Re­think your drink... choose

FACT BOX

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hy is it so im­por­tant to drink plenty of clean, safe wa­ter every day?

Wa­ter con­sti­tutes the ma­jor por­tion of the hu­man body (50-70 per cent or about two-thirds) and is es­sen­tial for life. It reg­u­lates body tem­per­a­ture and is needed to en­able the body to ab­sorb nu­tri­ents from food and trans­port them around in the body. Wa­ter also re­moves waste prod­ucts from the body. It is im­por­tant to drink clean, safe wa­ter to re­place wa­ter losses that oc­cur through the body to pre­vent de­hy­dra­tion. Other fac­tors that in­crease the amount of wa­ter that is needed are breast­feed­ing, phys­i­cal ac­tiv­ity, vom­it­ing, di­ar­rhoea and fever due to ill­ness. Fa­tigue, ir­ri­tabil­ity and headaches are some of the symp­toms of de­hy­dra­tion. When a per­son is de­hy­drated for a long time they may have pain in the joints, lower back, be con­sti­pated and their urine is a dark colour. Do not wait for your body to get thirsty – drink plenty of clean, safe wa­ter only to re­place these losses. Sug­ary drinks in­clud­ing fruit juice, sweet­ened cof­fee or tea are not rec­om­mended in place of wa­ter.

At what age is it ap­pro­pri­ate to start giv­ing my baby wa­ter?

Only af­ter six months if your baby is breast­feed­ing, then you can con­tinue. Breast milk con­tains all the en­ergy, vi­ta­mins and other nu­tri­ents in the cor­rect amounts and wa­ter that the baby needs. Even on a very hot day, breast milk sat­is­fies a baby’s thirst. It is im­por­tant for the mother to drink suf­fi­cient wa­ter. Ba­bies should not be given any other food or flu­ids not even wa­ter, ex­cept for medicine pre­scribed by a doc­tor or nurse. From the age of six months, com­ple­men­tary foods should be in­tro­duced and breast­feed­ing con­tin­ued un­til the child is at least two years old. You can give your child clean safe wa­ter to drink dur­ing the day, but it is im­por­tant to boil the wa­ter (to kill germs) and then cool it be­fore you give it to your baby.

What is the rec­om­mended amount of wa­ter per per­son per day?

For chil­dren and adults? A com­mon rec­om­men­da­tion is to drink six or eight glasses of wa­ter or other fluid every day, but some adults may need more or less, de­pend­ing on how healthy they are, how much they ex­er­cise, and how hot and dry the cli­mate is. Wa­ter is in­gested as plain drink­ing wa­ter and as bev­er­ages and in food, such as ap­ples, or­anges and mel­ons.

There are some fairly easy rules of thumb to fol­low when it comes to hy­dra­tion. One of the im­por­tant ones is to pre-hy­drate. In other words, drink wa­ter BE­FORE you start feel­ing thirsty, or BE­FORE you do an ac­tiv­ity. It is also help­ful to mon­i­tor your urine. If you are ad­e­quately hy­drated, you should be uri­nat­ing about once every two to four hours, and your urine should be colour­less or a very pale yel­low. If it is darker than that, you haven’t had enough fluid. Headaches and dizzi­ness are a late sign of de­hy­dra­tion. If you start ex­pe­ri­enc­ing those, you re­ally need to up the wa­ter in­take, and quickly.

What are the tips for drink­ing more wa­ter every day?

Drink a glass of wa­ter rather than hav­ing a sug­ary drink. Al­ways carry wa­ter with you. Keep a re­us­able wa­ter bot­tle with you and make sure to re­fill it reg­u­larly.

Take a bot­tle of clean, safe wa­ter to school/work­place.

Try set­ting re­minders on your cell­phone or com­puter every hour or notes at your desk to drink wa­ter reg­u­larly.

Make it a habit to drink wa­ter with meals.

In­crease daily wa­ter in­take when the weather is hot.

Drink one to two glasses of wa­ter 30 min­utes be­fore ex­er­cis­ing and sip ex­tra wa­ter for the next few hours af­ter­wards.

