This Issue

Sugar-sweetened beverages

Water: It’s the real thing

Skipping sugar-sweetened beverages

Q & A

A closer look

Often people do not realize they are consuming so much sugar because the sweetener goes by many different names. One hint — words ending in “ose,” such as sucrose, glucose and fructose are all sugars.

Because this is a juice drink people assume it is healthy. It does contain some juice, but most of the sugars are added, not natural. Learn to read between the lines. While the first ingredient is water, the next five are sugars, but the word “sugar” is listed only once.

One serving (one cup) of this fruit drink contains 120 calories and 31 grams or almost 8 teaspoons of sugar, exceeding the American Heart Association’s recommended daily limit of added sugars. One teaspoon of sugar has about 4 grams of sugar and 16 calories.

A closer look

Spot the added sugars

Stop. Rethink your drink.

Water — all dressed up

How much is too much?


Spot the added sugars



• Brown sugar

• Cane sugar

• Corn sweetener

• Corn syrup

• Evaporated cane juice

• Fruit juice concentrates

• High-fructose corn syrup

• Honey

• Maple syrup

• Molasses

• Raw sugar

• Syrup

How much is too much?


honeyThe body requires glucose to provide energy to do its job. We can get that sugar naturally from fruits, vegetables, milk and whole grains, which are full of nutrients. Added sugars, on the other hand, are sugars and syrups added to foods during preparation or at the table. These added sugars bring with them sweetness and calories, but lack nutrition. The American Heart Association recommends a daily limit of added sugars according to the information below.


Women’s daily limit
6 teaspoons = 100 Calories = 25 grams

Men’s daily limit
9 teaspoons = 150 Calories = 37.5 grams

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Water — all dressed up

Infused water is plain tap water flavored with fruits, vegetables or herbs, and is a healthy alternative for those who find the beverage bland.

Citrus Cucumber Water

1 large lemon, sliced
1 large orange, sliced
1 large cucumber, sliced
1 half gallon of water

Place all sliced fruits and vegetables in a pitcher and add water. Refrigerate and allow the water to “infuse” for at least two hours. Pour over ice and enjoy.

Source: Boston Medical Center Nutrition and Fitness for Life Program

Skipping sugar-sweetened beverages


This summer, a national health study ranked Massachusetts fourth among states with the lowest rates of obesity. Zooming in more closely, though, the picture looks less rosy. More than half of Boston adults — and nearly 44 percent of Boston public school students — are overweight or obese, according to the Boston Public Health Commission. Black and Latino residents are almost twice as likely to struggle with obesity as white residents, and sugary drinks are part of the problem. Skipping them could help whittle down waistlines while improving health.

What is sugar?

Sugar is a sweetener derived from plants that the body converts easily to fuel. The sweet, white crystals of table sugar made from cane or beets are one easily recognized form of it.

“Often, people don’t realize they’re consuming sugar because it goes by many other names,” said Dr. Jan Cook, medical director of Blue Cross Blue Shield of Massachusetts. “Checking ingredients listed on food labels helps. High fructose corn syrup, honey, concentrated fruit juice and cane juice, are forms of sugar often used as added sweeteners. Also look for ingredients that end in ‘ose,’ such as sucrose (table sugar), fructose (fruit sugar), dextrose (another name for glucose, the sugar that circulates in blood to deliver energy to cells), maltose (malt sugar) and lactose (milk sugar).”

What is a sugar-sweetened beverage?

The Boston Public Health Commission defines it as a drink that has any kind of caloric sweetener added to it. Most sugar-sweetened drinks have little or no nutritional value. Some examples are sodas and other carbonated soft drinks; energy or sports drinks; fruit drinks and fruit punches; sweetened coffee and tea drinks and sweetened milk and milk alternatives like chocolate milk or vanilla soy milk.

Sweet drinks rarely make you feel full, so you probably won’t eat less than usual to compensate for the extra calories you’ve sipped. This can quickly add up. According to the Harvard School of Public Health, a can of soda averages 150 calories. Unless you eat less or exercise more to balance those calories, a single soda a day can pack 15 extra pounds onto your body per year. What’s more, studies show higher consumption of sugar-sweetened drinks raises risks for developing diabetes, heart disease, gout, tooth decay and other ailments.

Bigger gulps containing 20 ounces of soft drinks have closer to 250 calories and 16 teaspoons of sugar, notes the Boston Public Health Commission. That far exceeds the American Heart Association’s healthy eating guidelines, which recommend no more than 6 to 9 teaspoons per day of added sugars in foods and beverages.

Which healthy drinks could I choose instead?

Sugar-free diet drinks

Sugar-free diet drinks promise all the sweetness at few — or zero — calories. Sounds like a win-win, right? Not quite. Artificially sweetened drinks may condition taste buds to crave sweet foods, warn experts at Harvard School of Public Health. That cycle is hard to break. Just as with any high-calorie food, skip these drinks or make them an occasional treat.

Reach for water first. Turning on the tap saves you money right away and may improve your health in the long run. You might find water a boring alternative, but spicing it up by adding crushed mint or lime, lemon or orange slices for flavor may change your mind. Other healthy choices are:

  • Unsweetened seltzer, available flavored or plain.

  • Unsweetened coffee or tea, brewed hot or cold in caffeinated or caffeine-free versions. A wide variety of flavorful green teas and herbal teas exists. Adding cinnamon or a dash of vanilla extract may help satisfy a sweet-tooth.

  • Unsweetened fat-free or low fat milk, which delivers added nutritional benefits of calcium, vitamin D and protein at 86 or 102 calories per cup, respectively.

Watch out for blended products labeled “100 percent fruit juice” that are sweetened with grape or pear juice or a concentrated fruit juice. These have little nutritional value. Fruit punch and juice drinks or cocktails may have added sugars like corn syrup that make them a poor choice, too. Reserve sports drinks intended for fueling athletes for tough workouts lasting 60 minutes or longer.

How can parents encourage children to drink healthy beverages?

Try these tips for healthy choices:

  • Stock up. Keep cool water, flavored seltzers and unsweetened fat free or low fat milk in the fridge. (Note: the American Pediatrics Association recommends whole milk products for most children younger than 2. At that age, fat is important for energy and healthy growth.)

  • Shop wisely. Cross soda, sweetened milk, energy drinks and sports drinks off the family grocery list (see “Strike a bargain,” below). Encourage children to read food labels with you and make smart choices. When buying juice, for example, check ingredients on food labels for added sweeteners. Pure apple, orange or vegetable juice is a healthy choice in small amounts (4 to 6 ounces or less per day, say nutrition experts at Harvard School of Public Health. Better still, eat the fruits and vegetables, which have fiber and other nutrients).

  • Try spritzers. Let children mix plain or flavored seltzers with a splash of juice. Add a squeeze of lemon or lime, if you like.

  • Fill ‘er up. Reach for refillable water bottles rather than juice boxes or sodas. Straws and popular characters can make these especially appealing to younger children.

  • Be a good model. Put a pitcher of ice water on the table at meals. If you drink it yourself, children are more likely to follow suit.

  • Check school beverage options. Encourage schools to make sure water fountains work and allow students to carry refillable water bottles.

  • Strike a bargain. Put money saved by not buying sugary drinks into a jar. Agree on a fun way to spend the sweet savings.