If you reach for orange juice each morning as an easy way to get your daily recommended amount of fruit, you could be doing your body a huge disservice. I’ve definitely wondered if fruit juice is bad for you, but I always figured it couldn’t be that bad. I mean, the main ingredient is fruit, right? Turns out, nothing may beat water when you’re looking to quench your morning thirst — even if your beverage promises the equivalence of two servings of fruit right on the label. 

Researchers from the Nutritional Epidemiology Research Team of the National Health and Medical Research Institute at the Paris 13 University published their findings in the medical journal, BMJ, on July 10, 2019. The study followed 101,257 participants, with an average age of 42 (all over 18) over the course of up to nine years. The study aimed to specifically look at the risk of sugary drinks, like fruit juice and soda, and cancer, since previous studies have already demonstrated the link between sugary drinks and obesity, heart attack, and other cardiovascular health issues.

The results throw into question the notion that even 100 percent fruit juices are good for you. Mathilde Touvier, the lead author of the study, said sugar was the leading factor associated with cancer risk. She and her team found that consuming a little over 3 ounces of a fruit juice or soda once per day was associated with a 22 percent increased risk of breast cancer and an 18 percent increased risk of overall cancer. The study participants were 79 percent women and 21 percent men.

Although sugar was cited as the main cause of association between sugary drinks and cancer, researchers noted that additives like 4-methylimidazole could also play a role in cancer risk. This is most commonly found in caramel coloring, which is present in sodas, but the additive can also be found in fruit juice. The study also pointed out that “fruit juice antioxidants might interact with tobacco smoke to potentialise carcinogenesis,” a term for the ability to cause cancer. This means that there could potentially be a reaction between ingredients in sugar-sweetened beverages and other cancer-causing substances which, when mixed together, may increase or decrease you risk of getting cancer. However, this study did not specifically look into this.

In this study, artificially sweetened drinks weren’t found to have an association cancer risk, but Touvier points out that consumption was lower, so the results may not be statistically significant. Men in the study consumed an average of 3 ounces of sugary drinks per day, while women consumed around 2.5 ounces. Of course this study is not the definitive answer on sugary drinks and cancer, but the findings provide interesting context to something that’s widely regarded as “healthy” for everyday consumption.

If you’re looking for a healthy swap for your morning OJ, Dr. Oz suggests reaching for lemon water in the morning to improve skin quality, support digestion, and more. Or, use soda water to create his double berry spritzer recipe, which serves as a healthy swap for sugary sodas.

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