Public Health

Ditch juice box, pick up water bottle to boost prevention

Drinking sugary beverages—even if they are 100% fruit juices that people typically believe are healthier options—is associated with a higher all-cause mortality risk, a new study suggests.

An investigation published in JAMA Network Open finds that each additional 12-ounce serving of fruit juice consumed daily is associated with a 24% higher all-cause mortality risk. Each additional 12-ounce serving of sugary beverages consumed daily is associated with an 11% higher all-cause mortality risk.

The study’s authors called for “further well-powered studies with long-term follow-up to clearly delineate the role that sugary beverages play in mortality risk.”

The AMA offers physicians resources for chronic disease prevention.

Target: BP™, a joint national initiative by the AMA and the American Heart Association, gives physician practices access to clinical tools and support to improve patients’ blood pressure control rates. The program offers annual, recurring recognition for all participating sites and for sites that have blood pressure control rates at 70% or higher for their adult patients. Last year, nearly 800 organizations were recognized for blood pressure control efforts.

The AMA Prevent Diabetes website offers physicians a comprehensive assessment and guided process to help organizations implement a diabetes prevention strategy, including a diabetes prevention toolkit to aid different members of the practice and access to an evidence-based diabetes prevention lifestyle change program.

Related Coverage

1 big reason for racial gap in hypertension: the Southern diet

Authors warn about fruit juices

The cohort study, “Association of Sugary Beverage Consumption With Mortality Risk in U.S. Adults,” included data from 13,440 black and white adults 45 years or older who did not have known coronary heart disease, stroke or diabetes at the baseline of an earlier study, Reasons for Geographic and Racial Difference in Stroke (REGARDS).

Researchers from Emory University, the University of Alabama, Birmingham, and Cornell University performed a secondary analysis of data the REGARDS study collected while following participants for an average of six years. While earlier studies have shown that added sugar intake from food and beverages increased the risk of cardiovascular mortality among U.S. adults, JAMA Network Open study provides evidence that fruit juices alone appear to elevate mortality risks.

“Given the prominent role that sugary beverages play in the U.S. diet, these results provide support for public heath efforts to reduce consumption,” the study’s authors wrote. “Importantly, while an increasing number of program and policy initiatives have focused on reducing the consumption of SSBs [sugar-sweetened beverages] our results suggest that these efforts should be extended to include fruit juices.”

Why a concern about fruit juices?

Fruit juices often contain as much sugar and as many calories as sugar-sweetened beverages. There are already efforts afoot to discourage people from consuming too many SSBs, including taxes and restrictions on marketing to children.

And while the sugar in fruit juices are 100% naturally occurring and there are some vitamins and phytonutrients not present in most sugar-sweetened beverages, once the body metabolizes the sugar, the biological response is essentially the same as it is to added sugar, Mara Guasch-Ferre and Frank B. Hu, MD, PhD, wrote in an invited commentary accompanying the study.

The evidence from the mortality outcomes is only suggestive, the commentary says, but it brings attention to potential adverse effects of SSB versus fruit-juice consumption on health, and the commentary authors wrote that “further research is needed to examine the health risks and potential benefits of specific fruit juices.”

The authors noted that evidence for an association between consuming fruit juices and health outcomes is less abundant and consistent than those linking sugar-sweetened drinks with health outcomes. Previous studies show that moderate consumption of 100% fruit juices—seven or fewer five-ounce glasses per week—is associated with lower risk of cardiovascular disease, stroke and cognitive decline.

The commentary concludes that “although fruit juices may not be as deleterious as SSBs, their consumption should be moderated in children and adults, especially for individuals who wish to control their body weight.”