“Drink Responsibly.” Examine and Eliminate Hidden Calories and Sugars from Beverages

| August 1, 2015

A Message from Dr. Christopher Still

Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania. Dr. Still is also a board member of the Obesity Action Coalition, Tampa, Florida.


Dear Colleagues,
In June, I discussed choosing the best diet for weight loss and recommended prescribing a 500-calorie reduction of a patient’s total daily caloric intake. Another part of examining calories is looking at not only what the patient eats, but also what he or she drinks every day. For many individuals, a large portion of daily calories comes from the beverages they consume. Regular soda, fruit juices, energy drinks, and gourmet coffee drinks are all popular sources of hidden calories in one’s diet. These drinks contain fructose, sucrose, and pure sugar, which all easily metabolize to fat and cause rises in blood sugar and insulin.

I feel there is an opportunity to help decrease a patient’s daily caloric intake by encouraging them to switch out high-sugar, high-fat beverages with lower calorie options. It is a strategy I call “drinking responsibly.” Swapping out high calorie beverages for water and low-calorie drinks is an easy fix for patients who are motivated to make the change.

For many patients, learning about the amount of sugar contained in beverages like soda is eye opening. When they learn that a 12-ounce can of soda contains roughly 10 tablespoons of sugar, they seem to realize that just because they aren’t eating it, does not mean it does not count toward their calories. Orange juice, which can be perceived as a healthy drink, contains fructose. It’s more beneficial to just eat an orange. Once patients understand how much sugar is in a drink, it becomes easier to avoid.

While diet sodas are far better than regular soda, water still remains the best choice. I recommend that patients drink 64 ounces of water per day. Water allows our liver to break down fat, which helps in a patient who is trying to reduce calories as the body tries to conserve its fat stores. After fulfilling the H2O quota, they can then enjoy low- or no-calorie beverages.

There has been controversy over the harmful effects of artificial sweeteners in low calorie drinks like diet soda, but studies haven’t shown convincing evidence. In the weight loss world where we are trying to get patients off of the regular soda, the diet version isn’t so bad and it’s saving a lot of calories (approximately 140 to 150 calories in a 12-ounce can).

But it isn’t only what patients drink, it is the quantities in which they are consuming. Patients can consume multiple beverages daily, easily taking in 500 liquid calories and well over 100g of sugar. To put it into perspective, just four drinks could cost an extra 605 calories and 145 grams of sugar: 1) eight-ounce glass of orange juice (~122 calories, 30g sugar), 2) 12-ounce blended coffee drink (~180 calories, 36g sugar), 3) one 12-ounce can of soda (~143 calories, 40g sugar), and a 12-ounce energy drink (~160 calories, 39g sugar). This amount easily increases with popular larger sizes like 7-Eleven’s “Big Gulp” and Starbuck’s large or “Venti.”
I’ve found that the message of drinking responsibly resonates with patients, especially when they learn that cutting out these extra 500 calories per day could potentially result in losing one pound per week, which is a meaningful change.

Sincerely,
Christopher Still, DO, FACN, FACP

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