Put the num­ber of wa­ter bot­tles you would like to drink the next day in the re­frig­er­a­tor.

Drink a glass of wa­ter first thing in the morn­ing.

How can I make drink­ing wa­ter more in­ter­est­ing?

Fresh slices of lemon, cu­cum­ber, mint leaves, lime slices or berries add a dif­fer­ent flavour to your wa­ter. Most fresh or frozen fruits and herbs ac­cord­ing to your favourite flavours and what you have on hand in your fridge, can be used to make nat­u­rally flavoured wa­ter. You can drink it right away, but the flavour in­ten­si­fies if it’s made an hour or two ahead. Kept re­frig­er­ated, the flavour is even bet­ter the next day. Flavoured wa­ter can keep up to three days in the fridge. Make home­made unsweet­ened iced tea with rooi­bos or other fruity herbal teas. Add ice and gar­nish with lemon slices, mint leaves and fresh fruit slices. Do not add sugar or honey to the cof­fee or tea.

What about com­mer­cially avail­able flavoured wa­ter?

Com­mer­cially avail­able flavoured drinks such as sweet­ened flavoured wa­ter, co­conut wa­ter or vi­ta­min en­riched wa­ter con­tain sugar. For ex­am­ple, 500 ml of these drinks con­tain 15g – 31g sugar per 500 ml (two av­er­age-sized cups/ glasses), which is about four to eight tea­spoons of sugar.

Can you get sick from drink­ing too much wa­ter?

There are no health ben­e­fits to drink­ing more wa­ter than what is needed; when ex­cess wa­ter is con­sumed it will be ex­creted as urine. How­ever, the max­i­mum amount of wa­ter that a per­son with a nor­mal kid­ney func­tion can drink is 800-1000 ml/hr to avoid hy­pona­tremia (low sodium lev­els) symp­toms. If you suf­fer from kid­ney fail­ure, you may have wa­ter/ fluid re­stric­tions. Is tap wa­ter safe to drink? South African tap wa­ter is gen­er­ally safe to drink and the South African na­tional stan­dard com­pares well with the World Health Or­ga­ni­za­tion’s (WHO) lim­its. Tap wa­ter also costs a lot less than bot­tled wa­ter and is healthy for the en­vi­ron­ment too. There may be ar­eas around the coun­try where the wa­ter may at times not meet the re­quired tech­ni­cal stan­dard; hence the need to en­sure that the wa­ter one drinks is clean and safe.

What can one do to make drink­ing wa­ter safe?

If you are con­cerned about the safety of your wa­ter sup­ply, then you should ei­ther boil the wa­ter for three min­utes or add one tea­spoon of bleach to 25 litres and leave it to stand for two hours. Some tap and nat­u­ral wa­ter may have a slight brown tinge which is harm­less and does not af­fect drink­ing wa­ter qual­ity. It is im­por­tant to store cook­ing and drink­ing wa­ter in sep­a­rate con­tain­ers.

What are sug­ary drinks? Sug­ary drinks are drinks that are sweet­ened with var­i­ous forms of free sug­ars. Ex­am­ples in­clude fizzy drinks, teas or cof­fees, flavoured wa­ters, drink­ing yo­gurt and sport and en­ergy drinks. Fruit juices have a sim­i­lar kilo­joule and sugar con­tent as drinks that have added sugar and are there­fore re­garded as sug­ary drinks. Sug­ary drinks, there­fore, in­clude sugar sweet­ened bev­er­ages (SSBs) as well as fruit juices, in­clud­ing sweet­ened milk drinks. What is the dif­fer­ence be­tween free to­tal sugar?

Ac­cord­ing to the World Health Or­ga­ni­za­tion (WHO), free sug­ars are sug­ars that are added to foods and bev­er­ages by the man­u­fac­turer, cook or con­sumer, and sug­ars nat­u­rally present in honey, syrups, fruit juices and fruit juice con­cen­trates. Free sug­ars do not in­clude in­trin­sic sug­ars, which are sug­ars that ex­ist within the struc­ture of in­tact fresh fruits and veg­eta­bles, and sug­ars nat­u­rally present in milk. To­tal sug­ars are the sum of the sug­ars that are added (free sug­ars) and the sug­ars that are nat­u­rally present in food and drinks. sug­ars and

Is brown sugar or honey not a healthy al­ter­na­tive to white sugar?

