What to Drink? 

​Besides water, it sometimes seems like there is nothing truly safe to drink. Let’s start with the most obvious problems – sweetened drinks. Unfortunately this includes most of our favorites,such as sweet tea, Mountain Dew, Dr. Pepper, Coke, Pepsi, Gatorade, Powerade, Red Bull and many more. As a major source of empty calories and carbs, these are seen as the number one dietary cause of obesity. What’s more, they are major contributors to diabetes. As this liquid sugar is consumed it hammers the pancreas into putting out a big bunch of insulin to deal with it. Over time the body gets less and less responsive to this insulin, which then leads to diabetes. Eventually the pancreas usually wears out in its ability to secrete adequate insulin.

​Ok, so how about diet drinks? Many of these, unfortunately, have their own problems. This is currently a growing area of research. Some recent studies showed that consuming a diet soda daily was associated with a higher stroke and dementia risk. It looks like some of this may have been due to other factors rather than a direct result of the diet soda consumption. Still, it certainly gives one pause. Similarly, another study showed that routine diet soda drinkers had higher levels of certain hormones that stimulate transport of glucose (sugar) into fat cells. Likewise, switching to diet soda consumption doesn’t routinely encourage weight loss. This may have be due to the just-mentioned hormone effect, or perhaps drinking diet sodas keeps the taste and desire for sweet things in our brain so that we seek them out.  

​Even juices don’t get a pass. Like sweetened drinks juices are rather packed with calories and carbs. On the plus side, at least they provide some nutrition and vitamins in the mix. But in general it is better to eat the whole fruit rather than just the juice.

​Milk? Many folks have lactose intolerance and get gastrointestinal symptoms if they drink milk. Others worry about the calories in milk. Still, if you tolerate milk, drinking it in moderation (perhaps an 8 ounce glass or so per day) at least gives some protein, calcium, vitamin D and other nutrition in exchange for the calories.

​Well, what about unsweetened coffee or tea? Here the findings are mostly positive. Of course if you have problems with anxiety, heart palpitations, or acid reflux, caffeinated beverages may not be for you. On the other, if you don’t struggle with these issues, unsweetened tea and coffee may be a reasonable options. Several coffee studies have indicated positive benefits such as lower incidence of type 2 diabetes, diminished Parkinson’s disease, decrease in certain cancers, and sharper mental focus.  

​Naturally, alcohol also has its challenges. Some simply don’t like it or have been impacted by alcoholism in a loved one. If a person has no objection to drinking alcohol and can limit themselves to no more than two drinks daily (if they are males) or one drink daily (if they are females) then alcohol in careful moderation may be ok. Of course it will still often have empty calories and carbs.

​So finally that brings us to water. Here is still the best source for quenching our thirst and hydrating. There is no scientifically based right amount of daily water intake for everyone. But keeping well hydrated and thirst-quenched is certainly a good start. Yet even water has a couple of cautions. Drinking it unfiltered from local streams can lead to catching parasites such as Giardia. Even the plastic bottles that bottled water comes in have come under suspicion in recent years. Some studies have suggested that a chemical called PBA leaches from the bottles into the water, or other liquids, that they contain. It has been suggested that this may have negative effects such as lowering testosterone in men. The findings are still early, but they are enough to promote concern.

​So, what to drink seems to boil down to plenty of water from safe sources with options for unsweetened tea and coffee, and smaller amounts of juice and milk, and even smaller amounts of alcohol. There do seem to be a few non-sweetened seltzer type drinks that are likely not harmful as well. So when somebody asks, “What’ll you have to drink?” it’s a bit more complicated than it used to be… or on second thought, maybe the known healthy choices are getting fewer and simpler. One way or the other, find a way to keep healthy and hydrated in these hot summer months in Tennessee.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. He is contracted with some commercial insurance carriers and sees Direct Primary Care patients who do not have insurance, who belong to a cost sharing ministry, or who are on Medicare. He is accepting new patients. You may contact him at 982-0835


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