Time to Focus on Healthier Drinks
Table of Contents
Introduction
It’s time to address America’s hidden drinking problem—the rivers of sugary soft drinks, juices, and other beverages we guzzle daily. Soft drink makers produce a staggering 10.4 billion gallons of sugary soda pop each year (), enough to serve every American a 12-ounce can every day, 365 days a year. They also make billions more gallons of sports drinks, fruit drinks, heavily sweetened iced tea, and other sugary drinks. On a typical day, four out of five U.S. children and two out of three U.S. adults drink sugar-sweetened beverages, gulping them down in astonishing amounts. (, ) Teen boys average more than a quart of sugary drinks a day. () Even adults trying to lose weight average more than two 12-ounce cans of sugary drinks a day. () Fruit juice doesn’t offer a better option, though it has more nutrients, because ounce for ounce it contains as much sugar and calories as soda pop.
Video: Watch Dr. Walter Willett discuss sugary drinks and health risks.
Do the math—each 12-ounce can of sugary drink or juice typically has 10 to 12 teaspoons of sugar, and 150 or more calories—and it’s no surprise that America’s rising thirst for sugar-water has paralleled the epidemic rise of obesity and type 2 diabetes. There is now strong evidence that sugary drinks have contributed mightily to the rapid growth of “diabesity”—women who have one or more servings of a sugary drink per day have nearly double the diabetes risk of women who rarely have sugary drinks, for example ()—and that curbing our taste for high-calorie sweetened drinks could help contain these epidemics and their disabling and deadly consequences. (-)
Read More: The relationship between sugary drinks and diabetes risk.
The latest research out of Harvard School of Public Health finds disturbing evidence of a link between sugary drink consumption and heart disease. The study, published in the April edition of the American Journal of Clinical Nutrition, followed the health of nearly 90,000 women over two decades. It found that women who drank more than 2 servings of sugary beverage each day had a nearly 40 percent higher risk of heart disease than women who rarely drank sugary beverages. () Having an otherwise healthy diet, or being at a healthy weight, only slightly diminished the risk associated with drinking sugary beverages. In addition to weight gain, the adverse effects of these beverages on blood sugar, blood cholesterol fractions, and inflammatory factors throughout the body are likely to contribute to the increase in heart disease. (For more in-depth background information on the research that links sugary drinks to obesity, diabetes, and heart disease, see The Nutrition Source article, )
The Need for Better Beverages
Better beverage choices can help fight and prevent obesity and diabetes. Water, of course, is the best beverage option. It delivers everything the body needs—pure H2O—with zero calories. But for some tastes, plain water is just too plain—and it may be unrealistic to ask everyone to kick the sugar-water habit overnight. We must instead work to retrain the American palate away from sweet drinks. Cutting our taste for sweetness will require concerted action on several levels—from creative food scientists and marketers in the beverage industry, as well as from individual consumers and families, schools and worksites, and state and federal government. Here are steps that each of these groups can take to address America’s hidden drinking problem:
Beverage manufacturers: Create beverages that have much less sugar.
Beverage manufacturers can make it easier for everyone to drink more healthfully by creating beverages that are simply less sweet. A good target: Beverages that have no more than 1 gram of sugar per ounce, and are free of non-caloric sweeteners (such as sucralose, aspartame, or stevia). This is about 70 percent less sugar than a typical soft drink, or about 3 teaspoons per 12 ounces. That’s sweet enough to please the palate but, at 50 calories per can, isn’t so hard on the waistline—as long as people drink these reduced-sugar beverages in moderation. Harvard School of Public Health conducted a of beverage offerings from the leading beverage manufacturers in the U.S., and there are only a few beverage options currently on the market that meet or come close to this 1 g/oz threshold and are free of non-caloric sweeteners. (Our guide to the calories and sugar in common beverages, , includes a few of the low sugar beverages we found.) The talented and creative food scientists in the beverage industry can certainly come up with more low-sugar options, and beverage marketers can turn their energies on promoting these drinks as a better alternative to the full-sugar drinks.
We also encourage beverage manufacturers to offer smaller single-serving (8 ounce) bottles of sugary drinks, and encourage their sales channels to stock these smaller-sized bottles. A 20-ounce bottle of sugary soft drink has nearly 17 teaspoons of sugar and 250 calories; some have even more calories and sugar than that. If you read the fine print on the Nutrition Facts label, you’ll see that a standard serving of soft drink is 8 ounces, and that each 20-ounce bottle has 2.5 servings. But how often do you see someone buying a 20-ounce bottle of soda to share with one or two friends—or saving half the bottle to drink another day?
Individuals: Make healthy drinking your personal priority.
Start by choosing beverages with few or no calories. Water is best. If you crave drinks with flavor, there’s plenty of ways to spice up water without adding sugar or calories: Brew a pot of coffee, make a pitcher of iced green tea, or create your own spa-style water, infused with cucumber, herbs, and citrus—check out The Nutrition Source article for suggestions. If you indulge in sugar-sweetened drinks, stay away from 20-ounce bottles, which can deliver nearly 17 teaspoons of sugar and 250 calories. Ask food companies to make sugar-reduced beverages, by calling their customer service numbers, or sending them a message on their Web site comment forms. Ask schools and workplaces to offer filtered water or functioning water fountains. And ask your local stores, schools, and workplaces to carry 8-ounce or 12-ounce containers of sugary drinks, to make it easier for you to choose a smaller serving.
