I am very careful about what I eat, but I am not losing weight. Why not?

Your question may have a simple answer. Have you considered what you are drinking? How many cups of sugar and cream-laced coffee or cans of sugary soda do you drink each day? Some drinks can have as many as 500 calories. If you consider that most people need somewhere between 1800 and 2500 calories to maintain their weight (and less to lose weight), you can see how what you are drinking might affect your success.

A recent study showed that 21% of Americans' calorie intake comes from the beverages they drink. Americans are drinking more sweetened beverages than ever before. Between 1977 and 2001, the proportion of calories obtained from calorically sweetened soft drinks and fruit drinks (sweetened fruit beverages, not 100% fruit juices) increased three times.

Your body does need liquids to keep it healthy. The amount of liquid you need depends on your health and body size. Meeting all of your fluid needs with beverages containing sugar is not a good idea.

What is the best thing to drink?
For calorie-free hydration, you cannot beat good old water. Water is one of the best fluids to drink, because it contains no calories, no artificial flavors or colors, and no sugar.

Other calorie-free beverages, such as black coffee and tea without sugar or milk, are good beverage choices. Although these beverages do contain caffeine, they do not appear related to any health problems. The Beverage Guidance Panel recommends you limit your intake of caffeine-containing drinks to three to four 8-fluid-ounce (fl oz) servings/day.

Artificially sweetened teas, lemonades, and sodas also are calorie-free choices that are preferred over sugary drinks, such as soda, fruit punches, and regular lemonade. The US Food and Drug Administration (FDA)-approved artificial sweeteners are considered safe. Using this type of beverage can add variety and taste without the extra calories.

Low-fat milk, skim milk, soy milk, and 100% fruit juices are good beverage choices, because they are loaded with nutrients your body needs. However, it is important to realize that these drinks contain calories. Too many calories, even healthy ones, can result in weight gain. Therefore, you should limit yourself to three 8-fl-oz servings of low-fat milk/day and one 4- to 6-fl-oz serving of juice/day to help meet your nutritional needs without adding to your waistline.

What about sports drinks?
Sports drinks contain sugar and also small amounts of nutrients. Most experts agree that sports drinks can replenish nutrients, such as sodium and potassium, when you exercise for more than 60 minutes. However, sports drinks do contain around 150 calories for 12 fl oz. For the average exerciser, the electrolytes lost during exercise are easily replenished through eating a healthful diet. Unless your exercise is long and intense, water is a great calorie-free way to quench your thirst.

Does alcohol have more calories than soda?
Alcohol and soda are both high in calories. A 12-fl-oz beer has about the same number of calories as a 12-fl-oz cola. However, a 1.5-fl-oz serving of spirits (gin, vodka, etc) has about 100 calories. Combine that with 8 fl oz of a mixer and your drink will have more than 200 calories. Large specialty drinks can contain up to 500 calories. To save calories, drink diet soda or water, use diet sodas as mixers, or drink lite beer or wine. Remember, the larger the portion of any drink, regular or alcoholic, the more calories you will consume.

I love specialty coffees. Are they healthy?
Many of these delicious coffee and tea drinks are loaded with calories. For example, a 16-fl-oz café mocha with no whipped cream contains 240 calories. Whipped cream, cream, and whole milk add many calories to any coffee or tea drink. Instead, order a smaller drink with skim milk to save fat and calories.

The following table shows the number of calories in 12 fl oz of several different types of drinks. This 12-fl-oz serving is the size of a beer or soda can.

Compiled from Popkin and CDC references.

References and recommended readings

Dept of Health and Human Services, Centers for Disease Control and Prevention. Rethink your drink.Available at: http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/rethink_your_drink.pdf. Accessed June 13, 2012.

Popkin BM, Armstrong LE, Bray GM, Caballero B, Frie B, Willett WC. A new proposed guidance system for beverage consumption in the United States. Am J Clin Nutr [serial online]. 2006;83:529-542. Available at: http://www.ajcn.org/cgi/reprint/83/3/529.pdf. Accessed June 13, 2012.