates that sugar-sweetened beverages and fruit juice relate to increased risk, while whole fruit does not,” he said. The American Heart Association's 2026 Dietary Guidance to Improve Cardiovascular Health recommends minimizing added sugars in beverages and foods.
The study also supports policies aimed at reducing sugary drink consumption, such as taxes, improved school meal standards, and enhanced nutrition in the Supplemental Nutrition Assistance Program (SNAP). More information on reducing sugary drinks is available from the American Heart Association's Rethink Your Drink resource.
Limitations of the study include its reliance on self-reported data and a predominantly non-Hispanic white cohort, which may limit generalizability. However, the authors note that non-Hispanic Black and Hispanic populations have the highest sugar-sweetened beverage intake, making these findings potentially even more relevant for those groups.
