A new study published today in the American Heart Association’s flagship journal Circulation reveals that consuming sugar-sweetened beverages and fruit juice during childhood and continuing through adulthood is associated with a higher risk of developing high blood pressure later in life. The research, which followed more than 25,000 participants for up to 25 years, underscores the long-term impact of early dietary habits on cardiovascular health.
“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 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.”
High blood pressure can lead to serious conditions such as heart attack and stroke. While some risk factors like family history and age are uncontrollable, unhealthy lifestyle factors—including poor diet—can increase risk. The study analyzed data from the Growing Up Today Study (GUTS), which included participants aged 9 to 16 at baseline, mostly non-Hispanic white. They reported their intake of sugar-sweetened beverages (sodas, punches, lemonades, teas, sports drinks), fruit juice, and whole fruits via food frequency questionnaires every 1 to 4 years.
Key findings showed that 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 sports drinks with a 36% higher risk. Those who drank 1.5 or more servings of fruit juice per day (8-ounce glass) had a 35% higher risk. Notably, each daily serving of orange juice was linked to a 20% higher risk.
However, the substitution analysis offered encouraging news: replacing a daily serving of sugary beverage with whole fruit was associated with a 22% lower risk of 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 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.”
American Heart Association volunteer expert Amit Khera, M.D., FAHA, noted that these findings add new insights, particularly the focus on childhood behaviors and adult risk. “The total amount of fructose seems less important than the type of food where it is consumed,” he said. “Sugar-sweetened beverages and fruit juice relate to increased risk, while whole fruit does not.” He also highlighted that non-Hispanic Black and Hispanic populations have the highest sugar-sweetened beverage intake, making these findings especially relevant for those groups.
The study’s limitations include its reliance on self-reported data and a predominantly white cohort, meaning results may not apply to other groups. Nonetheless, the findings align with the American Heart Association’s 2026 Dietary Guidance to Improve Cardiovascular Health, which recommends minimizing added sugars. The Association advocates for policies such as taxes on sugary drinks and improved nutrition standards in schools.
For business and technology leaders, this research underscores the importance of workplace wellness programs that promote healthy beverage choices and the potential market for alternatives like whole fruit and water. As hypertension rates rise among younger adults, companies may see increased healthcare costs, making early intervention a strategic priority.
