Whether you’re out with family eating dinner, celebrating a promotion with co-workers after hours, or just looking for a quick-fix of caffeine or an energy boost in the morning, sugary drinks are just about everywhere — and they often can be hard to avoid.

When you’re in the mood for a little something extra, you may order a fresh raspberry iced tea, a cinnamon-infused Coke or a citrusy margarita to quench your thirst. But there’s a problem with those sweet, refreshing treats: Those tasty beverages can be deceptively high in sugar, which in large amounts can lead to life-altering health problems.

“Sugar-sweetened beverages are my personal nemesis as a registered dietitian,” says Christen Cupples Cooper, founding director of the nutrition and dietetics program at Pace University in New York City. “If you think about it, no one needs soda or juice to live. Years ago, when we limited sugary beverage intake to birthday parties and other special occasions, having 6 or so ounces at a time, we didn’t have much to worry about. Today, with Americans regularly drinking 32 ounces of what amounts to sugar, caramel coloring and carbonated water, we have a lot to worry about.”

The Centers for Disease Control and Prevention says sugar-sweetened beverages (SSB) are the leading sources of added sugars in the American diet. According to the USDA, nearly 40% of all added sugars come from sugary drinks. Frequently consuming them is associated with weight gain and obesity, Type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, and tooth decay and cavities.

That’s why making smarter drink choices can pay off big time — not just for your waistline but your overall health and well-being.

So, what does sipping on soda, juice and other sugar-containing beverages do to the body? What’s considered a sound sugary-drink dosage? What happens to cells when sugar and insulin are released into the bloodstream? And how you can curb your sweet tooth and stay hydrated with some healthier drink choices?

Sugar overload

Sugar-sweetened beverages are any liquids that are sweetened with various forms of added sugars, according to the CDC, such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar and sucrose. Regular soda (as opposed to sugar-free), fruit drinks, sports drinks, energy drinks, sweetened waters, and coffee and tea beverages with added sugars are all examples.

“Coca-Cola, Pepsi, Dr. Pepper, Mountain Dew and the majority of soft drinks found in vending machines, sold in grocery stores and purchased at public venues have an average of 65 grams of sugar,” says George Roberts, the Texas-based president of the National Association of County and City Health Officials, headquartered in Washington, D.C. “One gram of sugar within any beverage or within any food is equivalent to 4 teaspoons of sugar, and drinking 65 grams of sugar is the same as consuming 16 spoonfuls of sugar.”

Other high-sugar beverages include RedBull, Rockstar and Monster energy drinks, Dunkin’ Donuts' mocha drink, Cherry Coke, McDonald’s McCafe Mocha drink, Sprite, and Lipton and Arizona iced teas, according to recent research by Euromonitor, a market research company that focuses on consumer products and consumer lifestyles in the United States.

“SSBs deliver an enormous number of calories with absolutely no nutritional benefit — no vitamins, minerals, fiber or protein,” Cooper says. “SSBs have been linked to being overweight and obesity, increased risk of cardiovascular disease, and increased risk of mortality.”

The World Health Organization recommends that adults limit themselves to 25

grams of added sugar per day. But the U.S. Food and Drug Administration is a bit more generous with its guidelines, suggesting that Americans consume no more than 50 grams of sugar daily.

“The Institute of Medicine of the National Academies of Science recommends that less than 25% of our total daily caloric intake should come from sugar,” Cooper says. “The American Heart Association recommends limiting added sugars, those found in SSBs, candy, sugary snacks, baked goods, some breads and even some condiments like ketchup, to less than 100 calories per day for women and 150 calories per day for men. That’s less than half of a 20-ounce bottle of soda per day and less than a candy bar or a bag of candy.”

The average American, meanwhile, eats or drinks nearly double the FDA’s limit, and experts are increasingly finding out about the consequences of such excess amounts.

“The increased consumption of sugary beverages have been blamed globally for the increase in obesity and its associated diseases — Type 2 diabetes, heart disease, cancer, etc. — over the past decades,” says registered dietitian Ronette Lategan-Potgieter, a visiting assistant professor at Stetson University in DeLand, Florida. “The main concern with sugary beverages is the amount of ‘easily consumed’ calories that are provided with very little or no other micronutrients.”

