AAP comes out strongly against sugary sports drinks

David Ludwig, MD, PhD, director of the Boston Children's/New Balance Foundation Center for Obesity Prevention.

The American Academy of Pediatrics (AAP) sent a strongly worded message to parents this week: your children should not drink sports drinks or energy drinks.

The ads for these drinks are full of athletes exercising and the message is clear: sports drinks will help us be faster and stronger. More than that, the message is that we need them for exercise, because they replace the fluid we lose in sweat. “Energy and sports drinks are marketed in a way that imbues them with a healthy halo,” says David Ludwig, MD, PhD, director of the New Balance Center for Obesity Prevention at Children’s Hospital Boston.

“Over the last decade, many studies have highlighted the adverse effects of the traditional sugar-sweetened soda,” says Ludwig. With declining consumption rates of these drinks, the food industry has tried to create a submarket of alternative beverages. Sports drinks are still sugar-sweetened, but they typically have about 25 percent less sugar and some electrolytes.

But they aren’t healthy at all. Quite the opposite, in fact. “Sports drinks still provide many unnecessary, low quality calories. Moreover, since they seem healthy, people may tend to consume even more of them,” says Ludwig.

It’s important, says the AAP, that parents understand the difference between sports drinks and energy drinks. Sports drinks are flavored beverages with some electrolytes, minerals or other stuff thrown in; “energy” drinks additionally have some sort of stimulant, most commonly caffeine.

The biggest concern with sports drinks is that they are extra calories, and can increase the risk that a child will become obese.

“Humans are designed to get their calorie requirements from solid foods, and their water requirements from drinks,” says Ludwig. “When we mix those up, problems can arise. We don’t seem to regulate body weight effectively when large numbers of calories come in liquid form. Liquid calories seem to slip underneath the body weight regulating radar system, so we don’t perceive that we’ve consumed the same number.”

“Humans are designed to get their calorie requirements from solid foods, and their water requirements from drinks,” says Ludwig. “When we mix those up, problems can arise.”

In one classic study, participants were given a fixed amount of sugar—but one group got it as jelly beans, the other got it as a sugared beverage. The participants who got the jelly beans stayed fuller longer, and ate less, than those who got the beverage.

“When we chew and swallow a solid food, and it takes up space in our digestive tract for a while, the gastrointestinal track sends sensory and hormonal messages to the brain that make us feel full. That doesn’t occur as effectively with liquids. The body isn’t evolutionarily prepared to recognize that liquids could actually contain a lot of calories. It’s not just how many calories are in a food, but how full those calories make us feel.”

Another problem with calories in liquid form is that we often consume them out of thirst, not hunger. The liquid satisfies our thirst—but the calories are left behind.

The AAP has even stronger wording about energy drinks, which it says are not appropriate for children and adolescents and should never be consumed. Ludwig agrees with this position. “They are not only of poor nutritional value, but they could also cause acute problems, such as caffeine overdose, or other toxic side effects.”

So what should children and adolescents drink when they exercise? Water, says the AAP. That’s all they need. Sports drinks only really make sense when kids are engaged in prolonged, vigorous activity, like a soccer tournament or a track meet. They make no sense for the average soccer game—and they certainly make no sense as a regular beverage (video games do not count as a sport).

Bottom line: calories should come from food, and our water requirements should come from beverages (preferably water).

“That, as a single step, could do more to reduce obesity prevalence than any other dietary change,” says Ludwig. “As changes go, it’s as easy and powerful as it gets.”