Hands On

Sugar-sweetened beverages

Background

Between 1977 and 1996 the intake of sugar-sweetened beverages (SSBs) increased dramatically for both adults and children. Children consume about 40% of their added sugar intake in the form of beverages, and adults consume about 55% of their added sugar intake in this form. Dietary recommendations for SSB intake remain unchanged, yet the marketing of some SSBs as healthier options is confusing. The carbohydrate composition of beverages commonly consumed in the United States was explained, the

Carbohydrate Composition

In the process of developing dental caries, carbohydrates are fermented by oral bacteria on the tooth surface, producing acid, which dissolves the enamel. Sugars are more bioavailable than refined or modified starches and therefore more readily fermented by the bacteria. Monosaccharides and disaccharides are equally fermentable. The distinction made in beverages between “processed” or “natural” added sugars has no impact on the sugar's ability to be fermented.

Nutritionally, beverages that

Caries Risk

Caries experiences associated with human milk, cow's milk, and cola have been found in studies of rats, but those associated with soda, 100% fruit juice, juice drinks, sports drinks, and milk have been documented in human studies. Some studies find associations between SSBs, 100% fruit juice, and milk and caries experiences in young children, but other studies find no relationship. Observational studies of the links between beverage intake and caries often focus on quantity or frequency of the

Guidelines

Dietary guidelines are designed to limit the quantity, frequency, and duration of SSB intake, which will decrease exposure time (Box). Thus individual caries risk associated with SSBs can be modified by changing beverage consumption practices, meal patterns, and oral hygiene.