More serious consequences

According to Lategan-Potgieter, our body needs a certain amount of nutrients each day to function, perform and repair itself. Refined sugar is not among those nutrients and is, in fact, something the body is better off never being exposed to.

Adverse health conditions directly linked to sugary drink consumption include diabetes, cardiovascular disease, cavities and excess body weight, according to the American Cancer Society. The ACS also says drinking sugar-sweetened beverages is “associated with overall poor diet quality, including higher intakes of refined grains and lower intakes of fruits and vegetables… In addition, when calories are consumed as beverages people do not feel as full.”

“Fullness suppresses hunger and helps us avoid overeating, and the low satiety achieved with sugary beverages makes it easier for a person to add extra calories without feeling full,” says Roberts.

He adds that soft drinks are equivalent low-nutrient beverages that also contain carbonic acid, which contributes to the degradation of tooth enamel. Soft drinks also contain phosphoric acid, which acts as an anti-fungal and antibacterial agent by slowing the growth of molds and bacteria.

“Without phosphoric acid, molds and bacteria would rapidly multiply within the carbonated beverage due to the high sugar content that is contained within the most frequently consumed soft drinks,” Roberts says.

The American Cancer Society says sugary drinks are related to cancer risk in relation to excess body weight, and that approximately 20% of all cancers are caused by poor diet, excess body weight, physical inactivity or excess alcohol consumption.

Excess body weight is clearly associated with an increased risk of developing at least 13 cancers including those of the breast (postmenopausal), colon, rectum, kidney, uterus, pancreas, liver, gastric cardia, kidney, gallbladder, thyroid, and adenocarcinoma of the esophagus, meningioma and multiple myeloma, according to the ACS. Excess body weight also increases the likelihood of cancer recurrence and lowers the chance of surviving several cancers, the ACS states.

The body breakdown

On a cellular level, the body’s reaction to sugar involves “various cause-and-effect processes,” says Kelly Miller, a Denver-based nutrition recovery coach and owner of the virtual coaching company Addiction Nutritionist.

“Sugary drink consumption causes a sharp spike in blood sugar, which leads to an overproduction of insulin, which causes our blood sugar to crash,” Miller says. “When blood sugar gets that low, the body’s adrenals react by releasing adrenalin, and that process causes the prefrontal cortex area of the brain to shut down.”

She adds that sugar ingestion blocks the absorption of essential nutrients, including vitamin D and calcium, which are vital for bone formation. Sugar ingestion also blocks the absorption of magnesium, chromium and vitamin C, she says.

According to Miller, the prefrontal cortex portion of the brain enables us to make good decisions, and sugar can lead to this part of the brain shutting down. As a result, the primitive, “survivalist” part of the brain takes over and the ability to think things through and make healthy decisions is inhibited.

“The reptilian portion of our brains simply seeks survival and puts us at great risk for making bad eating decisions,” she says. “For example, we get ‘hangry’ and grab a candy bar and soda because it’s quick and easy. When this process happens repeatedly, our body experiences adrenal fatigue. Longer-term effects of sugar-induced adrenal fatigue include an inability to cope with stress and bounce back from life’s everyday challenges.”

Sugar causes an overproduction of insulin, Miller says, resulting in weight gain. Insulin is a fat-storage hormone, so spiking it is essentially telling the body to store more fat. Because it spikes the blood sugar, sugar also causes “brain fog,” where people may have trouble concentrating and thinking clearly, she says.

And similar to addictive substances such as alcohol, nicotine and cocaine, sugar causes an unnatural and excessive release of dopamine and serotonin within the brain, according to Miller.

“Because it’s not a natural release, the body responds by lowering the endogenous production of these two chemicals to maintain a state of homeostasis, i.e., a natural balance,” she says. “This process often leads to depression, irritability, anxiety, lethargy and loss of motivation. Additionally, sugar causes an inflammatory state in the body. Multiple studies have closely linked inflammation with depression.”

Is parting such sweet sorrow?

