Welcome to the Making Healthy Food Choices program. In this session you will learn about making healthy beverage choices. This session is a part of the Making Healthy Lifestyle Choices Initiative. It focuses on behaviors outlined in the 2010 Dietary Guidelines. Many of us are aware that we need to make healthy food choices such as eating vegetables, fruits, whole grains, low-fat or fat-free milk and milk products and lean protein foods. However, many of us do not realize that making healthy food choices includes paying attention to what we drink.

These sessions are meant to be interactive and fun, and allow you to think about your food choices. The overall goal is to improve your health, well-being, and quality of life! Ice-breaker: Are you sweet smart? See handout. Ask participants to guess the amount of sugar in the various beverages.

Objectives

- State what is a sugar sweetened beverage (SSBs)

- Explain what happens when a person consumers too many SSBs

- Identify sources of sugar in food- Reflect on your personal beverage intake- Be empowered to make smarter beverage

choices- Set goals for healthy beverage choices

At the end the presentation you should be able to: • State what is a sugar sweetened beverage

(SSBs) • Explain what happens when a person

consumers too many SSBs • Identify sources of sugar in food • Reflect on your personal beverage intake • Be empowered to make smarter beverage

choices • Set goals for healthy beverage choices

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Beverage Facts

Sugar sweetened beverages are a major contributor to obesity.

The average per capita consumption of sugar sweetened beverages is 46 gallons per year or approximately 40 pounds of sugar.

• Soft drinks are a favorite among many in Kentucky and the nation.

• There has been an increase of sugar sweetened beverage consumption

• Soft drinks provide many calories and they are a major factor in weight gain and obesity.

Beverage Facts

• About half of the population drinks anywhere from one to more than four sugar sweetened beverages daily.

• Drinking more than four 12 ounce sodas a day adds as many as 567 calories – only from sugar sweetened beverages.

• This could add about 4½ pounds a month or 54 pounds a year.

• A child’s risk of becoming obese

increased 60 percent with every additional sugar sweetened beverage consumed daily.

• If the extra calories are not “burned up” they are stored in the body as fat.

• Soda and other sweetened beverages lead to tooth decay.

Some reasons for this phenomena:

• Fluids may not be as filling as solid foods and they may trigger a response that tells the body to keep eating.

• The body may not register fluid as carefully as it does solid foods.

• The sweet taste of soft drinks may stimulate the appetite for other sweet, high calorie foods.

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Did You Know?

Several research studies point to decreasing sugar sweetened beverages as a good strategy to decrease calories and help manage body weight.

Consumption of sugar sweetened beverages will contribute to weight gain if the amount of calories a person takes in is more than the total amount of calories required to maintain his or her weight.

Give up or limit sodas and other sugars sweetened beverage.

Did You Know?

• Giving up two cans of soda a day could lead to 20 pounds of weight loss in six months.

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Definition of SugarSweetened Beverage

Liquids sweetened with various forms of sugars that add calories.

What is a Sugar Sweetened Beverage?

Any drink sweetened with any form of sugar that adds calories. There are many types of sugar, for example, high fructose corn syrup, glucose, sucrose, honey, brown sugar, cane sugar, dextrose, etc. Sugar sweetened beverages may be commercial or could be made at home. For example, flavored drink mixes, sweetened teas, coffee (if sugar is added), different punch drinks, sport and energy drinks, and cocktails. Most sugar sweetened beverages provide calories with little nutrients.

ExamplesType of Beverage Calories in 12 ounces

Fruit punch 192

100% apple Juice 192

100% orange juice 168

Lemonade 168

Regular cola 136

Sweetened ice tea (not homemade) 135

Sports drink 99

Energy drink 160

Chocolate milk (2% reduced fat) 190

Café Latte (whole milk) 200

• Even flavored milk and 100% juice could be counted as sugar sweetened beverages if too much are consumed.

• A product that contains 100% juice provides several nutrients, but they also contain sugar present in the fruit and some even have added sugar.

• It is recommended that only 6 ounces of 100% fruit juice be used daily as a way to limit the intake of sugar.

