The claimEvidence A · guideline-tier
Sugary drinks / 100% juice are as good as eating fruit
The evidence
Sugar you drink bypasses fullness, so its calories stack on instead of replacing food. One daily serving of a sugary drink raised type 2 diabetes risk by 18% (13% after adjusting for body fat); juice by about 5% (not significant), 7% after adjusting for body fat (Imamura 2015, BMJ, 17 cohorts, 38,253 cases).
The mechanism, in brief
Three common misconceptions can be cleared up at once: drinking juice is not the same as eating fruit; an ordinary workout does not need a sports drink to rehydrate; and diet drinks are not safe in unlimited amounts.
Sources (2)
- Imamura, F., O'Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2015). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ, 351, h3576. 17 cohorts (38,253 cases; 10,126,754 person-years). Per serving a day: sugar-sweetened beverages +18% (+13% after adjusting for adiposity); artificially sweetened beverages +25% (+8%), with publication bias and residual confounding indicated; fruit juice +5% (non-significant) and +7% after adjustment. Population attributable fraction for SSB: 8.7% in the US, 3.6% in the UK (abstract, PMID 26199070).
- Muraki, I., Imamura, F., Manson, J. E., Hu, F. B., Willett, W. C., van Dam, R. M., & Sun, Q. (2013). Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ, 347, f5001. Across 187,382 participants in three cohorts, higher whole-fruit intake was associated with lower type 2 diabetes risk while higher fruit-juice intake was associated with higher risk; substituting whole fruit for juice was associated with lower risk. Abstract figures (NHS, NHS II, HPFS; 12,198 cases): per 3 servings a week, whole fruit HR 0.98; blueberries 0.74, grapes and raisins 0.88, apples and pears 0.93, bananas 0.95, cantaloupe 1.10; fruit juice 1.08 (1.05-1.11). Observational (abstract, PMID 23990623).