Given that juices and soft drinks both can contain a lot of sugar in them, you might often wonder what’s the better option? Sure, many juices may offer some additional vitamins, but there can still be a lot of empty calories, according to Lategan-Potgieter.

“Fruit juice also contains a lot of sugar, although in other forms,” she says. “Fruit juice, however, also provides vitamins and minerals that soft drinks typically do not provide.”

Lategan-Potgieter recommends we drink water and eat whole fruits to ensure enough fiber is consumed.”

When it comes to alcoholic beverages, sugar is often added back to them for extra flavor, or the fermentation is prematurely stopped to leave some residual sugars. Wine coolers, white wines, beer, daiquiris and hard seltzers are loaded with sugar.

“Our body prioritizes what it will metabolize,” Miller says. “The body views alcohol as a poison and works to rid itself of that substance first, so other fats move to our body’s fat storage area and stay there for longer time periods.”

Alcohol’s presence in the body can block fat burning for 48 to 72 hours, and we often consume alcohol when we’re eating high-fat and high-carbohydrate foods — fried chicken tenders, nachos, etc. — so those foods automatically take lowest priority for metabolization efforts. Alcohol can also affect decision-making and lead to high calorie consumption.

“People who seek to lose weight need to understand the effects of alcohol on their efforts,” Miller says.

A “healthy” limit of consuming sugary beverages, according to Roberts, depends on a person’s health history and weight control goals.

“Whole fruits are a better choice,” he says. “Sugary beverages are empty calories that contribute no nutritional value to food intake. Most of the general public does not need the added empty calories, yet in the United States, one in three adults and one in five children consume at least one sugary drink per day."

The concerning words within the previous sentence are “at least,” he adds, as there is a difference between the scientifically calculated serving size of a sugary beverage and the volume that is contained within a person’s beverage holder.

According to the Tri-County Health Department’s 2017-2018 Sugary Drink Public Information Campaign, by drinking one sugary drink per day, a child has a 25% increased risk of developing Type 2 diabetes, a 55% greater risk of being overweight or obese, and a 150% greater risk of developing fat deposits in their liver, contributing to diabetes and heart disease as they age. And sugary drinks are associated with nearly twice the risk of cavities in children.

“Children have small stomachs compared to adults,” says Cooper of Pace University. “Therefore, when they fill up on candy, sugary snacks and SSBs, there’s little room for more nutritious foods that they truly need for healthy growth and development.”

The World Health Organization and the Food and Agriculture Organization of the United Nations recommends that sugar intake “should be restricted to less than 10% of total energy,” Lategan-Potgieter says. “For a person requiring 2,000 calories per day, that will be less than 200 calories, or about 50 grams of sugars.”

If you want to curb your sweet tooth for sugary beverages, Dr. Rocky L. Napier, president of the South Carolina Academy of General Dentistry, has some advice.

“The best way to curb the sweet tooth is to simply cut the sweets, as sugar can have an addictive component to it in many individuals,” he says. “As you drink more water and lower fat milk, 1% or 2% milk and no higher, the sweet drinks will become too sweet, and the 4% milk will become too heavy or thick.”

Also, instead of fruit juice — and no more than 6 ounces per day, in his opinion — eat whole fruit.

“It is better for you since it contains all the natural fiber of the fruit,” Napier says. “There is a saying I use: If you want to drink some fruit juice, then eat it.”

Roberts says if it’s inevitable that sugary beverages will be the only type of drinks being served at a function, it’s OK to consume a soft drink or your favorite sugary alcoholic or nonalcoholic beverage. Just remember to employ these strategies:

• Alternate drinking a beverage with drinking water

• Consume the beverage in combination with eating a meal that has complex carbohydrates (e.g., brown rice, sweet potatoes, cruciferous veggies)

• Try to drink water during the meal, and save the sugary beverage as the dessert of your meal

• Invoke your willpower and avoid the sugary beverages altogether

Lategan-Potgieter adds one last go-to grocery tip: “It is important to read food labels to compare sugar and energy content because even seemingly healthy drinks can be loaded with sugar and calories,” she says.