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Sugar and Beverages: How Much is Too Much?

Massachusetts General

In this Q&A, Deborah Krivitsky, MS, RD, LDN, a dietician in the Mass General Cardiovascular Disease Prevention Center, offers her insight on sugary beverages.  The topic recently made national news headlines with New York City's sugary drink ban.

Q. What is your take on sugary drinks like sodas and sports performance beverages?
A. An increased intake of added sugar is associated with metabolic abnormalities and adverse health effects.  These drinks provide source calories that are often not associated with essential nutrients.  In a world of epidemic numbers of obesity and diabetes, sugar sweetened beverages are the primary source of added sugars. Although data is limited, an increased intake of soft drinks is associated with increased weight, increased energy intake, and decreased intake of essential nutrients.

Q. Is it safe/healthy for the average American to consume one or two sodas a day? 
A. The Dietary Guidelines recommend Americans limit their intake to no more than 5-15% calories of SOFAs - solid fats and added sugars.  Often, foods such as desserts contain a combination of solid fats and added sugar.  The guidelines ask Americans to limit their intake of added sugar to no more than approximately 100 calories per day from added sugar for women and no more than 150 calories from added sugar for men.  Words that let you know there is added sugar in your food include: sugar, high fructose corn syrup, maple syrup, malt syrup, molasses, etc.  Between 2001-2004, the average American consumed 22.2 teaspoons of added sugar each day!   

Q. What are some examples of beverages that contain too much sugar and how does the body process the sugar?
A. Americans are consuming too much added sugar in the form of beverages.  This includes juice. When you put a fruit or vegetable in a blender, the fiber is broken down and so it presents as sugar to your body.  Fiber slows down the absorption of food.  When the fiber has been broken down by a machine, it gets absorbed quickly, causing a rapid rise in blood glucose or sugar.  This results in an increase in inflammation which is associated with poorer outcomes for heart disease, diabetes, and cancer.  Sugar is no longer thought of as benign, empty calories.  Sugar is also thought to raise dopamine levels.  People get hooked on drugs such as cocaine or heroine for it's rise in dopamine as it gives them a "high" or a rush.  Sugar does the same thing. So where a few cookies initially gave you the fix, it won't be long before you're finishing the package or adding ice cream.  So, detox by limiting or no longer including juice and desserts.

Q. Regular vs. diet sodas – your take?   
A. Diet sodas are calorie free so they are thought to aid in weight loss.  Some studies suggest, however, that people get used to having a sweet taste in their mouths, so it sabotages their efforts.  Some studies also suggest, although more research is needed, that drinks high in phosphorus, such as diet colas, increase risk of heart disease.

Q. What is the best way to empower people to make healthier food and beverage choices?
A. 
We have a great challenge in the U.S. to educate people as to how, particularly in a world that's filled with stress, how to adopt a healthy lifestyle.  This will include emphasis on stopping smoking and the need to include regular exercise.  We also need to educate people as to how to make healthy food choices and the impact that their choices will have on their health.  My thought is that people do not know what's in the food that they are eating, and if they have a better sense of the ingredients, they'll make better choices.  

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