This is the third article in our series on Eat Smart Move More Core Behaviors, evidence-based lifestyle behaviors that can improve overall health. Our first two topics focused on designing a healthy plate and reading food labels. This month’s article offers tips for making smart drink choices. Do you have a favorite beverage? Do you drink it every day, sometimes, or rarely?

Making healthy drink choices can have a big impact on overall health. When deciding which drinks to choose, it may help to consider them in three categories: everyday beverages, occasional beverages, and those that should be consumed rarely, if at all. Water, milk, and unsweetened coffee and tea can be consumed regularly. Low-calorie, low-sugar (“diet”) beverages and 100% juice should be consumed only occasionally. Beverages that fall into the rarely category include regular soda, fruit-flavored drinks, and sports and energy drinks.

Let’s begin by discussing the best choices – water and milk. As you know, water does a body good. It helps your muscles and brain stay hydrated for best physical and mental performance and it keeps your stomach, intestines and kidneys working smoothly. Adequate water intake keeps you from overheating, lubricates joints and tissues, and maintains healthy skin. It is the perfect zero-calorie beverage for quenching thirst and rehydrating your body. Each person’s exact fluid needs vary depending on size, gender, activity level, and even the weather. When it is very warm, our bodies need more water. Men need more water than women and people who are larger need more water; so do people who are more active. The general rule of thumb is to strive for 6-8 cups (48-64 ounces) each day. About 20 percent of our daily water intake comes from water-rich foods such as lettuce, leafy greens, cucumbers, bell peppers, summer squash, celery, berries, and melons – so keep eating those fresh fruits and vegetables. Milk is another great beverage option. About 2-3 cups of low-fat or skim milk can be consumed daily. Less milk is fine if you get enough calcium from other foods.

Unsweetened tea and coffee can also be consumed daily. Tea and coffee contain antioxidants, flavonoids, and other substances that may be good for health. However, people who have difficulty controlling blood pressure or have trouble tolerating caffeine due to jitteriness, anxiety, and insomnia, may want to moderate their intake or choose decaffeinated versions. Herbal teas do not typically contain caffeine since they are derived from dried herbs, spices, flowers, fruits, seeds, roots, or leaves of other plants (instead of the camellia sinensis “tea” plant). Because of the potential negative side effects some people experience when drinking caffeine, it is not recommended to start drinking it if you do not already or to increase the amount you currently drink. It is also important to keep in mind how you enjoy your brew. The extra calories from sugar and fat that you get in most coffee house beverages, especially when it is loaded with whipped cream and flavored syrup offsets any health benefits found in a basic black coffee.

Beverages that fall into the occasional category include diet soda and 100 percent juice. While juice contains some vitamins and minerals, it should be consumed in limited amounts due to its high calories from concentrated fruit sugars. If you are in the mood for fruit, enjoy a whole piece of fruit which is much lower in sugar than its juice equivalent and contains the added benefit of fiber from the skin and pulp. If you do consume juice, limit it to 4-6 ounces a day, or better yet, mix pure fruit juice with plain or sparkling water.

Diet sodas, or other artificially sweetened beverages, are chosen in an effort to reduce calories and sugar or to better control blood glucose. The health effects of low-calorie sweeteners are inconclusive, with research showing mixed findings. Some research suggests that artificially sweetened drinks may contribute to weight gain by conditioning you to crave other sweet drinks and foods. The other health effects, particularly the effects of specific types of sweeteners, remains largely unknown at this time. It is best to limit these beverages and eventually wean yourself off of them.

Sugar-sweetened beverages belong to the last category. These beverages include any drink that is sweetened with any form of sugar: corn sweetener, corn syrup, dextrose, fructose, sucrose, fruit juice concentrate, high-fructose corn syrup, honey, agave, etc. Beverages such as regular soda, fruit-flavored punch or “ade”, and sports and energy drinks are examples of sugary (aka “soft”) drinks. As a category, these beverages are the single largest source of calories and added sugar in the American diet. An estimated 49 percent of adults and 63 percent of children consume them every day; and we consume four times the amount today we consumed in 1965. There is strong evidence that indicates our increasing desire for “liquid candy” has been a major contributor to the obesity and diabetes epidemic. Furthermore, emerging evidence is showing a connection to increased risk for heart disease in addition to weight gain, diabetes, and gout.

Sports drinks are advertised to replenish carbohydrates, electrolytes and fluids lost during high-intensity workouts. This type of nutrient depletion generally occurs only with vigorous exercise that lasts an hour or more and causes heavy sweating. For the non-athlete, a sports beverage is just another sugary drink. While they do contain less sugar than soda, which may be why they are chosen over other beverages, they are still a source of unnecessary calories and added sugar. Of greater importance for both athletes and non-athletes, especially youth, is to consume a balanced diet, snacks as needed, and adequate water – all of which are better ways to replenish lost nutrients.

Energy drinks, in contrast, have as much or more sugar than almost any other beverage, enough caffeine to raise your blood pressure, and additives whose long-term health effects are still unknown. There are major concerns over the lack of regulation as well as the aggressive marketing tactics geared toward adolescents. The CDC has reported increasing numbers of emergency room cases related to energy drink consumption. Negative health effects include increased stress, aggressive behaviors, alcohol and cigarette abuse, high blood pressure, poor sleep, and stomach irritation. Energy drinks pose an even higher risk in children and pregnant women and among people with certain health conditions such as heart disease and diabetes.

Moderation is always a smart way to treat your body well. Steer clear of sugar-sweetened or super-charged drinks, stick to small amounts of diet drinks and juice, and make water your go-to beverage.

For additional resources, visit the Eat Smart Move More NC website at https://www.eatsmartmovemorenc.com/ and be sure to check out the Aisle by Aisle video on Choosing Healthy Beverages.