U.S. — Drinking fruit juice and sugar-sweetened beverages from childhood into adulthood may be linked to an increased risk of developing high blood pressure as an adult, according to research published in the journal Circulation.

The analysis included more than 25,000 participants from a study of U.S. youths, who were followed for up to 25 years. 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.

Each daily serving of soda was associated with a 23% higher risk of high blood pressure, and each daily serving of sports drinks was associated with a 36% higher risk. 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. Each daily serving of orange juice was associated with a 20% higher risk of high blood pressure.

Vasanti Malik, an associate professor at the University of Toronto and an adjunct faculty member at the Harvard T.H. Chan School of Public Health, said, "Dietary habits in early life can have lasting health consequences." She added, "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 link between sugary drinks or fruit juice and high blood pressure was independent of overall diet quality, physical activity, and other factors. Apple juice and other juices were not associated with an increased risk of high blood pressure in the analysis.

Replacing a daily serving of sugary beverage with whole fruit could be associated with a 22% lower risk of developing high blood pressure. Replacing fruit juice with whole fruit could result in a 19% lower risk. Substituting sugar-sweetened beverages with milk or water was associated with up to a 13% lower risk of developing high blood pressure. No association was found for replacing fruit juice with milk or water.

Malik said, "Sugar-sweetened beverages, such as soda and sports drinks, which are often marketed as somewhat healthy, should be limited." She added, "Fruit juice intake may be harmless at low levels yet harmful at higher intake levels," and stated, "Whole fruit should be emphasized over sugary beverages."

Amit Khera, the vice-chair of the dietary guidance writing committee for the American Heart Association, said, "First, the focus on childhood and the importance of health behaviors in childhood with adult risk factor development provides a critical opportunity for prevention." Khera, who is also the director of preventive cardiology at the University of Texas Southwestern Medical Center, noted, "As has been seen in adults, 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." He added, "Secondly, there has been a misconception about fructose in general being harmful for cardiovascular health regardless of the source, and that fruit juices are beneficial for health. This study demonstrates that neither seems to be correct."

A typical serving of a sugar-sweetened beverage was defined as a 12-ounce can or glass, and one serving of fruit juice was defined as an 8-ounce glass. Researchers noted the potential for misclassification, as orange-flavored drinks with added sugars may have been misreported as orange juice. The study population was mostly white children and adults. Participants for the Growing Up Today Study (GUTS) were recruited nationwide and were offspring of participants in the Nurses' Health Study II. The GUTS I study began in 1996 and GUTS II in 2004, following participants ages 9 to 16 for up to 25 years. About 55% of the participants were female, and about 96% were non-Hispanic white. The median age of participants was 36 years by the end of the follow-up period. Participants completed 132-item food frequency questionnaires annually from 1996 to 1998, and then in 2001, 2004, 2006, 2008, 2011, and 2015. Children with high blood pressure or missing dietary information at baseline were excluded from this specific analysis.

The American Heart Association advocates for science-based policies to reduce sugary drink consumption. The organization supports establishing taxes on sugary drinks to decrease consumption, improving nutrition standards in school meals, enhancing informed dining in restaurants, and improving diet quality in the Supplemental Nutrition Assistance Program.