Childhood sugary drinks, juice associated with adult hypertension

Clinical takeaway: Clinicians counseling children, adolescents, and families should emphasize whole fruit over fruit juice and sugar-sweetened beverages. Even 100% fruit juice should be consumed in moderation, while water, milk, and whole fruit are better routine options for long-term cardiometabolic health.

Long-term intake of sugar-sweetened beverages and fruit juice from childhood into adulthood was associated with higher risk of developing hypertension, according to a prospective cohort study published in Circulation.

Researchers analyzed data from 25,749 participants in the Growing Up Today Study, who were enrolled at ages 9 to 16 years and followed for up to 25 years. Participants regularly reported intake of sugar-sweetened beverages, fruit juice, and whole fruit, along with lifestyle and health information. By the end of follow-up, the mean participant age was 36 years, and 1,625 participants reported a hypertension diagnosis.

Participants who consumed at least two servings of sugar-sweetened beverages per day had a 52% higher risk of developing hypertension compared with those who consumed fewer than three servings per week. Higher fruit juice intake was also associated with risk: participants who drank at least 1.5 servings per day had a 35% higher risk compared with those who drank less than one serving per week.

Whole fruit showed a different pattern. Total fructose intake was not associated with incident hypertension, and whole fruit was not linked to higher risk. The findings suggest that the food or beverage source of fructose may matter more than fructose alone.

Substitution analyses offered practical counseling points. Replacing one daily serving of a sugar-sweetened beverage with whole fruit was associated with a 22% lower risk of hypertension. Replacing a daily serving with milk or water was associated with a 13% and 9% lower risk, respectively. Replacing fruit juice with whole fruit was associated with a 19% lower risk.

The results support limiting sugar-sweetened beverages, including soda and sports drinks, beginning in childhood. They also reinforce that fruit juice should not be treated as equivalent to whole fruit, particularly when intake is frequent or high.

Hypertension diagnoses were self-reported, and the cohort was predominantly non-Hispanic White, which may limit generalizability. Still, the long follow-up period strengthens the clinical relevance of early dietary habits for adult cardiovascular risk.

“Dietary habits in early life can have lasting health consequences,” said senior author Vasanti Malik, ScD, MSc, associate professor and Canada Research Chair in Nutrition and Chronic Disease Prevention at the University of Toronto. “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.”

Source: Nguyen M, et al. 2026 June 22. Circulation. Consumption of fructose-containing food and beverage sources in childhood through to adulthood and risk of hypertension: A prospective cohort study