As a reference throughout this article:

• 1 carbohydrate choice = 15 grams of carbohydrate
• 3-4 carbohydrate choices are typically recommended per meal (45-60 grams of carbohydrate)
• 0-2 carbohydrate choices are typically recommended per snack (0-30 grams of carbohydrate)

Some of the beverages people choose give the amount of carbohydrate that is recommended for an entire meal. Then add solid food, and blood sugar is high.

A couple of months ago, I met with a client whose blood sugar was always high. He had quit drinking regular pop, and switched to fruit juice because he thought it was better for him. Juice has some vitamins and minerals, but it has about the same amount of carbohydrate and calories as pop. Once he was able to eliminate regular pop and fruit juice from his diet, his blood sugars improved significantly without needing to increase medications.

Below is a summary of information from the Nutrition Action Newsletter on beverages. The Newsletter editor interviewed an expert from The Beverage Guidance Panel. The Panel was formed because people don’t understand that beverages are less satiating (filling) than solid foods. When you consume calories from beverages, you don’t compensate by eating less food later on. Liquid calories don’t register with our appetite controls. For example, if you drink a glass of milk, you don’t eat less food later. However, if you eat low-fat dairy products like yogurt and cottage cheese, you eat less food later. The same holds true for juice and fruit—better to eat the orange than drink the juice. Solid food fills us up, liquids don’t.

Water = Friend
Water is our Best Friend when it comes to beverages. It’s carbohydrate and calorie free so it won’t raise blood sugar or weight. If we have a healthy, balanced diet, it is the only beverage we need.

Tea and Coffee = Friends
Unsweetened tea and coffee don’t have many calories and thus don’t raise blood sugar or weight. The health benefits of tea are still being studied, while coffee has been shown to lower the risk of diabetes and Parkinson’s disease. Tea has about half the caffeine of coffee. A small amount of caffeine improves your mental acuity, physical performance, reaction time, vigilance, visual processing and your mood state. However, too much caffeine has adverse effects (400-500 milligrams per day). The Beverage Guidance Panel recommended a maximum of four cups of unsweetened coffee per day OR eight cups of unsweetened tea per day (8-ounce cups). Coffee is a good example of how beverages have changed over the years. An 8 oz cup of coffee with 1 liquid creamer and 1 sugar packet has 30 calories and 5 grams of carbohydrate verses a 20 oz Starbucks Cappuccino which has 210 calories and 17 grams of carbohydrate.

Skim Milk, 1% Milk, Plain Soy Milk = Friend
2% Milk, Whole Milk, Flavored Milk = Foe
Skim and 1% milk supply calcium, magnesium, potassium, and vitamin D. If you can’t drink cow’s milk, fortified soy milk has many of the same nutrients. The Beverage Guidance Panel doesn’t think anyone school-aged or older should consume whole or 2% fat milk because of the saturated fat. The Panel recommended up to two cups of skim or 1% fat milk a day, and maybe more for children and adolescents. An 8-ounce serving of Skim milk has 12 grams of carbohydrate and 80 calories. The carbohydrate stays the same in an 8-ounce serving of whole milk, but the calories go up to 150. The Panel didn’t recommend flavored milk because the calories double, and so does the carbohydrate.

Fruit Juice = Acquaintance
Fruit juices may have health benefits, but they also have a lot of calories and carbohydrate. 8 ounces of orange juice has 110 calories and 30 grams of carbohydrate.

Fruit juices raise blood sugar quickly which is important if you are having a low blood sugar. Juices are processed, so they lose the fiber and some of the vitamins and minerals that the whole fruit provides. The Panel recommends limiting fruit juice to a maximum of four to eight ounces daily.

Regular Soft Drinks = Foe
Diet Drinks = Acquaintance
Regular soft drinks are high in calories and have been shown to cause weight gain. They are also high in carbohydrate and will raise your blood sugar. Diet drinks don’t have calories or carbohydrate so they won’t cause weight gain or raise your blood sugar. There are a few studies that suggest that diet drinks condition us to have a high preference for sweetness, but it hasn’t been proven yet. The Panel thinks it’s better to drink diet drinks than regular soft drinks, fruit drinks, etc. and didn’t think there was much evidence against the safety of any of the FDA-approved sweeteners. They were cautious about saying that you can consume a lot of diet drinks because of the possibility that they condition people to prefer sweets. Neither regular soft drinks or diet drinks have any health benefits, but people enjoy the taste. A 20 oz Coke has 240 calories, 65 grams of carbohydrate, and 60 milligrams of caffeine. A 20 oz Diet Coke has 0 calories, 0 grams of carbohydrate and 80 milligrams of caffeine.

Sports Drinks = Friend When Needed
Sports drinks have fewer calories and carbohydrate than soft drinks, but only endurance athletes need them. For regular physical activity, satisfy your thirst with water.

Alcoholic Beverages = Acquaintance, Friend & Foe
One drink a day for women and two a day for men is considered moderation and may lower risk of cardiovascular disease, diabetes and gallstones. However, excessive alcohol consumption causes serious health and social problems. Alcohol may cause a low blood sugar reaction. It is high in calories and stimulates appetite. With diabetes, alcohol can be safely used only when blood sugar is well controlled.

Summary
The Panel’s advice was adjusted to accommodate preferences and nutrient needs. Per day, they suggest we drink:

• mostly water
• 0-5 servings of unsweetened coffee or tea
• 0-2 servings of low-fat milk
• 0-4 servings of diet drinks
• 0-1 servings of 100% fruit juices, sports drinks, and alcoholic beverages
• 0-1 servings of regular soft drinks and fruit drinks

A serving is one cup (8 oz), not a 12 oz can of soda. A serving of beer is 12 oz., wine is 5 oz., and distilled spirits are 1 1/2 oz. The most important change is to eliminate regular soft drinks or fruit drinks and switch to water and low-fat milk.