Rethink your drink, choose water

Overwhelmed with the wide choice of what to drink, most of it sweetened with sugar, we’ve somehow left the simple, but profound goodness of water behind.

National Nutrition Week 2017, running from 9 to 15 October and, with its theme “Rethink your drink – choose water”, aims to help us rethink when it comes to water and get into the habit of making water our beverage choice each day. Water hydrates and contains no kilojoules. It is essential for health and is the best choice to quench thirst.

What the campaign highlights is that when we are not drinking water, we are probably choosing a sugar-sweetened drink which spikes our daily kilojoule intake, degrades our diet, and leads to weight gain and the onset of non-communicable diseases such as type 2 diabetes, heart disease and dental caries.

“The prevalence of obesity and non-communicable diseases in the country is alarming,” says Rebone Ntsie, Director of Nutrition of the National Department of Health.

“The South African Demographic and Health Survey conducted in 2016 found that the prevalence of overweight was 13.3% among children 0 – 5 years of age. About 67.6% and 31.3% of South African women and men respectively are overweight and obese. These findings show that overweight and obesity among children and adults have increased from earlier surveys. Replacing sugary drinks with water can help.”

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA), warns that the risk of coronary heart disease and ischaemic stroke rises with an increase in body weight.

“There is also a clear link between sugary drink consumption and heart disease,” she says. “Indicators of heart disease such as blood lipids and uric acid also increase with an increase in consumption of sugary drinks.”

Daily consumption of two or more sugary drinks has been found to increase the risk of developing diabetes by at least 24% compared to consuming less than one sugary drink per month. According to Statistics South Africa, diabetes was the second leading underlying cause of death in the country in 2015, accounting for 5.4% deaths and the leading cause of death in females (7.1%).

On average, commercially produced sugary drinks contain the following amounts of sugar per 500 ml serving (2 average-sized cups/glasses):

• Sweetened fizzy drinks: 13 – 17 teaspoons
• Energy drinks: 13½ to 15 teaspoons
• Fruit juice: 12 – 16 teaspoons
• Sweetened milk or yoghurt-based drinks: 7 – 13½ teaspoons
• Sweetened iced tea: 8 – 10½ teaspoons
• Sports drinks: 4½ – 12 teaspoons
• Sweetened drinks, such as sweetened flavoured water, vitamin enriched water and coconut water: 4 – 8 teaspoons of water

The World Health Organization (WHO) recommends that the intake of free sugars, i.e. sugars added by the manufacturer, cook or consumer or sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, should be less than 10% of the total daily energy intake for adults and children and less than 5% for further health benefits.

“This means that the maximum intake of free sugars from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 12 teaspoons, and for adult women and children 5 – 13 years, not more than 9 teaspoons,” says Nicole Lubasinski, President of the Association for Dietetics in South Africa (ADSA).

“To achieve more health benefits, the number of teaspoons of sugar from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 6 teaspoons, and for adult women and children 5 – 13 years, not more than 5 teaspoons.”

“Some sugary drinks have a nutrition information label. This will indicate how much of the carbohydrate in the drink is found as sugar,” says Carol Browne of the Nutrition Society of South Africa (NSSA).

“Sugar is one of the primary ingredients in drinks, and so it will be listed high up on the list of ingredients. In milk based drinks some of the sugar will be the sugar from milk, and this is not classified as a ‘free sugar’. In these products the total sugar content on nutrition information label should be considered with the ingredient list.”

“It makes good sense to replace sugary drinks with lots of clean safe water, says Rebone Ntsie. “Drinking lots of clean and safe water is essential for one’s health. Besides keeping you hydrated, it helps with digestion, regulate your body temperature, and to lubricate your joints. Furthermore, tap water is cheaper than any other drinks.”

“There are several ways to increase your intake of water,”, says Abigail Courtenay, registered dietitian and spokesperson for ADSA. “Make sure you always carry water with you; set reminders on your cell phone or notes at your desk every hour; drink water with meals; before and after exercising; and send a bottle of water with your child to school every day.

You can also add fresh slices of lemon, cucumber, mint leaves, lime or fresh fruit to your water or unsweetened rooibos or herbal teas to add more flavour.”