25 Feb

By Amy Gannon, MS, RD, LD
WVU Extension Service Family Nutrition Program Specialist

juice_box_1 A trip down the beverage aisle in your local grocery store provides a glimpse into the hundreds of drinks that are available to quench our thirst. Products run the gamut from flavored water to soda, fruit drinks, sweetened tea and chocolate milk. However, there is one element many of these beverages have in common – sugar. Drinks that contain sugar are often called sweetened beverages because they contain caloric sweeteners such as sucrose (table sugar), fructose (sugar derived from fruit), corn syrup, high fructose corn syrup and fruit juice concentrates.

Most people agree that we crave sweetened beverages because they taste good and because they are readily available. Common choices include sodas, Kool-Aid, Capri-Sun, Sunny D, Hi-C and Gatorade. The intake of sweetened beverages has dramatically increased for over the past several decades; doubling for the average American from 1977 to 2002. They are now the number one source of sugar in the average child’s diet. Most children consume about 172 calories per day from sweetened beverages alone (Brownell, et al, 2009). apple-juice

All beverages help meet fluid needs and most beverages quench thirst. However, when making a choice, it is important to look beyond basic information and understand the larger role beverages play in calorie intake. Sweetened beverages are calorie dense, meaning they contribute excess calories without providing nutrients such as vitamins and minerals. They can cause an energy imbalance, leading to excessive weight gain. Sweetened beverages displace nutrient rich foods such as milk, fruits and vegetables. Although sweetened beverages contribute excessive calories, studies indicate that they do not provide the same sense of fullness that would be achieved if we ate the same amount of calories from food (US DHHS, 2010).

lemonade Rates of obesity have increased dramatically in the US in the past few decades. Nationwide, approximately 17 percent of children are believed to be overweight or obese (JADA, 2006). In West Virginia, the number is even more staggering. The CARDIAC project has shown a rate of obesity greater than 30 percent in WV teenagers (, 2008). Consumption of sweetened beverages is one cause of excessive weight gain and is also linked to other health disparities, such as insulin resistance and metabolic syndrome. Sadly, children who are overweight have more than 70 percent chance of becoming overweight as an adult (JADA, 2006).

One reason excessive intakes of sweetened beverages leads to obesity is related to the way in which the body manages and processes sugar. In terms of our metabolism, the body treats all forms of sugar the same. All caloric sweeteners cause an increase in blood glucose, commonly called blood sugar. To offset the rise in glucose, the pancreas releases a surge of insulin, which is a hormone that helps maintain a steady level of sugar in the blood. Over time, this leads to elevated blood levels of insulin and is associated with diseases such as metabolic syndrome, type 2 diabetes and heart disease. In fact, the well publicized Nurses’ Health Study found that women who consumed one or more sweetened beverages per day, had double the risk of developing type 2 diabetes compared to women who did not consume any sweetened beverages. In the same study, consuming one sweetened beverage per day increased the chance of developing heart disease by 23 percent and drinking two or more per increased the risk of heart disease by 35 percent (Brownell, et al, 2009). smoothie_Full

Given the negative information on sweetened beverages, you might wonder what you should drink. Water is the best source of hydration. It is calorie free, inexpensive and very accessible. It is essential to human life and is the most easily metabolized of all the nutrients. It does not need to be digested and is rapidly absorbed in the GI tract, so it starts hydrating body cells as soon as it is consumed. Nonfat and low fat milk (1 percent) are other great options. Milk contains essential nutrients such as calcium, vitamins A and D and protein and is a rich source of many other nutrients. It also hydrates the body and quenches thirst.

Many fruit and vegetable juices contain vitamins and minerals, but they also contain lots of sugar and/or sodium. The American Academy of Pediatrics recommends children ages 1 to 6 consume no more than 4-6 ounces of juice per day. Children 7 to 18 years of age should limit juice to 8-12 ounces per day (American Academy of Pediatrics, 2001). Although the sugar in 100 percent juice is all natural, it also contributes excess calories and has been linked with excessive weight gain in children. Finally, you should not put juice or any other sweetened beverage in a baby’s bottle as this leads to cavities.

When trying to manage your weight and choose healthy foods and beverages, small changes go a long way. Reducing your intake of sweetened beverages is a great beginning to a healthier diet. Start by making a goal to have only one sweetened beverage per day and continue to gradually reduce your overall intake. For more information on choosing healthy foods and to access recipes for healthy beverages, visit the Family Nutrition Programs’ Web site at milk


  • American Dietetic Association (JADA). (2006). Position of the American Dietetic Association: Individual-, Family- School and Community-Based Interventions for Pediatric Overweight. Journal of the American Dietetic Association, 106: 925-945.
  • American Academy of Pediatrics. (2001). The Use and Misuse of Fruit Juice in Pediatrics. PEDIATRICS , 7, 1210-1213.
  • Brownell, K., Farley, T., Willett, W., Popkin, B., Chaloupka, F., Thompson, J., et al. (2009, September 11). The Public Health and Economic Benefit of Taxing Sugar-Sweetened Beverages. The New England Journal of Medicine.
  • CARDIAC- Coronary Artery Risk Detection in Appalachian Communities (2008). Accessed online February 2, 2010,
  • U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.