Cardiovascular Health

Detailed Nutrition Information

Vitamins and minerals found in 100% orange juice may play a role in heart health: Vitamin C has been shown to reduce monocyte adhesion to vascular tissue, improve nitric oxide production and vasodilation, and reduce vascular smooth muscle cell death, factors which support cardiovascular health ¹⁰. Orange juice is an excellent source of vitamin C providing more than 100% of the recommended Daily Value (DV) in an 8-ounce glass.* Potassium is an electrolyte that helps maintain fluid balance which affects blood pressure. It is also needed for heart function and nerve transmission. Diets containing foods that are a good source of potassium and low in sodium may reduce the risk of high blood pressure and stroke¹². People suffering from kidney disease should consult their doctor on how much potassium is right for their diet. 100% orange juice provides 10% of the Daily Value of potassium in one 8-ounce serving.* Folate and Vitamin B6 Regulate Homocysteine – While research has not shown definitive results, some studies show folate and vitamin B6 may help protect against heart disease by lowering homocysteine levels in the blood,¹² an amino acid believed to cause damage to the arteries and increase the risk of blood clots when elevated. One 8-ounce glass of orange juice contains 15% Daily Value of folate and 8% Daily Value of vitamin B6.*

Citrus and 100% Orange Juice May Help Support a Healthy Heart

Epidemiological data suggest consuming fruits and vegetables, including citrus and citrus juices, may be beneficial to the cardiovascular system as they have been associated with reduced risks of cardiovascular disease and stroke.^13-18 A recent meta-analysis found 100% citrus juice consumption related to a lower risk of cardiovascular disease and ischemic stroke.³³ Many heart benefits may be partially attributable to plant compounds such as flavonoids. In several prospective cohort studies, higher intakes of the flavonoids found in citrus, hesperidin and/or naringenin, were associated with:

• 52% reduction in cardiovascular events⁸
• 41% reduction in all-cause mortality¹⁹
• A decreased CV risk score, and lower changes in CV risk score over time in older men (45-64 years)¹⁹
• 22% decreased risk of ischemic stroke in men²⁰
• 19% decreased risk of ischemic stroke in women²¹
• 22% lower risk of coronary heart disease in post-menopausal women²²

A narrative systematic review revealed that compared to lower intakes, higher intakes of hesperidin delivered by 100% orange juice were reported to be associated with better health outcomes, including some related to cardiovascular issues such as blood lipids and blood pressure, as well as oxidative stress and inflammatory markers.³⁹ The strongest associations appeared to be for antioxidant and phenolic biomarkers, suggesting that hesperidin and orange juice were effective at increasing the intake or levels of nutrients in the body or having beneficial effects on specific markers of diseases or conditions.

Blood Lipids

Based on NHANES 2003-2006 data, children and adolescents who were orange juice consumers had significantly lower serum LDL concentrations compared to non-consumers.²³ Observational studies also report associations between adults who consume orange juice and significantly lower total and LDL cholesterol levels, with males having a 23 percent reduced risk for having low HDL concentrations, compared to non-consumers.²⁴ Several clinical studies report significant decreases in total cholesterol and LDL cholesterol in adults who consumed orange juice.^1-5 Significant increases in HDL have also been reported,^1,8 including in participants who were hyperlipidemic.⁸ Notably, increases in HDL were observed in adults consuming 500mL of orange juice with a high-fat/carb meal compared to when the meal was consumed with water or a glucose drink.⁹ Most studies show no effect on triglycerides with orange juice consumption,^1-3,34 although reduced triglycerides in inactive men have been reported.⁴ A systematic review and meta-analysis of randomized clinical trials related to 100% orange juice and cardiovascular risk factors found that based on 15 clinical trials and a total of 639 study participants, 100% orange juice was associated with reducing total cholesterol in studies that were at least eight weeks in length.⁴⁰

