Nutrition experts propose new class of low-sugar drinks to help stem obesity and diabetes epidemics

Strong evidence developed at Harvard School of Public Health (HSPH) and elsewhere shows that sugary drinks are an important contributor to the epidemic rise of obesity and type 2 diabetes in the United States. Faced with these growing public health threats, experts from the Department of Nutrition at HSPH believe beverage manufacturers, government, schools, worksites and homes must take action to help Americans choose healthier drinks. They propose that manufacturers create a class of reduced-calorie beverages that have no more than 1 gram of sugar per ounce—about 70 percent less sugar than a typical soft drink—and that are free of non-caloric sweeteners. They also propose that the Food and Drug Administration (FDA) require beverage manufacturers to put calorie information for the entire bottle—not just for a single serving—on the front of drink labels. The aim is to re-educate the American palate to a lower expectation of sweetness, as well as to give consumers clear information to help them make healthier choices. "The scientific evidence is now clear; soda and other sugar-sweetened beverages are important contributors to obesity in children and adults," said Walter Willett, professor and chair of the Department of Nutrition at HSPH. "Healthier beverage options would allow individuals to make better choices."

**A media teleconference will be held today, Monday, April 20, from 3:00-4:00 PM ET. Walter Willett and Lilian Cheung, lecturer in the Department of Nutrition and editorial director of The Nutrition Source website will discuss the need to focus on healthier beverages. To register for the conference call, please RSVP to Todd Datz, tdatz@hsph.harvard.edu, 617-432-3952. Reporters who register to participate will receive the call-in information.

The Nutrition Source (http://www.thenutritionsource.org), a website maintained by the Department of Nutrition at HSPH, has created new content to provide consumers with information that can help them choose healthier drinks, including a chart that lists the sugar content of a variety of popular sodas, fruit drinks, sports/energy drinks, and sweetened waters. The site also provides specific recommendations for how key societal sectors can make changes that will help Americans choose healthier drinks. (See links to the new "Choosing Healthy Drinks" section of The Nutrition Source website below.)

Americans consume sugary beverages in staggering amounts. On a typical day, four out of five children and two out of three adults drink sugar-sweetened beverages. Teen boys drink more than a quart of sugary drinks, on average, every day. A 12-ounce can of soda or juice typically has 10-12 teaspoons of sugar and 150 or more calories; the popular 20-ounce bottle size now prevalent on store shelves and in vending machines carries nearly 17 teaspoons of sugar and 250 calories. According to research at HSPH and elsewhere, sugared beverages are the leading source of added sugar in the diet of young Americans. If a person drank one can of a sugary beverage every day for a year and didn't cut back on calories elsewhere, the result could be a weight gain of up to 15 pounds.

Consuming sugary drinks may have other harmful health outcomes: The latest research from HSPH published in the April issue of the American Journal of Clinical Nutrition, followed the health of 90,000 women over two decades and found that women who drank more than two servings of sugary beverages each day had a nearly 40 percent higher risk of heart disease than women who rarely drank sugary beverages.

By choosing healthier beverages, individuals can reduce risks to their health. Water is the best option, but Willett and his colleagues understand that people will not be able to kick their sugar-drink habit overnight. Therefore, they believe that Americans need to lower their sugar expectations.

"We need to retrain American tastes away from super-sweet drinks," said Lilian Cheung, lecturer in the Department of Nutrition and editorial director of The Nutrition Source website. "If we can shift the present American norm back to a lower expectation of sweetness, people will adjust their palates, particularly the younger population."

To do this will require concerted action from the following:

Beverage manufacturers: Create reduced-calorie beverages with no more than 1 gram of sugar per ounce and that are free of non-caloric sweeteners, such as aspartame, sucralose or stevia. That's about 3 teaspoons per 12 ounces and about 50 calories. Manufacturers should also offer smaller (8-ounce) bottles of sugary drinks.

Individuals: Choose beverages with few or no calories; water is best. Call manufacturers' customer service numbers and ask them to make sugar-reduced drinks.

Food shoppers: Purchase less juice and cross the soda off your home shopping list. Skip the "fruit drinks" too, since these are basically flavored sugar water.

Schools and workplaces: Offer several healthy beverage choices and smaller serving sizes. Also make sure water is freely available.

Government: The FDA should require companies to list the number of calories per bottle or can—not per serving—on the front of beverage containers.

Source: Harvard School of Public Health