--- topic: "Sugary Drinks" title: "Soda, Juice, and Energy Drinks" order: 1 description: "What studies show about soda, fruit juice and energy drinks and their links to weight, diabetes, liver fat, heart rhythm and lifespan, with practical swaps." question: "Are soda, fruit juice, and energy drinks as bad as they say?" answer: "Soda likely is, with regular intake tied to weight gain, diabetes and earlier death; juice is milder, and energy drinks mainly strain the heart." actions: - "Swap daily soda for water, sparkling water or unsweetened tea: in adult trials, cutting sugary drinks produced about 0.5 kg of weight loss on average [1]." - "Choose whole fruit over juice: in three large US cohorts, whole fruit was not linked to higher diabetes risk, while fruit juice was [4]." - "If you enjoy 100% juice, treat it as an occasional drink, not water; a review of 15 systematic reviews found mostly neutral effects but advised caution for some groups [10]." cautions: - "Children and teens: juice's sugar can promote weight gain and tooth decay [12]; energy drinks offer no benefit and are linked to harm with seizures, diabetes or heart conditions [11]." - "With heart rhythm problems, high blood pressure, anxiety or stimulant medicines, avoid energy drinks: 32 oz within an hour lengthened QT and raised blood pressure in healthy young adults [6]." - "With diabetes or prediabetes, talk to your care team before changing drinks, especially if you take insulin or sulfonylureas; both soda and juice are linked to higher diabetes incidence [9]." confidence: 3 confidenceNote: "Trials and large cohorts agree on soda and weight, but death and diabetes links are observational, juice effects are small and mixed, and the energy drink trial had 34 people." evidenceSummary: rctCount: 3 observationalCount: 2 metaAnalysisCount: 5 totalParticipants: "540,000+" replicated: true newestStudyYear: 2025 references: - id: "1" pmid: "36789935" title: "Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials" authors: "Nguyen M, Jarvis SE, Tinajero MG, et al." year: 2023 journal: "Am J Clin Nutr" - id: "2" pmid: "20693348" title: "Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis" authors: "Malik VS, Popkin BM, Bray GA, et al." year: 2010 journal: "Diabetes Care" - id: "3" pmid: "30882235" title: "Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults" authors: "Malik VS, Li Y, Pan A, et al." year: 2019 journal: "Circulation" - id: "4" pmid: "23990623" title: "Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies" authors: "Muraki I, Imamura F, Manson JE, et al." year: 2013 journal: "BMJ" - id: "5" pmid: "38227336" title: "Consumption of 100% Fruit Juice and Body Weight in Children and Adults: A Systematic Review and Meta-Analysis" authors: "Nguyen M, Jarvis SE, Chiavaroli L, et al." year: 2024 journal: "JAMA Pediatr" - id: "6" pmid: "31137991" title: "Impact of High Volume Energy Drink Consumption on Electrocardiographic and Blood Pressure Parameters: A Randomized Trial" authors: "Shah SA, Szeto AH, Farewell R, et al." year: 2019 journal: "J Am Heart Assoc" - id: "7" pmid: "10878689" title: "Liquid versus solid carbohydrate: effects on food intake and body weight" authors: "DiMeglio DP, Mattes RD" year: 2000 journal: "Int J Obes Relat Metab Disord" - id: "8" pmid: "22205311" title: "Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study" authors: "Maersk M, Belza A, Stødkilde-Jørgensen H, et al." year: 2012 journal: "Am J Clin Nutr" - id: "9" pmid: "26199070" title: "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" authors: "Imamura F, O'Connor L, Ye Z, et al." year: 2015 journal: "BMJ" - id: "10" pmid: "38679915" title: "Health effects of drinking 100% juice: an umbrella review of systematic reviews with meta-analyses" authors: "Beckett EL, Fayet-Moore F, Cassettari T, et al." year: 2025 journal: "Nutr Rev" - id: "11" pmid: "21321035" title: "Health effects of energy drinks on children, adolescents, and young adults" authors: "Seifert SM, Schaechter JL, Hershorin ER, et al." year: 2011 journal: "Pediatrics" - id: "12" pmid: "28562300" title: "Fruit Juice in Infants, Children, and Adolescents: Current Recommendations" authors: "Heyman MB, Abrams SA, SECTION ON GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION, et al." year: 2017 journal: "Pediatrics" --- For soda, mostly yes. Trials show sugary drinks add body weight [1], and large cohort studies tie regular intake to diabetes and earlier death in a dose-related way [2][3]. Juice is a milder concern: it delivers sugar without most of the fruit's fibre, and its effects are small and mixed [4][5]. Energy drinks matter most for the heart: in one trial, a large volume lengthened the QT interval (a heart-rhythm measure) and raised blood pressure [6]. ## How it works **Liquid sugar slips past your appetite.** In a crossover study of 15 adults, the same extra energy eaten as jelly beans was offset by eating less of other foods, but the same energy drunk as soda was not, and weight rose only in the soda period [7]. **Soda also adds fat in the liver and belly.** In a six-month trial of 47 overweight adults, 1 litre a day of regular cola raised liver, muscle and belly (visceral) fat and blood triglycerides more than milk with the same calories, diet cola or water did [8]. **Dose matters.