Honey and brown sugar fall in the cat­e­gory of sug­ars and do not have any health ben­e­fit over any other type of sugar or syrup and con­tain the same amount of kilo­joules. Al­though brown sugar and honey may con­tain trace ele­ments, the quan­ti­ties present are very small.

Why is there a fo­cus on de­creas­ing the drink­ing sug­ary drinks?

Sug­ary drinks are ma­jor con­trib­u­tors to the ris­ing prob­lem of obe­sity rates. The con­sump­tion of sug­ary drinks has in­creased world­wide and South Africa is no ex­cep­tion. A 2014 study showed that the per capita con­sump­tion of soft drinks in the coun­try in­creased by 69 per cent. A re­cent study4 among ado­les­cents in Soweto showed that sug­ary drink con­sump­tion among them was rel­a­tively high. On av­er­age, males con­sumed 44.7 g (11 tea­spoons) and fe­males 28.4 g (seven tea­spoons) of added sugar per day from sug­ary drinks. Their to­tal sugar in­take per day from sug­ary drinks and con­fec­tionary was 80 g (20 tea­spoons) for males and 69.1 g (17 tea­spoons) for fe­males.

What ef­fects does the con­sump­tion of fre­quent or large amounts of sug­ary drinks have on health?

Fre­quent con­sump­tion is associated with weight gain and obe­sity; the devel­op­ment of other chronic dis­eases such as Type 2 Di­a­betes and heart disease; frag­ile bones and other bone dis­eases like os­teo­poro­sis as well as tooth de­cay Un­healthy di­ets and phys­i­cal in­ac­tiv­ity are among the lead­ing causes of the ma­jor non­com­mu­ni­ca­ble dis­eases (NCDs), in­clud­ing car­dio­vas­cu­lar disease, type 2 di­a­betes and cer­tain types of can­cer.

These con­trib­ute sub­stan­tially to the global bur­den of disease, death and dis­abil­ity.

Ac­cord­ing to Statis­tics South Africa, di­a­betes was the sec­ond lead­ing un­der­ly­ing cause of death in the coun­try in 2015.

The risk of di­a­betes, coro­nary heart disease and is­chaemic stroke rises with an in­crease in body weight, as well as the risks for can­cers of the breast, colon, prostate and other or­gans. and cav­i­ties.

I’m not over­weight. Why do I need to worry about what I drink?

Weight alone is not the only in­di­ca­tion of your over­all health. There­fore, every per­son should eat healthy, ir­re­spec­tive of their weight. Sug­ary drinks can lead to in­creased vis­ceral fat, a fat that builds up in and around or­gans in your body. This can lead to di­a­betes, heart disease.

Why are peo­ple con­sum­ing so many sug­ary drinks?

Sug­ary drinks are avail­able ev­ery­where and peo­ple have easy ac­cess to them at home, school, work, and re­tail food out­lets. The prices of sug­ary drinks have also de­creased whilst the por­tion sizes and mar­ket­ing of sug­ary drinks have in­creased.

Is there a rec­om­mended daily limit of free sug­ars?

The WHO rec­om­mends that adults and chil­dren through­out life should re­duce the in­take of free sug­ars to less than 10 per cent of to­tal en­ergy in­take and for more health ben­e­fits, to less than five per cent of to­tal daily en­ergy. This means that the max­i­mum in­take of free sug­ars from food and bev­er­ages per day for adult men and ado­les­cents (14 – 18 years) should not be more than 12 tea­spoons and for adult women and chil­dren five to 13 years, not more than nine tea­spoons. To achieve more health ben­e­fits, the num­ber of tea­spoons of sugar from food and bev­er­ages per day for adult men and ado­les­cents (14 – 18 years) should not be more than six tea­spoons and for adult women and chil­dren five to 13 years, not more than five tea­spoons.

