The connection between fruit juice and heart attacks?

Dear Dr. Mirkin:

How does drinking fruit juice increase risk for heart attacks?

Answer: The CARDIA study shows that all sugared drinks, including fruit juices, raise total cholesterol, the bad LDL cholesterol, triglycerides, and blood pressure (American Journal of Clinical Nutrition, August 13, 2010). People who drink fruit juice also have much larger waist circumferences. Abdominal obesity means that a person has high insulin levels and is at markedly increased risk for heart attacks and diabetes.

Taking sugar in drinks when you are not exercising increases risk for heart attacks, diabetes and premature death. Before food can pass from the stomach into the intestines, it must be converted to a liquid soup. No solid food passes into the intestines. When solid food enters your stomach, the pyloric sphincter at the end of the stomach closes and the stomach continuously squeezes the food until it is turned into a liquid soup. This can take up to four hours, which markedly delays the rise in blood sugar. Since fruit juice is already a liquid, it passes immediately into the bloodstream to cause a high rise in blood sugar.


Here’s how high rises in blood sugar cause heart disease: When blood sugar levels rise too high: 

  • your pancreas releases huge amounts of insulin which converts sugar to triglycerides (high triglycerides), which clog up your bloodstream to increase risk for clots, so you use up huge amounts of your good HDL cholesterol (low HDL cholesterol) in carrying triglycerides and your bad LDL cholesterol from your bloodstream into your liver.
  • low HDL (good) cholesterol causes heart attacks because HDL is not available to carry cholesterol and triglycerides from your bloodstream.
  • high insulin levels constrict arteries to cause heart attacks.
  • high blood sugar levels cause sugar to stick to the surface membranes of cells to destroy them and cause all the horrible side effects of diabetes.
  • high triglycerides in your liver cause a fatty liver that can lead to diabetes.
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Dr. Gabe Mirkin

A practicing physician for more than 40 years and a radio talk show host for 25, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is one of a very few doctors board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology.

Dr. Mirkin's latest book is The Healthy Heart Miracle, published by HarperCollins. His daily short features on fitness have been heard on CBS Radio News stations since the 1970's.

He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. Dr. Mirkin did his residency at the Massachusetts General Hospital and over the years he has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine.


Please let us know what you think about this article. All comments will be moderated before being posted publicly.


  1. says

    It may be true, but I don’t agree. I used to drink TONS of OJ, etc… it cuts the blood of impurities etc…but when I ate tons of ICE CREAM THAT WAS A DIFFERENT STORY!!!! Triglycerides went through the ROOF!!!!
    In fruit juice, you still have the biological structure of things. In processed sugars in ICE CREAM you don’t. I would bet it is the OTHER THINGS you are eating, and not the fruit juices that are the real culprits! Like Ubiquinol, CoQ10 deficiency, high bad carb diet, etc…. Rather than that glass of OJ!!!!!!

  2. Anonymous says

    What a load of crap. Now fruit juices are unhealthy? Anything with sugar has become the whipping boy and bugabboo.
    May I remind readers that the brain runs exclusively on sugar, all foods must be broken down to sugar to be used as fuel by the body, photosynthesis takes water, sunlight and carbon-dioxide in the atmosphere to make …sugar, for growing plants. Sugar is the precursor of life, and the one fuel that burns the cleanest, leaving no residue, unlike fats, carbs and proteins that leave grease, phlegm and pus.

    The whole diabetes and cancer link to sugar is a food supply deficient in MINERALS, due to selective fertilization of but 4 elements– N, P, K & lime. Plants need more than these to be healthy, and so do people. The cancer connection is fungus and anerobiasis (fermentation in the absence of oxygen.) Cancer eats people away, but they generally die of suffocation/ asphyxia, and sugar is blamed. As for diabetes, the deficiency is chromium and vanadium. Farmers know this, and is why they supplement their animals to prevent these perfectly curable (or at least preventable) diseases. (The other causative factor is parasites, which they also treat preventively.)

    When will scientific simpletons stop adding their 2 cents?
    I just had a drink of fruit juice for dinner and it does me well.

  3. Anonymous says

    Dear Dr. Mirkin,
    You are right, but all what people are supposed to know and do is to remeber that:Free Radicals (ROS/RNS) are created during the metabolic process and cause Oxidative Stress (OS) main cause of metabolic syndrome (MTS).OS is the enemy of all living things.
    Soft Drinks (SFD)are the largest single cause and source of metabolic syndrome (MTS).The cause for the increasing prevalence of obesity among young/adults is sugar-sweetened sodas (SFD). Men and women who increase their sugar-sweetened SFD consumption also increase their MTS risk. In essence, just like with smoking, if you consume sugar-sweetened soft drinks, you increase your risk of several diseases, including diabetes, obesity, and cardiovascular disease.Fruit punches and fruit juices, much like sugar sweetened soft drinks, increase MTS risk.
    Tell everyone you care about!Eliminating soft drinks
    and following lifestyle medicine ( LM) may be the only single way to curb the MTS epidemic!


  4. Anonymous says

    I agree that everything that is not natural represents a risk factor, but nature has a way of giving beneficial solutions for our systems, take an avocado a few years back this was taboo, now we know different, calcium could be dangerous but nature provides the solution, some legumes, they will give us calcium along with magnesium to balance the proportions, I do not think natural squeezed juices represents any problems, but the fake ones do and this is where the problems arises let us think natural and we all be OK but remember overdoing it is something else. JAM

  5. Anonymous says

    While the doctor is right in general terms, he misses the distinction between 100%, no sugar added fruit juice (not fruit cocktails or punches) and other sugared drinks.

    The main point is that real fruit juices contain chemicals to offset the effect of the sugar, plus beneficial minerals needed for health. For example, pure blueberry juice, while quite sweet, contains pterostilbene, an anti-diabetic and cholesterol lowering agent. Grape juice contains reveratrol, orange juice with pulp contains fiber, and so on.

    Berries and their isolated active compounds have been shown to exhibit potentially beneficial effects in diabetes[footnote 27], memory enhancement[footnote 28], neurodegenerative diseases of aging[footnote 29], radiation protection[footnote 30], and as an anti-influenza agent.

    27. Chambers, B.K. and M.E. Camire. 2003. Diabetes Care. 26:2695-2696.
    28. Andres-Lacueva, C. et al., 2005. Nutr. Neurosci. 8:111-120.
    29. Neto, C.C. 2007. Mol. Nutr. Food Res. 51:652-664.
    30. Rabin, B.M. et al., 2005. Gravit.Space Biol. Bull. 18:71-77.

  6. says

    As with all scientific studies, you have to ready carefully between the lines.

    “all sugared drinks, including fruit juices…”

    I drink a couple glasses of juice a day – and I’m a size 2. Just make sure your juice is not full of added sugar or corn syrup.

    Use some common sense and you’ll be fine.

  7. Anonymous says

    Sugar really IS sugar, just like the corn-syrup association says, the body can’t distinguish real fruit sugar from high-fructose corn syrup. Let’s thank God that a human being figured out how to do this process economically, as nature does during photosynthesis. Observe how bees make honey (mostly sugar) to tide them over the winter, how ants attack a melting popsicle on a summer day. That’s all the information you need to know that nature values sugar as fuel, the FIRST molecule created during photosynthesis! If people are having heart attacks from drinking fruit juice (next it will be eating fruit is unsafe)…who does the above doctor shill for! …or is he simply outside his field of study! People who can’t handle sugar have mineral deficiencies. I make my soft-drinks healthy by adding herbs :O

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