May 21, 2018
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Sugar-sweetened drinks: there’s more to the story than soda

Meg Haskell | BDN
Meg Haskell | BDN
Teens may associate sweetened sport drinks with healthy activities and diets, but these beverages are no better for them than soda.
By Dr. Amy Movius, Eastern Maine Medical Center

Childhood obesity has been recognized as a very important topic in recent years. An estimated 17 percent of teenagers and children have a body mass index for their age that is greater than or equal to the 95th percentile. Many public health efforts have been made to understand and try to address the epidemic of obesity in our nation’s youth, such as Maine’s “Keep ME healthy 5-2-1-0” campaign.

The amount of sugar sweetened beverages (SSBs) consumed by our children is recognized as an important factor contributing to obesity. Adolescents have more than doubled their daily SSB intake since 1977. It now accounts for an average 10 to15 percent of total daily caloric intake! Drinking one 12 ounce can of SSB a day results in up to 15 pounds of weight gain per year. Also, studies have shown that drinking SSB has displaced (healthy) milk drinking.

Sugar sweetened beverages are often equated with soda, but actually include any drink that contains a caloric sweetener such as sugar or high fructose corn syrup. This includes a large variety of carbonated and noncarbonated flavored and sports beverages (FSBs) as well as soda.

A study in the October 2010 issue of the Journal of Pediatrics evaluates how food and activity choices of adolescents correlates with SSB consumption, and also evaluates the effects of soda and FSBs separately. More thamiddle and high school students from public schools across Texas participated. They reported how many SSBs (0, 1, 2, or 3 or more) they drank in the previous day and also answered questions about healthy food intake (fruits/veggies/milk), unhealthy food intake (fried meat/fried snack/dessert), physical activity (physical education, organized sports, own activity) and sedentary habits (hours of TV, computer, video games).

Alarmingly, 28 percent of all the teens drank 3 or more SSBs per day. All of the SSBs (soda + FSB) were associated with eating unhealthy foods and sedentary habits – i.e. the more SSBs you drank, the more unhealthy foods you ate while being sedentary for more hours a day. However, whereas drinking soda was also associated with less physical activity and less healthy food intake, drinking FSBs was associated with more physical activity and MORE healthy food choices. This means teens who drank more FSBs tended to do more physical activity and eat more healthy foods.

The positive association between drinking FSBs, physical activity and fruit/veggie/milk consumption suggests that FSBs are viewed as being consistent with a healthy lifestyle. This pattern is also seen with consumption of 100% fruit juice (which is not a SSB). The presumed explanation is that these products have been successfully marketed as relatively healthy. In fact, a 20 ounce bottle of a popular sports drink contains almost 9 teaspoons of added sugar. Public health efforts to date have discouraged intake of all artificially sweetened beverages without making much distinction between different types. Clearly, health professionals need to be more specific. In the meantime, encourage those around you to know exactly what they are drinking if it isn’t lowfat milk or water.

Dr. Movius is a pediatric intensivist at Eastern Maine Medical Centers’ Pediatric Intensive Care Unit.

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