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Beverage 2.0

Add-in nutritional supplements have turned water, soda and fruit juices into modern health elixirs. But do the benefits outweigh the costs – or the sugar?

Let’s be honest: the “healthy drink” world is confusing. And with new research coming out seemingly every day, it’s hard to discern the best drink for your needs.

When assessing these beverages, Dawn Jackson Blatner, RD, says first consider the calorie count. “People will like fruit water and think ‘oh zero calories,’ but you have to check,” says Blatner, a spokesperson for the American Dietetic Association, Chicago. “Anything more than 20 calories per eight ounces is getting pretty high.”

But what about all the additives that are supposed to make these drinks special? Consider these six categories of health and diet drinks to see if your favorites are living up to their claims.

Vitamin-Enhanced Waters

Products like Glaceau’s Vitaminwater, Special K20 water, Propel Fitness Water and H2Odwalla all claim to offer water with a kick, whether it is some extra calcium, vitamin C, antioxidants or even protein. But Linda Van Horn, PhD, RD, cautions that these products probably don’t practice what they preach.

“These specialized functional fluids are intended to meet a need, but they have no clinical data to determine whether they meet it or not,” says Van Horn, a clinical nutrition epidemiologist and professor of preventive medicine at Northwestern University’s Feinberg School of Medicine, Evanston, Ill. “So the question is, do you really want to pay that kind of money to get this product in absence of any evidence whatsoever that it will do you good?” she asks.

Should I be afraid of artificial sweeteners?

Additives aside, many health and diet drinks contain one or more artificial sweeteners such as aspartame (NutraSweet and Equal), sucralose (Splenda) and saccharin (Sweet’N Low). In a July 2007 press release, the American Heart Association said recent studies did not show that soft drinks and their artificial sweeteners caused risk factors for heart disease. The National Cancer Institute also states that there's no scientific evidence that any of the FDA-approved artificial sweeteners cause cancer. But with competing research on sweeteners’ effects, should you be afraid to use them? Hear four experts weigh in:

Sharon Fowler, MPH: “Some people are having bad reactions to aspartame, including damage to nerves, headaches and memory loss … It’s not the majority of the population, and no one knows the percent, but I’m concerned it’s a much larger number than we know.”

Dawn Jackson Blatner, RD: “I don’t put up a lot of scare tactics, but if you’re looking to have a cleaner diet with lots of fresh fruits and vegetables and less chemicals, this is one place to take out diet drinks and substitute sparkling waters with natural flavoring and no additives. It’s a personal preference because they’re safe.”

Dr. David Katz, MPH: “What I worry about is that they’re between 300-1200 times as sweet as sugar. There is pretty good scientific evidence that sugar has addiction properties … [and] I’m worried this will grow the sweet tooth and people will need more sugar in their diet to be satisfied.”

Leslie Bonci, RD: “Enough has been written about aspartame that we know there are some people who are sensitive to the amino acids in NutraSweet, so for those individuals, it’s not worth it. If you get a headache, don’t drink it. Is sucralose a health risk? I don’t think so. Is it the best alternative for people to use all the time? Well, studies show that nobody is getting thinner, so it’s a concern if people use it to justify eating cheesecake.”

Blatner adds that none meet daily vitamin requirements on their own and only include a small gamete of the total vitamins you need. She emphasized using food, not liquid, for vitamins and minerals: “We know it’s more absorbable and has more potency and more power to actually decrease disease in our bodies,” Blatner says, ““You’re probably better off to drink plain water and take a multivitamin.”

But even though vitamin-enhanced waters only contain small amounts of the vitamins, Blatner says to limit yourself to one per day to break up the monotony of plain water. Drinking more, plus a diet of fortified foods, can exceed the safe upper limits of vitamins and minerals.

And remember: Drinking these isn’t an excuse to splurge elsewhere. “I definitely think this is not something you have to give up if you enjoy, but don’t expect it to be some kind of magic bullet,” Blatner says.

