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Concept: Drinking


Tableware size may influence how much food and non-alcoholic drink is consumed. Preliminary evidence of the impact of glass size on purchasing of alcoholic drinks shows an increase in wine sales of almost 10% when the same portion of wine is served in a larger glass. The primary aim of the current study is to test if micro-drinking behaviours act as a mechanism that could underlie this effect, through an increase in drinking rate, sip duration and/or number of sips from a larger glass.

Concepts: The Current, Wine, Alcoholic beverage, Drinking culture, ACT, Drink, Drinking, Kefir


Sweetened beverages, coffee, and tea are the most consumed non-alcoholic beverages and may have important health consequences. We prospectively evaluated the consumption of various types of beverages assessed in 1995-1996 in relation to self-reported depression diagnosis after 2000 among 263,923 participants of the NIH-AARP Diet and Health Study. Odds ratios (OR) and 95% confidence intervals (CI) were derived from multivariate logistic regressions. The OR (95% CI) comparing ≥4 cans/cups per day with none were 1.30 (95%CI: 1.17-1.44) for soft drinks, 1.38 (1.15-1.65) for fruit drinks, and 0.91 (0.84-0.98) for coffee (all P for trend<0.0001). Null associations were observed for iced-tea and hot tea. In stratified analyses by drinkers of primarily diet versus regular beverages, the ORs were 1.31 (1.16-1.47) for diet versus 1.22 (1.03-1.45) for regular soft drinks, 1.51 (1.18-1.92) for diet versus 1.08 (0.79-1.46) for regular fruit drinks, and 1.25 (1.10-1.41) for diet versus 0.94 (0.83-1.08) for regular sweetened iced-tea. Finally, compared to nondrinkers, drinking coffee or tea without any sweetener was associated with a lower risk for depression, adding artificial sweeteners, but not sugar or honey, was associated with higher risks. Frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults, whereas coffee consumption may lower the risk.

Concepts: Coffee, Caffeine, Tea, Drink, Soft drink, Drinking, Sweeteners, Sugar substitute


BACKGROUND: Limited research suggests that alcohol consumed with an artificially sweetened mixer (e.g., diet soft drink) results in higher breath alcohol concentrations (BrACs) compared with the same amount of alcohol consumed with a similar beverage containing sugar. The purpose of this study was to determine the reliability of this effect in both male and female social drinkers and to determine if there are measureable objective and subjective differences when alcohol is consumed with an artificially sweetened versus sugar-sweetened mixer. METHODS: Participants (n = 16) of equal gender attended 3 sessions where they received 1 of 3 doses (1.97 ml/kg vodka mixed with 3.94 ml/kg Squirt, 1.97 ml/kg vodka mixed with 3.94 ml/kg diet Squirt, and a placebo beverage) in random order. BrACs were recorded, as were self-reported ratings of subjective intoxication, fatigue, impairment, and willingness to drive. Objective performance was assessed using a cued go/no-go reaction time task. RESULTS: BrACs were significantly higher in the alcohol + diet beverage condition compared with the alcohol + regular beverage condition. The mean peak BrAC was 0.091 g/210 l in the alcohol + diet condition compared with 0.077 g/210 l in the alcohol + regular condition. Cued go/no-go task performance indicated the greatest impairment for the alcohol + diet beverage condition. Subjective measures indicated that participants appeared unaware of any differences in the 2 alcohol conditions, given that no significant differences in subjective ratings were observed for the 2 alcohol conditions. No gender differences were observed for BrACs, and objective and subjective measures. CONCLUSIONS: Mixing alcohol with a diet soft drink resulted in elevated BrACs, as compared with the same amount of alcohol mixed with a sugar-sweetened beverage. Individuals were unaware of these differences, a factor that may increase the safety risks associated with drinking alcohol.

Concepts: Male, Gender, Alcoholic beverage, Drink, Soft drink, Drinking, Mix, Sugar substitute


The aim of this study was to compare the rehydration potential of a carbohydrate-electrolyte beverage with several varieties of milk following exercise-induced fluid losses. Fifteen male participants (age 24.9 ± 5.5 years, height 179.3 ± 4.9 cm, body mass 75.8 ± 6.6 kg (mean ± SD)) lost 2.0% ± 0.2% body mass through intermittent cycling before consuming a different beverage on 4 separate occasions. Drinks included cow’s milk (286 kJ·100 mL(-1)), soy milk (273 kJ·100 mL(-1)), a milk-based liquid meal supplement (Sustagen Sport (Nestle); 417 kJ·100 mL(-1)), and a sports drink (Powerade (Coca Cola Ltd); 129 kJ·100 mL(-1)). Beverages were consumed over 1 h in volumes equivalent to 150% of body mass loss. Body mass, blood and urine samples, and measures of gastrointestinal tolerance were obtained before and hourly for 4 h after beverage consumption. Net body mass at the conclusion of each trial was significantly less with Powerade (-1.37 ± 0.3 kg) than with cow’s milk (-0.92 ± 0.48 kg), soy milk (-0.78 ± 0.37 kg), and Sustagen Sport (-0.48 ± 0.39 kg). Net body mass was also significantly greater for Sustagen Sport compared with cow’s milk trials, but not soy milk. Upon completion of trials, the percentage of beverage retained was Sustagen Sport 65.1% ± 14.7%, soy milk 46.9% ± 19.9%, cow’s milk 40.0% ± 24.9%, and Powerade 16.6% ± 16.5%. Changes in plasma volume and electrolytes were unaffected by drink treatment. Subjective ratings of bloating and fullness were higher during all milk trials compared with Powerade whereas ratings of overall thirst were not different between beverages. Milk-based drinks are more effective rehydration options compared with traditional sports drinks. The additional energy, protein, and sodium in a milk-based liquid meal supplement facilitate superior fluid recovery following exercise.

