Is fruit juice really healthy? Why some say Coca-Cola might be a better choice
Fruit juice, once a simple way to get more nutrients into your day, has now joined the ever-growing list of foods to avoid.
Tim Spector, renowned epidemiologist and founder of the Zoe app, recently remarked “It’s pretty obvious Coca-Cola is a naughty treat. Nothing says it’s great for you and your teeth. Whereas orange juice is ultra-processed food, sold as a health food. It really should come with a health warning.”
Here we review the evidence on fruit juice: is it better left off the table?
Recent research suggests that 100% juice can offer real health benefits, particularly for heart health and inflammation. And contrary to popular belief, pasteurisation may not destroy its nutrients—in fact, it could even enhance them. So, if you enjoy a glass of juice with breakfast, rest assured that, in moderation, it can be part of a balanced diet.
If you’ve been skipping fruit juice thinking it’s all sugar and no benefits, you might want to read on.
Fruit juice matters in the context of your whole diet, there is no one-size-fits all answer, just like many things in nutrition.
A quick search for health information about fruit juice reveals no shortage of claims comparing it to eating 12 doughnuts, labelling it as bad for your health, or that pasteurisation destroys the vitamins. The latter has lead to the rise of unpasteurised “raw” juice, which is marketed as having a superior nutrient profile. Some raw juice companies perpetuate this belief with their own claims, for example, that heat used in pasteurisation destroys vitamins.
What does the science say about fruit juice?
A recent study published in the journal Nutrition Reviews suggests that 100% fruit juice can benefit markers of heart health and inflammation, with a neutral impact on several other health conditions. However, the researchers did find slightly unfavourable associations between 100% fruit juice and type 2 diabetes, prostate cancer, and heart disease mortality. Importantly, researchers noted that the effects of these conditions were very small, and more research is needed to fully understand heart health outcomes.
The data comes from an umbrella review that combines randomised clinical trials, which test subjects in controlled environments, with cohort studies that observe effects on large populations in real-life settings. This high-quality evidence gives us a clearer understanding of how foods like fruit juice impact health, though more research is still needed to fully clarify some of the findings.
In a recent LinkedIn post, Dr Flávia Fayet-Moore, PhD, pointed out, “The general rhetoric around 100% juice is that it’s not good for your health because it’s high in sugars and you’re eating 5 oranges. This is actually not correct. A 250ml glass of 100% orange juice has the same calories and sugars as 1.15 oranges, and now the evidence to have it for a benefit challenges this thinking and flawed statistic.” She added, “Plus, the vitamin C in my orange juice also helps me absorb the plant iron in my beans and lentil dishes! Win-win.” She added.
“I have patients on several medications and supplements, such as an iron supplement, where as dietitians, we are recommending to take with orange juice or another juice that provides vitamin C to help increase the absorption.”
Similar results have been found in previous studies. For instance, a 2022 review published in Nutrients, found that apple juice consumed in moderation can have a positive effect on markers of heart health and may be beneficial for chronic diseases, such as cancer.
Take a look at your overall diet. Are you consuming many forms of added sugars? I find this most often sneaks in with fancy coffee orders, regular soda or soft drink consumption, snacking on candy at the work desk, or adding lots of sweet sauces and condiments to foods. If your added sugar consumption is high (more than 40-50g per day), then my first focus would be on reducing this.
Next, ask if you are able to get 1.5 - 2 cups of whole fruits in your day. If this is difficult for you, juices may be able to help get those nutrients missing in your diet.
Also, where are you getting fibre from? We want to aim for 25 - 35 g of fibre per day. Most adults are not meeting this. Whole fruits and vegetables are a great way to add some fibre, juice, as we mentioned, is not, unfortunately.
What about pasteurisation?
It’s commonly believed that pasteurisation destroys juice’s nutritional value, but recent evidence suggests that’s not always the case. Pasteurizing juice involves heating it to a specific temperature to kill harmful bacteria and extend shelf life while preserving its flavor and nutrients. While unpasteurized juice carries a small risk of contamination from bacteria like E. coli and salmonella, pasteurised juice can still retain or even increase certain vitamins.
A pilot study published in Food Chemistry found a significant increase in ascorbic acid (vitamin C) content after conventional thermal processing. The researchers compared conventional thermal treatment (TT) with newer pasteurisation methods like high-pressure processing (HP), pulsed electric field (PEF), and ohmic heating (OH).
Their findings showed that TT and HP treatments retained the highest levels of B vitamins in strawberry juice, while OH resulted in the lowest retention. For example, riboflavin (vitamin B2) decreased by 34% after OH treatment, but B1 and B5 were not affected, and B1 increased by 18.1% after HP treatment. Vitamin C content also surged dramatically, increasing 15-fold after TT and 9-fold after OH. The researchers believe this could be due to heat-induced cell rupture, which releases more vitamin C into the juice.
While not all pasteurized juices will show such increases in nutrients, this research helps dispel the myth that pasteurised juices lack nutritional value.
What does this mean for your health?
If you’re not a big fruit eater or find it hard to get your children to eat fruit, this recent evidence suggests that 100% juice can be a good source of nutrition. For those on a plant-based diet, the vitamin C in juice can help boost the absorption of non-heme iron from plant sources, which is typically less bioavailable than iron from animal products. While you can add vitamin C to meals by including citrus fruits or lemon juice, a small glass of orange juice can also do the trick.
So, fruit juice may not be as bad for you as some claim.
Of course, juice lacks the fibre and fullness that whole fruits provide, which can help with satiety. Drinking juice might also make it easier to consume more calories without realising it.
For people who really enjoy juice, I recommend, as with all things, moderation. We don't necessarily want juice to be our main source of fluids throughout the day. Drinking a big, 16 oz glass of juice with each meal is going to total about 660 calories and not really be very filling. On the other hand, breakfast with a 12oz glass of OJ, a bowl of oatmeal topped with berries, 1 cup of milk, and 1/4 cup sliced almonds will total about the same 660 calories but keep me much fuller for a long period of time and provide a diverse amount of micronutrients and fibre.
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