• A good practice is to eat fruit rather than drink the juice.

Too Many Sugar

Sweetened Beverages Linked to overweight and obesity. This is

due to the high sugar content and calories in these drinks.

Increase the risk of heart disease.

Drinking calorie-containing beverages is connected with overweight and obesity.

Research suggests a very strong link to sweetened beverage such as soda and specialty coffee drinks with obesity. It is suggested that liquid calories are not as satisfying as calories consumed from solid foods, so people tend to consume more fluid calories to compensate. As a result, reducing liquid calorie intake has a stronger effect on weight loss than reducing solid calories People should carefully monitor the calories they drink and get enough water to maintain proper hydration every day. (American Heart Association).

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Too Many Sugar Sweetened Beverages

Increase chances of suffering from high blood pressure.

Replace healthy choices such as low-fat milk and fat-free milk and water.

• Increase the risk of heart disease: The extra calories from the sugar in these drinks lowers HDL (the good cholesterol that removes cholesterol from the arteries) and raises LDL (the bad cholesterol that clogs the arteries). A high level of LDL in the blood increases the risk for heart disease.

• Increases blood pressure: One study showed that individuals who consume one or more soft drinks per day increase their chances of suffering from high blood pressure.

• Lowers overall health: Strong evidence shows high soft drink intake is linked to lower intake of valuable nutrients, and lower overall health. It is important to be aware of your intake of sugar-sweetened beverages as their consumption may affect your health.

• Replaces healthy choices: When a person consumes too much sugar sweetened beverages the possibility exists that these drink are replacing healthy choices such as low-fat milk and fat-free milk and water

How Much Sugar is in Sweetened Beverages

http://www.youtube.com/watch?v=hF8XnU4L33U

What happens when you consume too many sugar sweetened beverages? Show video: Do You Drink 93 Packs of Sugar a Day?

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Just How Much Sugar is Needed Daily?

Women – 6 teaspoons Men – 9 teaspoons

• One 20 ounces soda has 16 to 18 teaspoons of sugar.

• A 20 ounce bottle of cranberry juice cocktail has 20 teaspoons of sugar.

• If we are to stay with the recommendations for sugar we have to limit these drinks and other sources of added sugar in the diet such as candies, cakes, and pastries.

What is Our Daily Intake?

22 Teaspoons Three times the recommendation!

Most of us take in more sugar than is needed.

What are the main sources of sugar in our diet?

The major sources of added sugars in the diets of Americans are soda, energy drinks, and sports drinks (36 percent of added sugar intake), grain-based desserts (13 percent), sugar-sweetened fruit drinks

(10 percent), dairy-based desserts (6

percent), and candy (6 percent).

Source: 2010 Dietary Guidelines for Americans.

How Much Sugar Are You Drinking?

http://www.youtube.com/watch?v=62JMfv0tf3Q&feature=watch_response

The American Heart Association recommends that all Americans consume no more than 450 calories (36 ounces) per week from sugar-sweetened beverages.

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One soda a day - 50 pounds of sugar a year.

Source: New York Health Department.

That is 12½, 4-pound bags of sugar per person.

There are plenty of naturally-occurring sugars, such as the fructose found in fruits or the lactose in milk. Those sugars are considered to be part of a healthful diet and won't be found in the ingredient list. If you do see sugar (or one of its other names) in the ingredient list, you can be sure it was added to the food; this is the type of sugar you want to limit in your diet

Source: American Institute for Cancer Research http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=20852

I-Spy Game Here are some practical tips for finding additional sugars on food labels. Hidden Sugar

Play the I-Spy Game. Look at the nutrition label and circle the different forms of sugar.

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Practical Tips to Identify

Added Sugars

Search the ingredient list for the word syrup, corn syrup, high fructose corn syrup, maple syrup or agave syrup

Look for words ending in “ose,” such as fructose, glucose and dextrose

Compare the unsweetened version of the product with the sweetened version

Beware of the health halo effect — brown rice sugar sounds more healthful — but it is just another added sweetener

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The ingredients on the label of a food product are listed in descending order with the largest amount first. If a sugar is among the first ingredients listed, or there are many different types of sugar listed, the product most likely has a lot of added sugar.

