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What's the Big Deal about Sugary Drinks?

Friday, July 6, 2012

You may have read that New York City now has a law limiting the amount a restaurant or other vendor may sell in one serving of a sugary drink to 16 ounces. Whatever you may think about the politics of this move, the big deal is that beverage calories may be a big contributor to America's obesity problem and people may not realize how damaging some of these drinks can be.   These sugary drinks do very little to curb hunger. They are “empty calories”, so to speak.

It comes down to some math. The average adult needs about 2000 calories a day to keep a steady weight. This can vary depending on their activity level, and children can have different calorie needs at different ages that vary , but 2000 is a good starting point to have in mind.  Our weight goes up or down based on our "calories in -calories out". One pound of weight is approximately 3600 calories. A 16 ounce soda is at least 100 calories.  An extra 100 calories a day, multiplied by 365 days a year adds up to a whopping 10 pounds of extra weight a year. That is a big deal at any age!

  • Most of us limit kid’s soda intake, but what about "healthy" drinks? "100 percent fruit juice" sounds great, but those little juice boxes are around 100 calories as well. The juice is the sugar dense part of the fruit, without the fiber and other ingredients that satisfy hunger and are building blocks of good nutrition. About the only advantage of juice over soda is some extra Vitamin C.   You are much better off having water and a piece of real fruit. 
  • Exercise is a good thing, right? You work your muscles and burn calories. However, rewarding or "hydrating" with sports drinks can undo all your good work from a calorie standpoint. Most people (including kids) will burn around 100 calories for each 15 minutes of moderate exercise they do (a good example is walking 1 mile). More intense exercise may burn 100 calories in 10 minutes (for example, running 1 mile). A nice cold bottle of Gatorade after your run is around; you guessed it, 100 calories.
  • There are a plethora of drink options with 0-5 calories, most made with sugar substitutes. One of my favorites for sports is “PowerAde Zero” which includes electrolytes athletes need after a prolonged period of working out, but not the sugar calories.  Despite internet rumors to the contrary, these substitutes have a good safety track record, although not a lot of long term studies in children.  Limiting these to 1-2 drinks a day is good practice. There is some debate about whether even these zero calorie sweeteners may encourage consumption of higher calorie foods or effect metabolism in a way that still encourages weight.  However, excess weight is a major and known health problem, so, I have believe  the sugar substitutes a better choice.
  • Other ways to flavor water include adding just a splash of juice (which would be about 10-15 calories) or flavoring water with various herbal and fruit teas. If you brew a cup of tea with boiling water and then pour it over a large glass full of ice, it makes a great drink. Add more ice after the initial ice melts from the hot tea. (Be careful to keep the boiling water well out of your child's reach though). In a pinch, I will put a tea bag in some warm water and add ice and leave the tea bag in. It's not quite as good as brewing, but still gives the water some good flavor. Use decaffeinated versions in young children and limit older kids (10 and above) to one caffeinated drink a day.
  • Fruit “smoothies” can be healthy if you make them with whole fruit (either frozen fruit or unfrozen with ice for texture) and water in a blender. Low fat yogurt or milk adds some calories (see below) but they are necessary calories (not empty ones).  If it improves the taste and helps your child get some dairy as a bonus, this can be a good addition. Beware of restaurant smoothies however. Many of these are calorie dense because of the extra juices or higher fat dairy they contain.
  • If your child is struggling with being overweight, I recommend having the only drinks with calories be 2-3 glasses of low fat (skim) milk a day (since they still need 2-3 dairy servings a day).  You can flavor milk by the “smoothie” method above, or add a small amount of low calorie chocolate or strawberry syrup if they don’t like plain milk.  
  • If your child is underweight, we may recommend they consume MORE calories dense drinks, but even these will be based on added protein and fat content, not just sugar.  Talk to us at your child’s next checkup about their weight and how drink calories may be affecting him or her.
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Dr. Vicki Roe is  a Pediatrician at Northpoint Pediatrics.  She received her  under graduate degree from Purdue, and her MD degree from IU School of Medicine. In her spare time she enjoys book collecting, genealogy, photography, Sc Fi and comic books.

Baby girl with pony tail in white