FDOC Statement on BMJ Study

July 12, 2019

On July 10, a new study, “Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort,” was published in The BMJ, a weekly peer-reviewed medical journal, originally called the British Medical Journal. 

The study suggests a possible association between higher consumption of sugary drinks and an increased risk of cancer. Researchers based in France assessed the associations between the consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices), artificially sweetened (diet) beverages, and risk of overall cancer, as well as breast, prostate and bowel (colorectal) cancers.

However, with this study, further research and testing is needed to understand these outcomes as many U.S. cohort studies have shown no correlation between 100% juice consumption and cancer, and in fact indicate positive outcomes on diet and health markers. Observational studies cannot establish that the identified associations represent cause-and-effect. A more comprehensive analysis of an individual’s lifestyle and eating patterns would need to be performed to better understand the cause-and-effect relationship. Additionally, the study followed the participants for an average of 5.1 years to draw these conclusions, which is far too short of a time period to accurately assess the correlation of cancer risk. Further, much of the data gathered was through participants’ self-reporting which can introduce errors.

Of the participant population, 79% were women, which is not representative of the global population. Additionally, participants were French, a population with different eating patterns than what is typical in the U.S.

Last, sugar’s negative effects on obesity, visceral adiposity, and glycemic load (with no delineation between naturally-occurring sugars, like those found in 100% fruit juices, and added sugars) are discussed as potential mechanisms that led to this study’s findings. However, additional studies report that children or adults who consume 100% orange juice are no more likely to be overweight, obese, or show signs of adiposity compared to those who do not consume orange juice.1,2,3  Furthermore, 100% orange juice scores in the “low” category of glycemic index and contains a flavonoid called hesperidin, which may help slow the absorption of sugar throughout the body.4

The Florida Department of Citrus consistently communicates a message of moderation. 100% orange juice never contains added sugar and serves as a nutrient-rich tool to be used as part of a healthy diet in moderation.

100% orange juice is the most nutrient dense of commonly consumed 100% fruit juices and has fewer calories. Many studies in both adults and children report that 100% orange juice consumption is associated with higher diet quality and increased levels of key nutrients.5,6,1,3

FDOC supports the U.S. 2015-2020 Dietary Guidelines for Americans which recognize that 100% fruit juice, along with water and low/fat-free milk, should be the primary beverages of choice to maintain a healthy diet.7 At a time when many Americans are not meeting recommended fruit and vegetable intakes, 100% orange juice can be a tasty and convenient way to meet daily fruit needs and to address under-consumed nutrients, like potassium, for both children and adults. An 8-ounce glass of 100% orange juice boasts an impressive 116% of your daily recommended vitamin C intake, 15% of your daily folate and 10% of your potassium. In fact, adult 100% orange juice drinkers were shown to have lower BMI, smaller waist circumference, and lower body fat compared to those who don’t drink orange juice.8

For more information and additional research, please visit www.FloridaJuice.com


  1. O’Neil CE et al. Nutr Res. 2011;31:673-682.
  2. Evidence Analysis Library (EAL), Academy of Nutrition and Dietetics. Dietary and Metabolic Impact of Fruit Juice Consumption Evidence Analysis Project.
  3. O’Neil CE et al. Nutr J. 2012;11:107.
  4. Kerimi, A., Gauer, J., Crabbe, S., Cheah, J., Lau, J., Walsh, R., . . . Williamson, G. (n.d.). Effect of the flavonoid hesperidin on glucose and fructose transport, sucrase activity and glycaemic response to orange juice in a cross-over trial on healthy volunteers. British Journal of Nutrition, 1-27. doi:10.1017/S0007114519000084. https://www.ncbi.nlm.nih.gov/pubmed/30670104?dopt=Abstract
  5. Yang et al. J Nutr Educ Behav. 2013;45(4):340-348.
  6. Lee et al. J Med Food. 2014;17(10):1142-1150.
  7. USDA/DHHS. 2015-2020 Dietary Guidelines for Americans. http://health.gov/dietaryguidelines/2015/guidelines
  8. Wang et al. Impact of orange juice consumption on macronutrient and energy intakes and body composition in the US population. Public Health Nutr. 2012;15(12):2220-2227.