Fruit Juice Has Long Counted as a Serving of Fruit, But a Study Found Only One Form Tracked With a Healthier Heart

Man slicing orange with fresh apple and banana arranged on cutting board, preparing nutritious fruit for healthy eating and homemade meal. (Somsri Luangsod via Getty Images)For years, a glass of 100 percent orange juice has been treated as a reasonable stand-in for an orange. It counts toward the daily fruit target, it carries the same vitamins on the label, and for many people it is the easiest fruit they eat all day.

The latest Dietary Guidelines for Americans, covering 2025 to 2030, kept the recommended amount of fruit the same but added a quieter shift: prioritize whole fruit over juice where possible. A study published in Current Developments in Nutrition helps explain why.

Researchers led by a team at the University of North Dakota analyzed the dietary habits and health conditions of 371,000 adults. They looked separately at how often participants ate whole fruit and how often they drank 100 percent fruit juice, then compared that with four cardiovascular conditions.

After adjusting for age, income, education, and smoking, eating whole fruit less often was linked to higher rates of high blood pressure, high cholesterol, coronary heart disease, and heart attacks.

Juice did not show the same pattern. The only statistically meaningful results were two isolated associations that pointed in opposite directions: slightly more frequent juice drinking with heart attacks, and slightly less frequent juice drinking with high cholesterol. Neither added up to a consistent relationship.

On average, participants ate whole fruit about 1.06 times per day and drank juice about 0.3 times per day, roughly once every three days.

The researchers offered two likely explanations, though neither was tested directly in this study.

The first is fiber. Juicing removes most of the fiber in fruit, and fiber slows how quickly the natural sugar in fruit reaches the bloodstream, which may soften spikes in blood sugar and insulin. Whole fruit also takes longer to eat and is more filling than the same amount of fruit as a drink.

The second is polyphenols, plant compounds with antioxidant and anti-inflammatory activity. The mix of these compounds differs between whole fruit and juice, and a growing body of research suggests the whole-fruit forms may be more beneficial.

The federal recommendation is about two cups of fruit a day for a 2,000-calorie diet. An estimated 8 in 10 Americans fall short, many eating less than half that amount. For people who rely on juice to close the gap, this study suggests the swap may not deliver the same heart benefits.

This study captured diet and health at one point in time, so it cannot show that whole fruit prevents heart disease or that juice fails to. The link may also partly run in reverse: people already diagnosed with a heart condition may change how they eat fruit, and the researchers called for further work on exactly that question. Diet was based on how often people reported eating fruit, not on precise amounts.

The authors did not conclude that juice is harmful. Earlier studies have suggested 100 percent juice may have some heart benefits, and those findings still stand. The point is that whole fruit appears to be the better choice.

People with diabetes, or who have been told to watch their blood sugar, should talk to their doctor about how fruit and juice fit into their diet.

In a study of 371,000 adults, eating whole fruit was consistently linked to better heart health, while 100 percent juice showed no clear pattern either way. For anyone trying to eat more fruit, reaching for the fruit itself rather than the glass is the simplest way to get the most from it.

Study reference: University of North Dakota researchers. Current Developments in Nutrition, 2026. DOI: 10.1016/j.cdnut.2026.109517