October 5, 2026, 7:47 am | Read time: 4 minutes
Whether you slice fruit into your cereal or drink a glass of juice apparently makes a difference for the heart. A large U.S. study shows that adults with high blood pressure, elevated cholesterol, or existing heart conditions are less likely to eat whole fruits. FITBOOK nutrition expert Sophie Brünke took a closer look at the study.
Fruit Offers More Than Just Vitamins
Fruit is a cornerstone of a healthy diet. It provides vitamins, minerals, fiber, and numerous secondary plant compounds. Yet, a large portion of the population does not meet the recommended amounts. Additionally, U.S. dietary guidelines long failed to distinguish between fruit and juice. Only since an update in early 2026 do they recommend prioritizing fresh fruit over juice.1 In Germany, it has long been recommended to drink only two glasses of juice per week alongside the “5 a day” (two servings of fruit, three of vegetables)–and even that is optional.2 This is because juicing results in the loss of large amounts of fiber and also alters the composition of certain bioactive plant compounds.
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Do Juice Drinkers Have More Heart Problems?
The study authors wanted to investigate whether the frequency of consuming whole fruits and 100% fruit juice differs between adults with and without cardiovascular diseases or their risk factors. The researchers analyzed data from 371,038 adults in the U.S. based on a 2019 telephone health survey. Participants reported how often they consumed whole fruits and 100% fruit juice. They also answered whether they had ever been diagnosed with any of the following conditions, which are risk factors for cardiovascular diseases:
- High blood pressure
- High cholesterol
- Heart attack
- Angina pectoris or coronary heart disease
- Stroke
On average, respondents ate whole fruits about 1.06 times daily and drank fruit juice about 0.30 times daily. Participants only reported how often they consumed fruit and juice, not the quantities.
For the statistical analysis, the researchers considered various factors such as age, education level, income, and smoking habits. This was to determine whether potential differences in fruit or juice consumption persisted after accounting for these factors.
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Does the Heart Prefer Whole Fruit?
The analysis showed that people with cardiovascular diseases or their risk factors ate whole fruits less frequently than those without these conditions. For example, individuals with high blood pressure ate whole fruits an average of 1.01 times daily, while those without high blood pressure ate them 1.09 times daily. This relationship remained even after considering age, income, education, and smoking habits. Only for stroke did the statistical relationship disappear after this adjustment.
For fruit juice, however, the picture was less clear. Initial analyses showed that people with heart conditions drank fruit juice slightly more often than those without. After accounting for additional factors (age, income, etc.), only two relationships remained: people with elevated cholesterol drank fruit juice slightly less often, while those who had a heart attack consumed it slightly more frequently.
Strengths and Weaknesses of the Study
With more than 371,000 people evaluated, the study is very large. The researchers also considered several social and health factors. However, its significance remains limited. It is a cross-sectional study that captured diet and health status at only one point in time. All information was based on the participants’ recollection. Additionally, portion sizes and specific types of fruit and juice were not recorded. Factors such as exercise, weight, vegetable consumption, and overall diet were also not fully included in the calculations.
Moreover, the direction of the relationship could be reversed: people may change their diet after a diagnosis. Therefore, the study does not allow conclusions about whether a specific fruit or juice consumption prevents or causes cardiovascular diseases.