How much sugar sug­ary drinks?

On av­er­age, com­mer­cially pro­duced sug­ary drinks con­tain the fol­low­ing amounts of sugar per 500 ml serv­ing (two av­er­age-sized is in cups/glasses):

Sweet­ened fizzy drinks: 13 – 17 tea­spoons.

En­ergy drinks: 13½ to 15 tea­spoons. Fruit juice: 12 – 16 tea­spoons. Sweet­ened flavoured milk or yo­ghurt-based drinks: 7 – 13½ tea­spoons.

Sweet­ened iced tea: 8 – 10½ tea­spoons. Sports drinks: 4½ - 12 tea­spoons. Sweet­ened drinks, such as sweet­ened flavoured wa­ter, vi­ta­min en­riched wa­ter and co­conut wa­ter: 4 – 8 tea­spoons of wa­ter.

How can I find out more abut how much sugar is in a drink?

The food la­bel on foods or drinks con­tain in­for­ma­tion on the in­gre­di­ents that were used to manufacture the food or drink as well as a nu­tri­tional in­for­ma­tion ta­ble that gives the nu­tri­tional value of that food or drink. Look at the ta­ble with the nu­tri­tional in­for­ma­tion on the food la­bel. Find the words: ‘To­tal sugar’ and see how much sugar in grams are in­di­cated next to it. The con­tainer has to in­di­cate the nu­tri­tional in­for­ma­tion per 100 ml and it may also in­clude it per serv­ing size. It is im­por­tant to note the amount per serv­ing size is set by the man­u­fac­turer, and may dif­fer from what you typ­i­cally drink. To cal­cu­late the num­ber of tea­spoons of sugar, di­vide the num­ber of grams of to­tal sugar by four. For ex­am­ple: If a 500 ml drink has 60 grams of sugar, di­vide 60 by four. That equals 15 tea­spoons of sugar.

What about 100 per cent fruit juice, even freshly ex­tracted juice? Is that a healthy op­tion?

100 per­cent juice is more nu­tri­tious than sugar-sweet­ened fruit drinks, but it’s high in kilo­joules from nat­u­ral sug­ars found in fruit. For in­stance, it takes about two to four medium or­anges (de­pend­ing on the size than sug­ary drinks. If some­one is used to reg­u­larly drink­ing sug­ary drinks, then ar­ti­fi­cial sweet­en­ers or ar­ti­fi­cially sweet­ened drinks are a good step to cut­ting down. This does not mean ar­ti­fi­cial sweet­en­ers or ar­ti­fi­cially sweet­ened drinks are healthy, as they still taste very sweet and crav­ings for sweet foods can con­tinue. Ar­ti­fi­cially sweet­ened drinks there­fore should not be part of a long-term healthy eat­ing plan.

What about other bev­er­ages such as cof­fee or tea?

Cof­fee and tea, with the ex­cep­tion of Rooi­bos and herbal teas con­tain caf­feine, which is a stim­u­lant. It is also a di­uretic and stim­u­lates uri­na­tion. The in­take of caf­feine should not be more than 400 mg per day. Cof­fee con­tains about 60 – 180 mg of caf­feine and tea about 14 – 70 mg of caf­feine. This trans­lates into two to three cups of cof­fee or five to six cups of tea. Tea also con­tains tan­nins which are not al­ways ben­e­fi­cial and in­ter­fere with the ab­sorp­tion of cer­tain nu­tri­ents such as iron. Fur­ther­more, the ad­di­tion of cof­fee cream­ers or tea whiten­ers, cream and/or any type of sugar can turn tea and cof­fee into less healthy drinks.

Why should any­one de­cide what I can eat or drink?

What you eat and drink is your choice. We would like to give you the facts on how to make an in­formed de­ci­sion on what is healthy and why other al­ter­na­tives are not so healthy. It is im­por­tant to take note that the heav­ilyad­ver­tised bev­er­ages are the sin­gle largest driver of the obe­sity epi­demic, and that there are tasty, health­ier al­ter­na­tives.

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