** People in the highest intake group (most often 1 to 2 servings a day) had 26% more type 2 diabetes than people who drank none or under one a month [2]. Each extra daily serving went with 18% higher diabetes incidence, and 13% after adjusting for body fat, so the link is not only about weight [9]. Two or more servings a day went with 21% higher death risk [3]. "Sugar-sweetened" includes soft drinks, fruit drinks, iced tea, and energy and vitamin waters [2]. Diet drinks are not a clean swap: artificially sweetened drinks also tracked with diabetes, though that may reflect bias [9]. See our [artificial sweeteners article](/artificial-sweeteners/the-sweetener-problem). **Juice is different, not harmless.** It has fruit's sugar without most of its fibre or protein, which can promote excess weight gain and tooth decay in children [12]. In large US cohorts, each three servings a week of fruit juice went with 8% higher diabetes risk, while blueberries, grapes and apples went with lower risk [4]. Yet a review of 15 systematic reviews found about three quarters of outcomes unchanged and some, such as blood pressure, improved, and concluded the evidence does not justify excluding 100% juice from healthy-eating guides [10]. **Energy drinks** frequently contain high, unregulated amounts of caffeine alongside sugar and understudied ingredients, and 30% to 50% of adolescents and young adults report using them [11]. In a trial of 34 healthy adults, 32 oz within an hour lengthened the corrected QT interval and raised blood pressure compared with placebo [6]. **What to do.** Water, sparkling water and plain tea or coffee are the easy default. Check labels for added sugars, and for the wider picture see our [added sugar guide](/added-sugar/health-effects-and-how-to-reduce). ## The evidence in detail ### Weight A meta-analysis of 85 articles pooled cohorts and trials in children (40 cohorts, 91,713 children; 8 trials, 2,783) and adults (21 cohorts, 448,661; 16 trials, 1,343). In adult cohorts, each daily serving of sugary drink went with 0.42 kg more body weight (95% CI 0.26 to 0.58). In adult trials, adding sugary drinks caused weight gain (mean difference 0.83 kg, 0.47 to 1.19) and removing them caused weight loss (-0.49 kg, -0.66 to -0.32). In children, reduction programmes lowered BMI gain (-0.21 kg/m2, -0.40 to -0.01) [1]. The effects are real but modest. ### Diabetes and death A meta-analysis of 11 cohort studies (310,819 people; 15,043 diabetes cases) found a 26% higher diabetes risk in the top intake group (RR 1.26, 95% CI 1.12 to 1.41) and 20% higher metabolic syndrome risk (1.20, 1.02 to 1.42) [2]. A larger analysis of 17 cohorts (38,253 cases) found 18% higher incidence per daily serving (95% CI 9% to 28%), 13% after adjusting for adiposity, and estimated that, if causal, 8.7% of new US diabetes cases over 10 years would be attributable to sugary drinks [9]. In 37,716 men and 80,647 women followed up to 34 years (36,436 deaths), total mortality hazard ratios rose across intake groups: 1.06 for 2 to 6 servings a week, 1.14 for 1 to under 2 a day and 1.21 (1.13 to 1.28) for 2 or more a day; cardiovascular death was 31% higher at the extreme [3]. ### Liver fat and satiety In the 47-person trial, relative to the other three groups the cola group's change was larger by 132% to 143% for liver fat, 117% to 221% for muscle fat and 24% to 31% for visceral fat, and triglycerides were 32% higher, though total fat mass did not differ [8]. In the 15-person crossover, total daily intake rose by the full amount of the soda (compensation -17%), whereas people offset the jelly beans almost exactly (118%) [7]. Both studies were small and used large doses. ### Juice Across 66,105 women (Nurses' Health Study), 85,104 women (NHS II) and 36,173 men followed up to about 24 years (12,198 diabetes cases), every three servings a week of fruit juice carried a hazard ratio of 1.08 (1.05 to 1.11), whole fruit overall 0.98 (0.97 to 0.99), blueberries 0.74 (0.66 to 0.83) and cantaloupe 1.10 (1.02 to 1.18) [4]. A meta-analysis of 42 studies found each daily serving of 100% juice went with 0.03 higher BMI in children; in adults, cohorts that ignored total energy found 0.21 kg more weight, those that adjusted found 0.08 kg less, and 19 trials found no significant effect (-0.53 kg, -1.55 to 0.48) [5]. The umbrella review rated 10 of 51 meta-analyses as showing benefit, 3 as showing risk (cardiovascular death, prostate cancer, diabetes) and the rest no effect, with risks seen only in cohorts [10]. ### Energy drinks The randomised, double-masked crossover trial gave 34 healthy adults (mean age 22) 32 oz of one of two energy drinks or placebo. The maximum rise in corrected QT was 17.9 and 19.6 ms versus 11.9 ms with placebo (P = 0.005), and blood pressure was higher after both drinks (P < 0.001) [6]. A narrative review reported serious adverse effects mainly in young people with seizures, diabetes, cardiac abnormalities or mood disorders [11]. ### Where the evidence disagrees Diabetes and mortality findings are observational, so unmeasured lifestyle differences could inflate them; the juice-diabetes link was not significant in studies that confirmed diabetes objectively [9], and adult juice trials found no weight effect [5]. The energy drink trial used a very large volume, and QT prolongation is a surrogate, not proof of arrhythmia. **Bottom line (confidence 3 of 5).** Soda is the clear problem: trials link it to weight and fat gain, and cohorts to diabetes and mortality. Juice is a small, mixed signal best treated as a sweet occasional drink. Energy drinks are a stimulant risk for young people and anyone with heart conditions.