WHAT TO DRINK?

With so many drinks to choose from at home, in the supermarket, the corner store, the theatre or the club/pub/bar, it can be confusing to know which option is best. Like most things, it depends of course on your personal circumstances and the occasion. Let’s look at a few of the more common non-alcoholic options that are available to most of us.

Firstly: how much to drink?

Depending on our sex, level of physical activity, body composition and the weather, we need between 35–45 millilitres (mL) of fluid for every 1 kg (2.2 pounds) of our body weight, each day.

It’s relatively easy to work out how much fluid you need to drink as an individual. As an example, in 2022, the average Australian woman weighed 73 kg and the average man 87 kg, so a typical woman needs between 2.5–3.3 L, and a man 3.0–3.9 L of fluid each day.

All fluids do not need to come from drinks, however, as believe it or not, around 750 mL comes from food and a further 250 mL comes from the metabolism of food.

So, on average, women should aim to drink 1.5–2.3 L (6–9 Cups) of fluids each day and men 2.0–2.9 L (8–12 Cups) each day.

Water: the thirst quencher

It goes without saying that plain water is the best drink to quench your thirst: it is the most refreshing, provides zero kilojoules/calories, plus a few minerals (if it hasn’t been purified). Pure water doesn’t have any taste, although the minerals that are sometimes found in water naturally, or that are added (e.g., fluoride), can give it an unusual flavour. If water flavour is an issue for you, try a water purifier and/or adding some ice and a slice or two of lemon or lime.

Depending on the source, mineral water contains relatively small amounts of sodium, potassium, magnesium and calcium and is generally a suitable alternative to plain water for people with diabetes and those at risk.

Low energy (kilojoule or calorie) soft drinks (soda / pop / fizz)

Unlike plain or mineral water, people with diabetes and those at risk can enjoy low energy (“diet” or “no sugar”) soft drinks occasionally, but arguably should not consume them on a daily basis. This is because carbonated beverages have a low pH (they are acidic), and in theory, frequent consumption may increase the risk of developing tooth decay which is a serious health issue for many people. However, they have no effect on blood glucose levels, and provide very few kilojoules/calories, and there is evidence from randomised controlled trials in humans that substituting regular soft drinks with diet/no sugar varieties will help people to lose weight.

As you may have heard, low energy soft drinks that are sweetened with intense sweeteners are positively associated with increased risk of weight gain and type 2 diabetes in observational studies. The associations are likely due to what we call confounding: people that consume these drinks regularly have other health habits or characteristics that likely increase their risk. In support of this, when we look at observational studies that incorporate substitution analyses (i.e., when low energy soft drinks are consumed instead of sugar sweetened soft drinks), the results are consistent with the evidence from randomised controlled trials: people lose weight and don’t have an increased risk of diabetes.

Fruit juices and fruit drinks

Fruit juices are made from 100% fruit whereas fruit drinks are also made from fruit, plus water and added sugars.

Fruit juice and fruit drinks can also be enjoyed occasionally, but ideally not on a daily basis either. They are a source of kilojoules, vitamin C, dietary fibre and carbohydrate. On average, they provide 400 kJ per 250 mL serve (1 Cup), and are an important source of vitamin C providing on average 113 mg in a 250 mL serve (1 Cup), which is more than twice the Recommended Dietary Intake (45 mg per day). Most fruit juice contains a small amount of dietary fibre, but higher fibre varieties are also available.

Fruit juices and drinks have a low pH and are a source of fermentable carbohydrate for cariogenic bacteria. Frequent consumption may therefore increase the risk of developing tooth decay.

Fruit juices and drinks raise blood glucose levels in people with diabetes. On average, fruit juices and drinks provide 22 g of carbohydrate per 250 mL serve (1 Cup). All fruit juices made from low GI fruit and most fruit drinks have a low glycemic index; however, a 250 mL serve (1 Cup) of most varieties has a medium glycemic load (11-19 grams).

It may come as a bit of a surprise, but because gastric emptying, intestinal motility and absorption rates increase when a person is having a hypo (low blood glucose), fruit juices and drinks are suitable for treating the condition despite the fact that most varieties have a low GI.

Fruit juices are not associated with the risk of developing type 2 diabetes, but fruit drinks are slightly positively associated with increased risk of type 2 diabetes in observational studies. The association may be due to their kilojoule content which may contribute to weight gain, and higher glycemic load which may contribute to pancreatic stress.

Sugar sweetened soft drinks (soda / pop / fizz)

Ideally, people with diabetes and those at risk should save sugar sweetened soft drinks for special occasions only.

Like fruit juices and drinks, sugar sweetened soft drinks have a low pH and are a source of fermentable carbohydrate for cariogenic bacteria, and consumption is positively associated with increased risk of tooth decay.

On average, a 250 mL glass (1 Cup) of sugar sweetened soft drink provides ~440 kJs, 27 g of carbohydrate (~2 exchanges), and most varieties have a high glycemic index, and a high glycemic load, and consequently they will raise blood glucose levels in people with diabetes and those at risk.

Like fruit juices and drinks, sugar sweetened soft drinks are suitable for treating hypoglycaemia.

Sugar sweetened soft drinks are positively associated with increased risk of type 2 diabetes in observational studies. Like fruit drinks, the association may be due to their kilojoule content which may contribute to weight gain, and high glycemic load which may contribute to pancreatic stress.

Of course, if you are at a party, the pub, club or bar, some may argue that regular soft drinks are better choices than alcoholic varieties – particularly if you intend to drive home. That’s why they are called soft drinks after all!

Ultimately, the decision is yours…

Read more:

• Khan and colleagues. WHO guideline on the use of non-sugar sweeteners: a need for reconsideration. Eur J Clin Nutr. 2023.
• Lee and Myung. Consumption of Fruit Juice and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. The American Journal of Medicine 2025.
• Barclay. Reversing Diabetes. Murdoch Books, 2015.