One of the biggest public health wins of recent decades has been America's slow shift away from soda.
With more awareness about the very strong correlation between guzzling sweet, fizzy drinks, and obesity and tooth decay, sales of beverages like Coca-Cola and Pepsi have slumped.
But there's pretty good evidence that Americans are still getting hoodwinked by juices and other sugary beverages.
Check out this data from Euromonitor. Its analysis of US retail beverage sales over the past five years finds that while the soda category is shrinking, juice sales have held steady, and sales of energy and sports drinks have been growing. Here's how the market looks in terms of volume (millions of liters) sold:
This article in BMJ Open demonstrated the extent of the problem: The researchers looked at how much of the American diet is composed of ultra-processed foods and added sugars. They found that 58 percent of total energy intake — more than half of the calories Americans consume! — came from foods that are packed with lots of flavors, colors, and sweeteners. And almost 90 percent of the added sugars Americans consume came from heavily processed foods — the two main sources being soft drinks (17 percent) closely followed by fruit drinks (14 percent). (In this case, "fruit drinks" refers to processed juices with added sugars.)
To be clear: Soda remains a big public health threat. As Marion Nestle, a New York University professor and author of the new book Soda Politics. points out, "Sales of [soda alternatives] are up, but not nearly so much as to compensate for the decline in Coke and Pepsi." But the data suggests that Americans are finding new ways to pack calories into their diet through other sugary drinks.
We should think of juice as soda without the fizz
Most juices and sports drinks have as much or even more sugar than soda, as you can see in this chart from the Harvard School of Public Health:
You might think fruit juice is inherently healthier than soda because it comes from fruit. But that's not always the case.
I asked nutrition researchers this question, and they all pointed out that the sugar in fruit juice is more concentrated than it is in whole fruits. When you drink fruit juice, you get a mega dose of sugar the same way you do when you drink soda.
"Juices have some nutritional value when the sugars are not added. But people don't drink all that much [natural fruit] juice — it's too expensive. They drink juice drinks with added sugars," said Nestle.
These juices drinks — like bottled cranberry or grape juices — are basically sugar water with artificial flavors and little nutritional benefit. And even pure fruit juices that deliver vitamins and nutrients — like freshly squeezed orange juice — also deliver a lot of calories and sugar.
That said, nutritionists aren't arguing you have to avoid fruit juice entirely. Real fruit juices are nutritionally superior to sodas and can be part of a healthy diet — albeit in moderation, Nestle said. "Juices, like any other source of liquid sugars, are best consumed in small amounts."
We're starting to tax soda — but not juice
A handful of countries are moving to tax sugary drinks in an effort to fight obesity. But in some instances, the taxes continue to focus on soda, and overlook the huge quantities of sugar people are consuming in fruit juice.
In Britain, for example, the government just announced a forthcoming sugary drinks tax — but it only applies to soft drinks with added sugar, and excludes all milk-based beverages and fruit juices. (See the Treasury Department’s fact sheet on the soda tax). That means beverages like milkshakes and cranberry juices won't be taxed even though they're nearly as damaging to health from a nutrition standpoint.
Berkeley, California, has a tax on sugary drinks, but it also excludes sweetened milk products and 100 percent juices.
Soda companies in the UK are considering legal action over the tax on the basis of discrimination, since the tax excludes other sugary drinks.
They raise a fair point. If the taxes focused on sugar content and calories, many more beverage companies — makers of chocolate milk, energy drinks, and fruit juice — would be affected. But as Nestle pointed out, there are political reasons that doesn't happen. "A tax on sweetened milk," she said, "will bring down the wrath of the dairy industry, which no legislator wants to take on."
Correction: A previous version of this article incorrectly stated the details of exclusions on Berkeley's soda tax.