Childhood sugary drink intake linked to adult hypertension risk

Childhood sugary drink intake linked to adult hypertension risk

Drinking fruit juice and sugar-sweetened beverages during childhood and adolescence may increase the risk of developing high blood pressure in adulthood, according to research published June 22, 2026, in the journal Circulation.

The prospective cohort study utilized data from the Growing Up Today Study (GUTS), following 25,749 participants in the United States. The participants were between 9 and 16 years old at the start of the study and were tracked for up to 25 years. Throughout this period, they provided data on their health status, body measurements, and habits — including smoking and physical activity — via questionnaires completed every 1 to 4 years.

Researchers found that dietary habits established in early life have lasting health consequences. Specifically, children who consumed two or more servings of sugar-sweetened beverages daily, defined as sodas, sports drinks, punches, lemonades, and teas, faced a 52% higher risk of developing hypertension compared to those who consumed fewer than three servings per week. A standard serving was defined as approximately 350 milliliters.

The risk varied by the type of beverage. Each additional daily serving of soda was associated with a 23% higher risk, while each daily serving of sports drinks was linked to a 36% higher risk. Vasanti Malik, an associate professor at the University of Toronto and principal investigator of the study, noted that sports drinks often possess a health halo due to their association with athletics, but they are strongly associated with increased hypertension risk.

The study also examined fruit juice, finding that high intake levels could be harmful. Participants who drank 1.5 or more servings of fruit juice daily had a 35% higher likelihood of developing hypertension than those drinking less than one serving per week. Orange juice, in particular, showed a 20% higher risk per daily serving, though researchers noted that orange-flavored drinks with added sugars might have been misreported as orange juice.

In contrast, the consumption of whole fruit was not associated with an increased risk of hypertension. According to Malik, this is likely due to the fiber and essential nutrients found in whole fruits, which differ from the metabolic effects of liquid sugars.

Substitution Effects and Prevention

The researchers developed models to determine if replacing sugary drinks with other options reduced risk. The results indicated several beneficial substitutions:

• Replacing one daily serving of a sugar-sweetened beverage with whole fruit was associated with a 22% lower risk of hypertension.
• Replacing fruit juice with whole fruit was linked to a 19% reduction in risk.
• Substituting sugary beverages with milk or water was associated with reductions of up to 13%.

However, replacing fruit juice with milk or water did not show a significant difference in hypertension risk.

Amit Khera, director of preventive cardiology at the University of Texas Southwestern Medical Center, said the findings clarify a common misconception that all fructose is harmful or that all fruit juices are beneficial. He noted that total fructose consumption seemed less important for hypertension development than the specific food source. Khera also observed that while the study population was mostly white, the findings are particularly relevant for Hispanic and non-Hispanic Black American populations, who have the highest intake of sugar-sweetened beverages.

Wider Context and Limitations

The study found that about 6% of participants reported a hypertension diagnosis, with a median age of onset at 36 years. These findings align with a broader trend of high blood pressure emerging earlier in life among children, adolescents, and young adults.

Other research supports the importance of early sugar restriction. A study published in Science analyzed UK Biobank data regarding sugar rationing between 1942 and 1953. That research found that lower sugar intake during the first 1,000 days after conception reduced the risk of hypertension by 20% and delayed the disease's onset by two years.

Despite these links, researchers noted several limitations. The Circulation study was observational, meaning it does not prove that sugary drinks directly cause hypertension. It also relied on self-reported dietary information and diagnoses.

The American Heart Association advocates for science-based policies to reduce sugary drink consumption, including taxation, improved nutritional standards for school meals, and increased public awareness. Current guidance from the Association suggests that added sugars in foods and beverages should be minimized, emphasizing whole fruit over sugary drinks.