Artificial sweeteners are an option for people who need to wean themselves off of the sugary stuff, similar to a nicotine patch for a smoker. If you do choose artificially sweetened beverages, those sweetened with aspartame are probably the best choice, since aspartame is made of two substances found naturally in food and has a good safety track record. It is wise to wean yourself off of artificial sweeteners, little by little, because of the unanswered questions about the relationship between diet drinks and obesity. (For more information, see a related article on The Nutrition Source, )
Food shoppers for the family: Cut back on sugary drinks in the home.
Nationwide data show that children and teens drink most of their sugary calories at home. So parents can help kids cut back by not stocking soda, fruit punch, and other sugary drinks in the house, and making them an occasional treat rather than a daily beverage. Keep a pitcher of water with ice and lemon slices in the fridge, so there’s always a refreshing, healthy beverage ready to drink. Some people may enjoy a small glass of 100% fruit juice as a great way to start the day. After that, juice is just another high-calorie way to get water. Limit the amount of juice you buy, and skip the “fruit drinks,” which are basically flavored sugar water.
Schools and workplaces: Offer students and workers several healthy beverage choices.
Healthy choices for school and workplaces include water and reduced-sugar beverages, as well as single-serving or 12-ounce containers. Schools and workplaces should also make sure that they have functioning water fountains or filtered water available. Cut down on paper waste and help the environment by encouraging students and workers to carry reusable bottles.
Government: Require better labeling on sugary drinks, and scrap sugar subsidies.
The FDA should require companies to list the number of calories per bottle or can—not per serving—on the front of beverage containers. It should also create a new labeling category for low-sugar beverages. Under current labeling regulations, a beverage can be marketed as “reduced sugar” if it contains 25 percent fewer calories than the standard version of that beverage. () A better threshold for low sugar beverages would be 1 gram of sugar per ounce, which is about 70 percent less sugar than a typical soft drink. Sugar-added beverages with more than 50 calories in an 8-ounce serving should carry a warning label about obesity and diabetes.
It is also time to stop subsidizing the purchase of sugared beverages, which are covered as food under the food stamp program and thus not taxed in some states. Of course, any plan to close these sales tax loopholes—or to levy steeper taxes on sugary drinks than on more healthful options, such as the plan proposed in New York State—is met with fierce objections from the beverage industry. In these tight economic times, consumers, too, may balk at a tax hike. But steep taxes on cigarettes have helped slow cigarette sales, as well as fund antismoking campaigns, and public health officials concerned about obesity would do well to take a page from the antismoking playbook. Yale researcher Kelly Brownell makes a strong argument for taxing sugary drinks in the New England Journal of Medicine. () It’s worth remembering that if cost is a real concern for consumers, the best beverage—water—is almost free.
The Bottom Line: We Can Retrain America’s Palate Away from Heavily-Sweetened Drinks
There’s convincing evidence that sugary drinks are one of the major determinants of obesity and diabetes, and emerging evidence that high consumption of sugary drinks increases the risk for heart disease, the number one killer of men and women in the U.S. We believe we can retrain America’s palate away from sweet drinks—when government, businesses, families, and individuals all work toward that goal. Beverage makers can offer consumers a greater choice of low-sugar beverages on the market. Individuals and families can modify their drinking habits. Schools, worksites, and government can take steps to promote a healthier drink environment. We must work together toward this worthy and urgent cause: alleviating the cost and the burden of chronic diseases associated with the obesity and diabetes epidemics in the United States.
References
1. Beverage Digest. Beverage Digest Fact Book 2008: Statistical Yearbook of Non-Alcoholic Beverages. Bedford Hills, New York, 2008.
2. Bleich SN, Wang YC, Wang Y, Gortmaker SL. Increasing consumption of sugar-sweetened beverages among US adults: 1988-1994 to 1999-2004. American Journal of Clinical Nutrition. 2009; 89:372-81.
3. Wang YC, Bleich SN, Gortmaker SL. Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004. Pediatrics. 2008; 121:e1604-14.
4. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Journal of the American Medical Association. 2004; 292:927-934.
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8. Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Archives of Internal Medicine. 2008; 168:1487-1492.
9. Ebbeling CB, Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS. Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study. Pediatrics. 2006; 117:673-80.
10. Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. American Journal of Clinical Nutrition. 2009; 89:1037-1042.
11. National Archives and Records Administration’s Office of the Federal Register. Electronic Code of Federal Regulations. Title 21: Food and Drugs. Part 101: Food Labeling. Subpart D. Specific requirements for nutrient content claims. § 101.60 Nutrient content claims for the calorie content of foods. Accessed April 6, 2009.
12. Brownell KD, Frieden TR. Ounces of Prevention—The Public Policy Case for Taxes on Sugared Beverages. New England Journal of Medicine. 2009;NEJMp0902392.
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