High fructose corn syrup, apple juice and childhood asthma risk
What it found
In toddlers followed from about 12 to 30 months, drinking more 100% juice, soda, sports drinks or fruit drinks was linked to higher asthma risk.
The study was in children.
What they found
Studies in people
Juice and asthma
Children who drank 100% juice 3 to 7 times a week had about 1.5 times higher asthma risk than those who rarely drank it. Those who drank it more than once a day had about 2 times higher risk.
Soda and asthma
Children who drank soda, sports or fruit drinks 3 to 7 times a week had about 2 times higher asthma risk than those who rarely drank them. Those who drank them more than once a day had about 3 times higher risk.
Combined drinks
When 100% juice and soda, sports or fruit drinks were combined, higher intake was linked to higher asthma risk. Risk rose from 95% higher at 4 to 7 times a week to 259% higher at more than 2 times a day, compared with those who rarely drank them.
Asthma cases over time
The number of new asthma cases per 1000 children per year more than doubled with increasing 100% juice intake, and nearly tripled with increasing soda, sports or fruit drink intake.
Fast food
Fast food consumption was not linked to asthma risk in any of the analysis models.
Fructose malabsorption
In a 1995 study of 6 and 18 month old children, fructose malabsorption happened more often after apple juice (54%) than after grape juice (19%). Children were given juice amounts to equate to 1 g fructose per kg body weight.
What the authors conclude
“The 100% juice/soda/sports/fruit drinks/asthma link in toddlers appears to be with the excess-free-fructose in apple juice/HFCS.”
Also in their conclusions
- They say it is reasonable to suggest that the two-fold higher asthma risk linked to 100% juice is due to apple juice's high fructose-to-glucose ratio, and that the higher risk linked to soda, sports and fruit drinks is due to the excess-free-fructose in HFCS.
- They advise that recommendations to limit consumption are inadequate, because links were seen even at moderate intakes and the results do not include the added risk from HFCS, crystalline fructose or agave syrup in food.
- They warn that without adequate labels and warnings, these sweeteners will continue to be a public health hazard.
How it was done
The authors note that childhood asthma doubled from 1980 to 1995 and then plateaued, and that this pattern may be linked to the spread of high fructose corn syrup in the US food supply. They wanted to test whether excess-free-fructose intake is associated with asthma risk using data that follows children over time.
They analysed possible early childhood data from the National Children's Study, looking at children from about 12 to 30 months of age. Parents reported how often their child consumed 100% juice and soda, sports or fruit drinks. Asthma was defined as a doctor diagnosis reported at the 18 and 24 month exams.
What it can’t tell you
- This study followed children over time and found a link, but it cannot prove that these drinks cause asthma.
- The study only looked at drinks, not food sources of high fructose corn syrup, so it could not measure the full risk from excess-free-fructose in food.
- The data came from a group that is not nationally representative, so the results may not apply to all children.
Who paid
- Conflicts
- Authors declare no conflicts of interest.
- Authors work at
- NY Medical College, USA; University of Massachusetts Lowell, USA
The paper
- Title
- Excess free fructose, apple juice, high fructose corn syrup and childhood asthma risk - the National Children's Study
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- DeChristopher LR, Tucker KL (2020). Excess free fructose, apple juice, high fructose corn syrup and childhood asthma risk - the National Children's Study. Nutrition journal. doi:10.1186/s12937-020-00578-0Free full textPubMed 32576181DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error