Sugar and artificial sweetners are everywhere. Your condiments, your cereal, your kids lunch snacks. Virtually everything packaged has been engineered to enhance the taste and enhance the likelihood you will buy again. But this food manipulation may be most problematic in sugar or artificially sweetened drinks.

Get a (sugary) load of this brief list of examples:

1. A 12 ounce can of coke contains 39 grams of sugar.
2. A minute maid 100% juice, apple juice box contains 19 grams of sugar.
3. A Monster original 500ml energy drink has 55 grams of sugar.
4. A 20 ounce Gatorade Thirst Quencher has 36 grams of sugar.
5. A 93ml bottle of Activia Probiotic Strawberry drink has 10 grams of sugar.

Soda’s, fruit juice boxes, energy drinks, sports drinks, coffee/tea etc. If you are trying to cut back on sugar in your diet, you should probably start with analyzing your drink consumption.

Now “the sugar is the enemy” message is likely nothing new in your household. But what is new is data from a massive population wide survey of over 450,000 participants in Europe that was recently published in the JAMA 

These survey participants were followed for on average 16 years and in that time period 41693 deaths occurred from cerebrovascular disease, parkinson’s disease, ischemic heart disease or total circulatory diseases and cancer. The mortality rate for cancer was not significant, but it was for cerebrovascular, parkinson’s, ischemic heart disease and total circulatory diseases when 1 glass or less per month was compared against one glass or more per day.

Of additional interest was the risk of artificially sweetened drinks appears to be greater than sugary drinks. Sound the alarm on artificial sweeteners such as saccharin (sweet’n low, sugar twin), acesulfame K (sunett, sweet one), sucralose (Splenda) and aspartame (Nutrasweet).

Now there are certainly issues with nutritional survey data inferring causation, in this case that one glass of a sugary drink per day will directly lead to death. However experts believe this data (and previously published data with similar conclusions) are convincing enough to direct public health efforts to limit sugary drink consumption.

One such public health policy effort worthy of consideration is a tax on sugary drinks. Drive up the cost to consumers to curb the purchase and in turn those who continue to purchase will help fund other health promotion education programs. Philadelphia became the 2^nd city in the US to implement a distribution tax on sweetened beverages on January 1, 2017. Data published in JAMA earlier this year showed sugary drink sales in Philadelphia declined drastically in 2017, 38% in major chain food retailers and 51% overall (stores, supermarkets, pharmacies and mass merchandisers). The tax seems to work.