Energy Drinks

For some people, energy drinks offer a boost without the bitter taste of coffee. But according to Leslie Bonci, RD, MPH, they bring their own problems. “Unless they say sugar-free, they’re probably pretty high in sugar content,” says Bonci, director of sports medicine nutrition for the University of Pittsburgh Medical Center.

And though the boost might be satisfying, these drinks probably are not the optimal caffeine source for your body. “ [Energy drinks] have no benefits,” Blatner says. “They may not hurt you, but they’re not necessarily helping you in any way.” Blatner says to choose coffee or tea instead because they actually fight disease, and coffee may reduce risk of diabetes.

Diet Soda with Vitamins

According to the Beverage Marketing Corporation, New York City, Americans drank around 4.7 billion gallons of diet soft drinks in 2007, so with the culture’s emphasis on vitamin enhancement, it’s obvious why soda companies want a piece of the action. But like the waters, products like Diet Coke Plus and Pepsi’s Tava only offer select additives that don’t fulfill daily requirements. Some researchers also wonder if diet soda contributes to weight gain.

“Our research and data showed that the more diet sodas people drink, the more weight they gained,” says Sharon Fowler, MPH, University of Texas Health Science Center, San Antonio. “Is that a causal relationship or because of other reasons of lifestyle, we don’t know.”

In addition, these drinks are more acidic than standard coffee. “Phosphoric acid gives it a delightful bite, but what about what it does to our teeth and bones?” Fowler asks. “A health soft drink is an oxymoron – there is no such thing.”

Fruit Smoothies

Brands like Naked Juice, Odwalla and Tropicana offer fruit smoothies boasting their own additives to target specific aspects of health, but they come at a substantial caloric cost.

“Yes, they’re from natural sources,” Blatner says. “However, they’re racking up calories higher than most people know. These are not to be ‘in addition’ to your day.”

Blatner says to eat your fruits instead – you’ll get fewer calories with more fiber and fullness. But if you struggle to fit fruit into your diet, consider breaking out your own blender.

“The way to get around that is to do it yourself,” Bonci says. “But if someone uses a pre-made smoothie, then don’t have that extra cookie or biscotti so by the time the day is done, your body is still in balance.”

Fruit Waters

Products like Hint and seltzers from Polar Beverages, Inc. seem too good to be true: no calories, natural flavor and no artificial sweeteners. While, again, there is no research supports the additives’ effectiveness, some flavored waters can be a positive part of your diet.

“They provide excitement but don’t carry along with them things we don’t need,” says Dr. David Katz, MPH, adjunct associate professor of public health practice at the Yale University School of Medicine. “So it’s nice flavor, but none of the mischief.” Katz advises to look closely at the label and steer away from products containing any added sugar or calories.

The real downfall? Price.

“I think about everyone talking about their budget with the price of gas,” Blatner says. “You don’t necessarily need to buy these. Buy cucumbers and raspberries, throw them in a pitcher and fill it up with tap water. It tastes delicious.”

Ready-Made Coffee and Tea Drinks

“As with any coffee drink, you have to be conscious when you start adding cream and extra sizes,” Blatner says concerning products like Starbucks’ DoubleShot and Caribou ready-made drinks.

Caffeine also causes concern: Blatner says the perfect amount is 200 to 300 milligrams a day (about two to three cups of standard brewed coffee. With ready-made drinks, she says, people might drink three or four because of the sweetness – instead, get a skim latte and benefit from the milk.

Ready-made tea drinks also are often not as beneficial as they seem: Fowler says they have significantly fewer antioxidants than freshly brewed alternatives. Also, Katz says the calories burned by drinks like Enviga are insignificant because the rise in metabolism the caffeine provides is only slight.

Now what?

The conclusion: moderation. For those who are comfortable with artificial sweeteners, any of these drinks can be enjoyed in reasonable amounts. But realize that what you’re drinking is a treat that may offer small health benefits – it should not be used in place of healthy eating.

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