Source: American Institute for Cancer Research http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=20852

The Truth of the Matter

We all have a total number of calories we must consume each day

The number of calories we need varies based on a person’s age, gender, height, weight and level of activity

Food choices, as well as beverage choices, contribute to our calorie needs

• Very few of us, except for those physically active to the level of athletes, have room in our diet for many extra calories from added sugar in food and beverages.

• Sugar-sweetened beverages provide excess calories and few essential nutrients to the diet and should only be consumed when nutrient needs have been met and without exceeding daily calorie limits

Let us take some time and look at the amount of calories you should consume. Find your age and then your level of physical activity. How many calories should you be taking in? Allow time for participants to find their estimated calorie needs.

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• Food choices as well as beverage choices contribute to your calorie needs.

• Think of the amount of food you have to take in each day as your “calorie salary.” .

• Think of your calories like a budget. You should plan or include the essential food items first or the items needed to meet your nutrient needs.

• You can do this by making nutrient dense food choices.

• Another way to make sure you use your budget wisely is to use MyPlate to build a healthy eating pattern. Fill half your plate with vegetables and fruit. To fill the other half of your plate, add a some whole grains and lean protein food.

Getting calories from sugar sweetened beverages and other sugar products is like is squandering your money on things that are not important.

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To make sure you get what you need nutritionally, be sure to include essential foods with necessary nutrients first, then add non-essentials such as sweets or soda later.

Let’s look at Monica. She worked as an emergency medical technician. She had a very busy life, but wanted to be healthier, so she gave up drinking her 2 to 3 sodas per day. Since then she has lost 10 pounds. She now drinks more water and says that she does not miss the taste of soda.

How about you? Do you have a similar challenge? (wait for answers) What are some barriers to making healthy choices? (wait for answers) What can you learn from Monica’s story to help you overcome you barriers? (wait for answers) What are some other things you have given up? (wait for answers)

Jane allows her children Sara age 6 and Helen age 8 to drink orange juice throughout the day. They drink a total of five 8-ounce glasses of juice daily. They get 732 calories from orange juice alone. They should have 1600 calories a day. What suggestions do you have for Jane?

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Answers for Jane

• Limit 100 percent juice intake to 6 ounces a day

• Use fresh fruit instead of the juice

Those are very good suggestions. Here are some more good ideas. One glass of orange juice (8-ounces) has 122 calories. Use in moderation! Limit 100% juice intake to 6 ounces a day Use fresh fruit instead of the juice Drink water Be physically active each day.

Jim is a 50 years old and takes a 30-minute walk each day. After each walk he drinks a sports drink to quench his thirst. He confesses that he enjoys sports drinks and continues to drink them throughout the day. Jim notices that he has been gaining weight. What should Jim do? (wait for suggestions)

Those are very good suggestions, here are some more good ideas. Sports Drinks: Can contain up to 250 calories in 32 ounces and they are high in sugar and carbohydrates. Use water to quench your thirst.

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Making Healthy Beverage Choices

Mark has a very stressful job. Every evening before going home for dinner he and a couple of friends from work hang out at the bar for a couple of hours. He normally has two to three cocktails each evening. He mentions that he has made many business contacts at the bar and it has generally been good for his business. He noticed that he can no longer fit into some of his pants. What should Mark do?

Answers for Mark

• Choose lighter drinks like vodka with club soda, a glass of wine or a light beer.

• Use in moderation.

Those are very good suggestions, here are some more good ideas. Cocktails: Added sweet mixes, cream liqueur and coconut mix adds hundreds of calories. Remember alcohol contains a lot of calories and it is difficult to drink a lot while still maintaining weight.

• Choose lighter drinks like vodka with club soda, a glass of wine or a light beer.

Use in moderation. What about a diet soda with a twist of lime? An Arnold Palmer (tea and lemonade).

Anastasia is an admitted soda addict, she has one for breakfast every morning, and a big gulp at lunch to get her through the rest of the day. On her last doctor visit, he told her that she has pre-diabetes and if she does not lose weight, she will develop diabetes in 5 years. What should she do?

