371,000-Adult Survey Finds Link Between Lower Whole-Fruit Intake and Heart Disease

People with cardiovascular disease (CVD) or major CVD risk factors reported eating whole fruit less often than those without these conditions, according to a US study published in Current Developments in Nutrition.

Researchers analysed data from 371,038 adults who participated in the 2019 Behavioral Risk Factor Surveillance System. The analysis examined how often people consumed whole fruit and 100% fruit juice and compared those with and without high blood pressure, high cholesterol, heart attack, coronary heart disease or stroke.

Overall, participants reported eating whole fruit about 1.06 times per day, while fruit juice was consumed about 0.3 times per day. These figures describe how often the foods were consumed, not the amount eaten.

After adjusting for age, race or ethnicity, education, smoking and income, whole-fruit consumption was less frequent among people who reported high blood pressure, high cholesterol, coronary heart disease or a previous heart attack.

The initial difference in whole-fruit consumption between people with and without stroke did not remain significant after adjustment.

The findings for fruit juice were less consistent. After adjustment, people with high cholesterol reported drinking fruit juice less frequently, while those who had experienced a heart attack reported drinking it more frequently. No significant differences remained for high blood pressure, stroke or coronary heart disease.

The study does not show that eating less whole fruit causes cardiovascular disease. Because the research was cross-sectional, researchers could not determine whether dietary habits came before or after a diagnosis. People may also have changed their diets after developing a health condition.

The researchers noted that the study measured consumption frequency rather than portion size and did not account for factors such as physical activity, body mass index, vegetable and whole-grain intake. The findings highlight differences in fruit-eating patterns among people with cardiovascular risk factors, while further research is needed to understand the relationship.

REFERENCE: Kesler BJ, Hess JM, Bodensteiner A, Palmer DG, Tande D (2026). Examining the Differences in Frequency of Whole Fruit or 100% Fruit Juice Intake among United States Adults With and Without Cardiovascular Disease Risk Factors: Analysis of 2019 Behavioral Risk Factor Surveillance System Data. Current Developments in Nutrition, 10(9). DOI: 10.1016/j.cdnut.2026.109517