Concepts: Milk, Coffee, Electrolyte, Alcoholic beverage, Drink, Drinking, Kefir, Beverages


Nearly 10% of U.S. 12th graders report high-intensity drinking (10+ or 15+ drinks in a row), but the extent to which these drinkers also engage in nonmedical use of prescription drugs (NMUPD) is largely unknown. This study examined the associations between different thresholds of past two-week high-intensity drinking and past-month NMUPD among U.S. 12th graders.

Concepts: Pharmacology, Prescription drug, Grade, Drugs, Medical prescription, Drink, Drinking


Recurrent dehydration, such as commonly occurs with manual labor in tropical environments, has been recently shown to result in chronic kidney injury, likely through the effects of hyperosmolarity to activate both vasopressin and aldose reductase-fructokinase pathways. The observation that the latter pathway can be directly engaged by simple sugars (glucose and fructose) leads to the hypothesis that soft drinks (which contain these sugars) might worsen rather than benefit dehydration associated kidney disease. Recurrent dehydration was induced in rats by exposure to heat (36°C) for one hour/ 24 h followed by access for 2 hours to plain water (W), a 11% fructose-glucose solution (FG, same composition as typical soft drinks), or water sweetened with non-caloric stevia (ST). After 4 weeks plasma and urine samples were collected, and kidneys examined for oxidative stress, inflammation and injury. Recurrent heat-induced dehydration with ad libitum water repletion resulted in plasma and urinary hyperosmolarity with stimulation of the vasopressin (copeptin) levels and resulted in mild tubular injury and renal oxidative stress. Rehydration with 11% FG solution, despite larger total fluid intake, resulted in greater dehydration (higher osmolarity and copeptin levels), and worse renal injury, with activation of aldose reductase and fructokinase, whereas rehydration with stevia water had opposite effects. Similar findings were also shown in a second model of dehydration. In animals that are dehydrated, rehydration acutely with soft drinks worsens dehydration and exacerbates dehydration associated renal damage. These studies emphasize the danger of drinking soft drink-like beverages as an attempt to rehydrate following dehydration.

Concepts: Kidney, Nutrition, Glucose, Urine, Dehydration, Sugar, Sucrose, Drinking


The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences. © 2014 American Physiological Society. Compr Physiol 4:575-620, 2014.

Concepts: Nutrition, Physiology, Motivation, Drink, Drinking, Balance, Fluid balance, American Physiological Society


The 2010 Dietary Guidelines for Americans (DGA) state that if alcohol is consumed, it should be consumed in moderation, which is defined as up to two drinks in a single day for men and one drink for women. The purpose of this analysis was to estimate the percentages of adults who, on a given day, drank more than these limits and the percentages who drank too heavily; that is, more than four drinks for men and more than three for women. Dietary intake data from the National Health and Nutrition Examination Survey, 2009-2010, were analyzed. Using a computer-assisted protocol, 24-hour dietary recalls were collected from 2,740 men and 2,941 women, age 21 years and older. Results were weighted to be nationally representative. Estimated mean daily intake was 1.2 drinks for men and 0.4 for women (1 drink=14 g of ethanol). On a given day, 36% of men and 21% of women consumed alcohol. Whereas 82% of men and 89% of women did not exceed the DGA’s limits, 7% of men had more than four drinks, and 3% of women had more than three, amounts defined as heavy. The percentages who drank more than the DGA’s limits varied by age group and were highest among men age 31 to 50 years and women age 51 to 70 years. Excessive drinking is an important health problem and is not limited to college-age individuals. Registered dietitians and other health professionals should be aware of excessive drinking by the adult US population. Consumer education resources are available.

Concepts: Alcohol, Nutrition, Alcoholism, Alcohol abuse, Alcoholic beverage, Drink, Drinking, Dietitian


Fluid replacement during cycling exercise evolves on a spectrum from simply drinking to thirst to planned structured intake, with both being appropriate recommendations. However, with mixed findings suggesting fluid intake may or may not improve endurance cycling performance (ECP) in a diverse range of trained individuals, there is a clear need for summarised evidence regarding the effect of fluid consumption on ECP.

Concepts: Hypothalamus, Exercise, Cycling, Effect size, Meta-analysis, Drinking


Alcohol consumption can prime motivation to continue drinking and may contribute to excessive drinking. Most alcohol administration research assesses the effect of a single alcohol dose on outcome measures; however, this differs from typical drinking occasions in which several drinks are consumed over time. This research tracks priming measures (alcohol urge, latency to first sip, and consumption time) and subjective effects (intoxication, stimulation, and sedation) across consumption of 5 drinks, over a period of 2.5 hours. Alcohol, placebo, and no-alcohol (i.e., soft drink) conditions are compared with isolate the effects of alcohol expectancies and differentiate these from alcohol’s pharmacological effects.

Concepts: Pharmacology, Alcohol, Alcoholism, Alcoholic beverage, Drinking culture, Drink, Drinking, Kefir