Blood Pressure

In a randomized controlled trial, adults with clinically diagnosed stage 1 or pre-hypertension who consumed 500mL of orange juice daily for 12 weeks had significantly reduced systolic blood pressure (sBP; mean reduction of 6.35 mmHg) compared to a control drink matched for calories, vitamin C, and citric acid.³⁴ Greater changes in blood pressure (7.36 mmHg mean reduction) were seen with hesperidin-enriched OJ, containing almost twice the amount of hesperidin as regular orange juice, suggesting a dose-response effect with hesperidin. Consumption of hesperidin-rich OJ also reduced pulse pressure, a measure of arterial stiffness. Study participants who consumed either form of orange juice had significantly reduced blood homocysteine levels. Elevated homocysteine has been linked to increased risk for cardiovascular disease. Adults consuming 500mL of commercial orange juice daily for four weeks had significant decreases in sBP and diastolic blood pressure (dBP).⁶ As part of a hypocaloric diet, obese children (9 to 13 years old) consuming 250mL mandarin juice twice a day for four weeks had decreased sBP and dBP which was not observed in the control group on the same diet.²⁵ Other clinical studies report reduced dBP in inactive and overweight men who consumed orange juice.^4,7 Furthermore, a meta-analysis of randomized controlled trials concluded that fruit juice intake had a borderline significant effect on reducing dBP.²⁶

Endothelial Function and Inflammation

Research supports 100% orange juice and the plant compound hesperidin, found almost exclusively in citrus,²⁷ on reduced inflammation, improved blood flow, and other benefits of cardiovascular health. In a clinical trial of overweight older men (51 to 63 years old), the consumption of 500 mL of OJ or a hesperidin drink increased microvascular reactivity (skin blood flow) after six hours compared to the control. Interestingly, orange juice was more potent than hesperidin in acute measures of blood flow suggesting synergistic effects of the compound in orange juice.⁷ In a randomized controlled cross-over study in overweight adults, orange juice, high-flavanone orange juice, and homogenized whole orange attenuated the adverse effects of a high-fat meal on endothelial function (smaller reduction in blood flow) and sustained plasma nitrite levels (endogenous marker of nitric oxide production) compared to the control drink.²⁸ Hesperidin-enriched orange juice improved endothelial function in adults with pre- or stage 1 hypertension and also had beneficial effects on two inflammatory markers: high-sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in a randomized controlled trial.³⁷ These benefits were associated with measured changes in hesperidin-related metabolites linked to anti-inflammatory and anti-oxidant activity³⁸ as well as the down-regulation of proinflammatory genes.⁴¹ Orange juice intake had beneficial impacts on various markers of oxidative stress and inflammation,²⁹ and orange juice and hesperidin increased the expression of several genes associated with anti-inflammatory and antiatherogenic activities.³⁰ Notably, consumption of orange juice helped attenuate the inflammatory response of a high-fat meal.³¹ Furthermore, orange juice and red orange juice consumption decreased pro-coagulant activity of whole blood, thus lowering the ability for blood to clot, in healthy young adults.³²

100% Fruit Juice and Cardiovascular Health

Research supports either positive or no negative impacts of 100% fruit juice consumption on cardiovascular health markers. A systematic review and meta-analysis of prospective and randomized controlled studies found a dose-response relationship between 100% fruit juice consumption and cardiovascular outcomes, such that lower fruit juice consumption (up to 200 ml/day or up to 170 ml/day) was associated with a lower risk for stroke or total cardiovascular events, respectively, compared with no consumption.³⁵ Consumption above these amounts had no negative impacts on these cardiovascular outcomes. An analysis of randomized controlled trials revealed that 100% fruit juice was associated with a favorable and significant effect on blood pressure, endothelial function, and arterial stiffness/flexibility when compared to no consumption, with no impacts on lipid profile. A cohort modeling study found that substituting 100% fruit juice for sugar sweetened beverages resulted in a significant decreased risk for several cardiometabolic markers, including cardiovascular disease and coronary heart disease. Modeling a substitution of 100% juice for whole fruit did not result in adverse impacts on any cardiometabolic risk factor. These results suggest that although 100% fruit juice and sugar sweetened beverages have similar sugar content, they are not comparable with regard to cardiometabolic risk and that 100% fruit juice and fruit may be comparable regarding their impacts on cardiometabolic risk.^{36 *Values based on a 2000 calorie diet. FDA rounding rules applied when calculating percent DV based upon 2018 rules. Information is not intended for labeling food in packaged form. Nutrient values may vary based on brand or product types.}