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Answers for Anastasia

• Choose diet instead of regular soda

• Downsize your drink

• Share your drink with someone

• Choose water or unsweetened juice

Those are very good suggestions, here are some more good ideas Regular Soda has no nutrients. It is like liquid candy!

• Choose diet instead of regular soda • Downsize your drink • Share your drink with someone • Choose water or unsweetened juice

Let Water Be Your Drink of Choice

• When thirsty choose water instead of sugar sweetened beverages

• Serve water with your meals

• Carry a bottle of water with you

• Add slices of fresh fruit to your water

• Choose water at restaurants

How can you make the smartest beverage choice?

Here is a day of drinking unhealthy beverages that are full of calories. Notice how quickly they can add up.

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Here is a day of healthy beverages choices. Notice that it is less than a quarter of the calories from beverages from the last slide, but you still get to drink your coffee and beer.

Stay Active

Getting all of the nutrients you need isn’t the only thing necessary for good health. Guidelines for good health recommend being physically active for at least 30 minutes most days of the week. Some tips for staying physically active include: Find something that you enjoy. Plan the time. Have partners. If you like to walk, turn your

walk into time with family or friends.

Getting all of the nutrients you need isn’t the only thing necessary for good health. Guidelines for good health recommend being physically active for at least 30 minutes most days of the week. This can include anything from walking at work to working in a garden or going for a swim. Physical activity does not always mean going to the gym or running a mile, it can be enjoying some playtime with your kids, cleaning house or going for a walk with some friends. Some tips for staying physically active include:

• Find something that you enjoy, if you like to garden, plant some vegetables or herbs

• Plan the time. Many people have very busy lives, but if you set aside the time to be physically active, you are much less likely to skip it.

• Have partners, if you like to walk, turn your walk into time with family or friends. Being committed to this time with someone else will give you more incentive to get out and do it.

Stay Active

Find people to support you. Set manageable goals. Giving yourself goals to

celebrate along the way will make exercise more fun and rewarding.

Remember: If you eat 100 more food calories a day than you burn, you will gain about 1 pound in a month. That’s about 10 pounds in a year.

Read information on slide Ask participants which of the tips work best for them.

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Physical Activity and Sweetened Beverages

http://www.youtube.com/watch?v=jxfu-SVK6OA

References

Centers for Disease Control and Prevention. Consumption of sugar drinks in the United States, 2005–2008. Accessed March 2, 2012 from http://www.cdc.gov/nchs/data/databriefs/db71.htm

Centers for Disease Control and Prevention. Rethink your drink. Does Drinking Beverages with Added Sugars Increase the Risk of Overweight?

http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf eXtension. A Day of Good Beverage Choices. Accessed March 2, 2012 from

http://www.extension.org/pages/19894/a-day-of-beverages-make-good-choices Harvard University. (2012). The nutrition source: sugary drinks or diet drinks: what is

the best choice? Retrieved from http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/sugary-vs-diet-drinks /

NYC Health. (2011). Pouring on the pounds. Retrieved from http://www.youtube.com/watch?v=jxfu-SVK6OA

NYC Health. (2010). Man eating sugar Retrieved from http://www.youtube.com/watch?v=62JMfv0tf3Q

NYC Health. (2011). Do you drink 93 sugar packets a day? Retrieved from http://www.youtube.com/watch?v=hF8XnU4L33U

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Graphics: Microsoft Online, USDA Food and Nutrition Services

Ingrid Adams, Ph.D. R.D. L.D. Extension Specialist for Physical Activity and Weight ManagementElizabeth Creed, B.S.Woodford County Extension Agent for Family and Consumer Sciences Mallory Foster, B.S.Graduate Student, Dietetics and Human Nutrition

September 2012

Copyright © 2012 for materials developed by University of Kentucky Cooperative Extension. This publication may be reproduced in portions or its entirety for educational or nonprofit purposes only. Permitted users shall give credit to the author(s) and include this copyright notice.Educational programs of the Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability, or national origin.

Educational programs of the Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability, or national origin.