How sugary beverages affect health in Tennessee (and what to drink instead)

When it comes to staying healthy, people talk a lot about food and nutrition, but what part do beverages play? 

According to the Tennessee Department of Health, a big one. Did you know that just 20 ounces of regular soda a day can add up to 20 extra pounds over a year? And soda isn’t the only culprit. 

“Beverages can be a sneaky way of adding ‘empty’ calories to your diet,” says Reena Panjwani, registered dietitian-nutritionist at BlueCross BlueShield of Tennessee. “When I talk with people who want to lose weight to improve their health, I ask what they eat but also what they drink. Even if you’re eating a well-balanced diet, it can be hard to stay healthy or lose weight if you’re drinking a lot of high-calorie beverages.” 

The American Heart Association recommends limiting added sugars to: 

  • 6 teaspoons (25 grams or 100 calories) for most women and children over 2 years
  • 9 teaspoons (36 grams or 150 calories) for most men

What drinks cause the biggest health concerns?

In Tennessee, soda, sweet tea and drinks made from flavored mixes are the sugar-sweetened beverages of choice. 

“A lot of times people think, ‘As long as I’m not drinking soda all the time, it must be better,’” says Panjwani, “but all of these drinks contain high amounts of added sugar and calories.”  

Here’s how much sugar is in 12 ounces of these beverages:

Beverage Grams of sugar Teaspoons of sugar
Flavored drink mixes 24 
Cola 39-41 10 
Citrus soda 46  11.5 

Other sugar-sweetened drinks to look out for include:

  • Coffee-based drinks
  • Fruit juice
  • Packaged fruit drinks
  • Lemonade
  • Flavored drink mixes
  • Ginger ale
  • Milkshakes
  • Sports drinks
  • Sweet tea

Coffee drinks

“Coffee itself doesn’t contain sugar,” says Panjwani, “but milk, sugar, flavored creamers and sweetened syrups do. If you order a caramel latte, for example, you are getting a lot of added calories and sugar — nearly as many as a can of regular soda.” 


“Orange juice, apple juice and cranberry juice cocktail all contain a lot of sugar,” says Panjwani. “They seem like they should be nutritious because they’re fruit-based. But an 8-ounce glass of juice has about 26 grams of carbohydrates, and that can quickly spike your blood sugar, especially for people with diabetes.”

It is important to note, however, the difference between sugar and added sugar in drinks. For example, 100% orange juice has no added sugar — only natural sugar from the orange. So while a soda and a glass of orange juice contain the same amount of total sugar, it’s healthier to drink orange juice than soda. Nutrition labels should have these categories of sugar listed separately 

Instead of drinking juice, try eating whole fruit, which gives you the fiber and nutrients without the high concentration of sugar. And if you enjoy packaged, juice-based drinks, be sure to read the label. 

“It’s easy to get tripped up by drinks that seem healthy,” says Panjwani. “Those drinks may have some nutritional value, but an 8-ounce serving has half as much sugar as a can of soda. If you do drink these, choose one that’s only a single fruit per serving and the rest vegetables.”


A glass of lemonade is slightly better than drinking a sugary soda — 26 carbs versus 35 or 40 — but it’s still high in sugar and low in nutrients. 

Ginger ale 

“People often think ginger ale is a better choice than regular soda because it can settle their stomach,” says Panjwani. “While ginger may help, ginger ale still has a lot of sugar — about 32 grams per serving. Ginger tea may be a better option for a stomach ache or nausea.”  


Smoothies can be very healthy, but the sugar can easily add up. Retail smoothie makers often use juice to blend ingredients together, syrup to sweeten and peanut butter or chocolate to add a creamy texture.

“Make your smoothies at home where you have more control over your ingredients,” says Panjwani. “Consider working in greens as well since smoothies mask the taste. Baby spinach, for example, doesn’t have a lot of flavor once it’s blended up with yogurt, protein powder and fruit, but you still get all of its nutrients and some fiber.” 

Sweet tea

Similar to lemonade, an 8-ounce glass of sweet tea can have 20-30 carbs per serving, and many people drink more than that. 

How do diet drinks factor in?

“Most diet drinks are made with artificial sweeteners, which are generally recognized as safe in place of regular sugar,” says Panjwani. “If you’re using them short-term to wean yourself off of regular soda or get your blood sugar under control, they can be a good temporary switch.” 

While sugar-free sodas and low-sugar sports drinks are considered safe, some studies in animals have shown they can lead to weight gain. Artificial sweeteners may make us crave more sweets, so if you drink diet beverages, do so in moderation.

What part does alcohol play?

People under stress may use alcohol as a coping mechanism, which can be a slippery slope.

“If you do drink alcohol, the CDC suggests limiting your intake to 2 drinks per day for men and 1 drink per day for women,” Panjwani says. “And remember that some alcoholic beverages or cocktails can be high in sugar, carbs and calories. For example, a frozen margarita can have up to 50 carbohydrates. Even if your drink choice is lower in calories and carbs, such as white wine (4 carbs), you may make less healthy choices after you drink it.” 

What about caffeine?

“Many of us use caffeine, specifically coffee, to energize us in the mornings,” says Panjwani. “Caffeine can reduce your appetite for a brief period. If you drink coffee first thing, you may be tempted to skip breakfast and eat more later in the day.” 

Eat a breakfast with fiber and protein — an apple with peanut butter, for example — before your morning coffee and you may get the energy boost that you need. 

Rethink your drink: 3 tips to keep your beverages healthy

1. Drink water first

“Our bodies are mostly water, and we have to keep them hydrated in order for them to run properly,” says Panjwani. “Before you drink any beverage, drink one glass of water first. Not only will that combat the dehydrating effects of any caffeine or sugar, but you may end up drinking less of the sugary beverage.”

If you don’t like the taste of water, try:

  • Adding a squeeze of citrus (lemon, lime, orange, tangerine)
  • Infusing it with fruit (melon, apple, cucumber, herbs) 
  • Seltzer or carbonated water
  • Lightly flavored drinks such as Hint or Spindrift, which has just 1 carb and 2 grams of sugar per can

2. Make smart soda choices

“If you’re trying to lose weight, drinks are usually the first place you can cut back on excess calories,” says Panjwani. 

  • If you drink 3 regular sodas per day, try to cut back to 1. 
  • If the choice is between diet and regular soda, choose diet. 
  • If you do choose to drink diet soda instead of regular soda, avoid replacing the sugar from soda with high-sugar or high-carb foods such as cookies or sweets.

3. Temper your tea

“If you love sweet tea and don’t want to give it up, try diluting it with ice or water,” says Panjwani. “Or try half sweet and half unsweet. Then maybe back it off to just a splash of sweet tea in your unsweet.”

If you already enjoy tea, consider trying different varieties (green, Oolong, chai) or hot tea with sugar-free sweeteners, or a teaspoon of agave or honey.

For more healthy beverage ideas, check out 6 drinks to boost heart health. 

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).

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Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).