High intake of sugar-sweetened beverages (≥2 servings/d) was associated with a higher risk of incident hypertension compared to <3 servings/week (HR 1.52; 95% CI 1.27-1.83; P trend<0.001).
Cohort (n=25,749)
Hazard Ratio: 1.52 (95% CI 1.27–1.83)
p-value: p=<0.001
Background: High intakes of fructose-containing sugars among children and adolescents is implicated in obesity and related comorbidities, including hypertension. However, sugar-sweetened beverages (SSBs), fruit juices, and whole fruit have different nutritional profiles and matrices, which may confer different effects on blood pressure. Methods: GUTS (Growing Up Today Study) is a longitudinal cohort of 25 749 individuals (55% female) drawn from 2 enrollment waves, GUTS 1 (n=16 875; baseline 1996) and GUTS II (n=10 918; baseline 2004), followed up prospectively through 2021 (mean age at enrollment, 12 years; mean age at end of follow-up, 36 years). Participants provided updated information on lifestyle, health status, and habitual diet through validated food frequency questionnaires every 1 to 4 years. We conducted multivariable adjusted Cox proportional hazards regression models to estimate the associations of total fructose and SSB, fruit juice, and whole fruit intake (cumulative averages) with incident hypertension (hazard ratios HRs and 95% CIs), adjusting for major diet and lifestyle factors. We also modeled substitutions of SSBs or fruit juice with whole fruit, milk, and water. Results: During up to 25 years of follow-up, 1625 participants (6.3%) reported a hypertension diagnosis. Total fructose intake was not associated with incident hypertension (highest versus lowest quintile HR, 1.07 95% CI, 0.92, 1.25; P trend<0.001). However, participants with the highest intake of SSBs (≥2 servings/d versus <3 servings/week) and fruit juice (≥1.5 servings/d versus <1 serving/wk) had a higher risk of hypertension (HR, 1.52 95% CI, 1.27, 1.83; P trend<0.001 and HR, 1.35 95% CI, 1.06, 1.71; P trend=0.018, respectively). In contrast, whole fruit was not associated with hypertension (highest versus lowest category HR, 0.79 95% CI, 0.59, 1.05; P trend=0.08). Replacing 1 serving/d of SSB with milk, water, or whole fruit was associated with a 13% (95% CI, 5%, 20%), 9% (95% CI, 3%, 15%), and 22% (95% CI, 11%, 31%) lower risk of hypertension, respectively. In addition, replacing fruit juice with whole fruit was associated with a 19% (95% CI, 3%, 32%) lower risk of hypertension. Conclusions: SSB and fruit juice intakes were positively associated with a higher risk of hypertension independently of overall diet quality, physical activity, and other factors. Our findings support public health guidelines to limit the overconsumption of SSBs and fruit juice starting in childhood to protect against the development of hypertension.
“Despite the ongoing discussion, Nguyen, et al., emphasize that their findings 'support public health guidelines to limit the overconsumption of SSBs and fruit juice starting in childhood to protect against the development of hypertension.”
This long-term prospective study published in Circulation links the consumption of sugar-sweetened beverages and fruit juice in childhood to a higher risk of hypertension in adulthood. These findings have significant public health implications and have been widely reported in the media.
Nguyen et al. (Mon,) conducted a cohort in Hypertension (n=25,749). Sugar-sweetened beverages (SSBs) vs. <3 servings/week was evaluated on Incident hypertension (HR 1.52, 95% CI 1.27-1.83, p=<0.001). High intake of sugar-sweetened beverages (≥2 servings/d) was associated with a higher risk of incident hypertension compared to <3 servings/week (HR 1.52; 95% CI 1.27-1.83; P trend<0.001).