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Water is the healthiest option

By Jenny Favret, RD June 01, 2015

Good nutrition isn’t only what you eat; it’s what you drink too. Here, Duke pediatric dietitian, Jenny Favret, RD, reviews how much sugar can be found in some beverages, their impact on health, and how to help your kids make healthy drink choices.

It's called water

Cleverly packaged, brightly colored, inexpensive juices, drinks, flavored teas and sports beverages crowd grocery store shelves. Chocolate and strawberry milk, juice and sparkling juice are offered daily in your child’s school cafeteria. Many kids are rewarded with sweet refreshments following sports practices and games. Add them up, and you’ll find countless, daily opportunities for kids to indulge in liquid sweet treats.

An October 2013 analysis published in the Journal of Clinical Nutrition underscores the role that sugar-sweetened beverages play in promoting unhealthy weight gain. In April 2015, the World Health Organization stressed the importance of cutting back on sugar-sweetened beverages.

Although parents may wish to limit sugary drinks, they need alternatives to offer.  As a pediatric dietitian with the Duke Children’s Healthy Lifestyles Program, I get this question frequently. Wise mama bear, from the Berenstain Bears book, Too Much Junk Food, offers the best possible answer: “It’s called water.” 

Perfect thirst quencher

Water is the perfect way to quench thirst. Help your child discover that plain, unflavored water as an appealing beverage. Serve frosted glasses of water with meals at home. Add slices of fruit to “dress up” water at mealtime, but leave them out between meals because it's not wise to bathe the teeth in fruit acids. Kids who keep spill–proof water bottles with them during the day drink more water than kids who have to rely on limited water fountain breaks. Talk to your child’s teacher if water bottles aren’t allowed.

You can make a serious dent in your child’s consumption by no longer bringing sugary drinks into the home. Or, cut back on what you make available. Conflict occurs when parents drink soda and sports drinks while insisting their kids drink water. When mom and dad model the water habit for their kids, no one feels slighted.

Here’s some of the questions I’m frequently asked, and how I answer.

Is juice healthier than soda?

Soda is heavily processed and offers no nutritional benefit. A 100% fruit juice, on the other hand, is a naturally occurring product, and contains a host of nutrients including vitamin C, potassium and folate (depending on the specific type of juice).  However, when it comes to sugar content, soda and juice are essentially the same.  Both pack six to seven teaspoons of sugar in an eight-ounce serving.

The American Academy of Pediatrics recommends kids consume no more than four to eight ounces of 100% fruit juice per day (four ounces for preschoolers and up to 12 ounces for active teens). When kids get juice with school breakfast, purchase a sparkling juice drink at lunch, then drink juice with their after school program snack, they have already exceeded the daily recommendation. 

When are sports beverages ok?

Sports beverages hydrate, energize, and replace nutrients (electrolytes) lost through sweat during vigorous, prolonged exercise that lasts over an hour. Most children and adolescents need plain water before, during, and after physical activity to stay hydrated. Electrolytes can be replenished at meals or snack. Sports beverages were never intended to be a casual mealtime beverage or to stay hydrated during the day.

According to the American Academy of Pediatrics, “routine ingestion of carbohydrate-containing sports drinks by children and adolescents should be avoided or restricted, because they can increase the risk of obesity, as well as dental erosion.”

Are diet drinks and sugar-free flavoring packets a better or worse option?

While sugar-free or artificially flavored packets may seem like a good idea, they actually perpetuate the idea that all drinks must have a flavor. That makes it hard to position plain water as the beverage of choice.  

Dental health is also a concern. Phosphoric acid and citric acid are often added to diet drinks for flavor. A 2012 article in the International Journal of Dentistry found acidic beverages are the main cause of dental erosion in children and adolescents.

Research studies continue to examine the role artificially sweetened beverages play in weight gain and the development of type 2 diabetes.  An emerging area of research is looking at how artificial sweeteners may alter gut microorganisms and ultimately how this may affect metabolism.

How often should a sweetened beverage be allowed?

While water should be the “go to” beverage for the whole family, this doesn’t mean that sugary drinks should be prohibited. Some families allow sweet drinks when dining out, especially if these options aren’t available at home. Other families go from drinking a large volume of sugary drinks daily, to two or three times per week. Any reduction in sweet drinks is a step toward better health.  

When consuming sweet drinks

Keep these tips to keep in mind:

  • Drink sweet drinks with meals.  The protein, fat and fiber from the meal help to lower the glycemic response, meaning it minimizes blood sugar spikes that occur in the body when sugary drinks are consumed on an empty stomach.  Sugary drinks during meals are less damaging to the teeth since the saliva that flows during meals helps to protect tooth enamel from the acids in both sugary and diet drinks.
  • Less is more. Add less powder and more water than directed when using sweetened drink powders.  In restaurants, try mixing sweet tea with unsweetened tea.
  • Refill with water.  Have it both ways by following your sugary drink of choice with water re-fills.

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