Pour decisions: Water vs. sugary drinks
19 Feb 2026
By Ronald Allan M. Ponteres, MD, MBAH
Staying hydrated may seem like a simple daily habit, but its impact on the body is far-reaching. In an interview, Dr Lech Aldrin Gasapos, a primary care and occupational health physician, emphasized that hydration is not just about quenching thirst, it is a cornerstone of physiological stability. “Adequate hydration is fundamental to circulation; it preserves intravascular volume and blood pressure homeostasis that supports cardiac output and tissue perfusion,” he said. He added that hydration supports thermoregulation through sweating and heat dissipation and enables the kidneys to filter blood effectively to clear metabolic waste while keeping electrolytes in balance. “These are just a few of the physiological benefits of proper hydration,” he noted.
Scientific evidence aligns with these clinical observations. Water comprises roughly 50–80% of the human body, enabling cellular metabolism, nutrient transport, and the coordinated function of organ systems. Even mild dehydration impairs cognition, reduces alertness, and slows reaction time; physical performance likewise declines when fluid intake is insufficient, placing added strain on metabolic, cardiovascular, and renal processes. Emerging evidence suggests that chronically low water intake can disrupt metabolic stability over time (Widjaja Lukito, 2022), while inadequate hydration is associated with higher risk of kidney-related disorders, emphasizing the importance of maintaining sufficient fluid intake to support long-term renal health (Perrier et al., 2021). For most adults, aiming for roughly 2.5–3.5 liters of total water intake per day is a practical target that supports overall health and function (Widjaja Lukito, 2022).
Local data point to a sizable hydration gap. The 8th National Nutrition Survey by the Food and Nutrition Research Institute found that Filipinos consume an average of only 1,691 mL of fluid per day, well below common recommendations of about 2,000 mL or more depending on age and physiological needs. Adults reported the highest intake at approximately 1,976 mL daily, yet many still fall short of ideal hydration levels. Gaps are especially evident among vulnerable groups such as lactating mothers, who require higher fluid intakes to meet physiological demands. Notably, nearly one third of total caloric intake from fluids comes from soft drinks, signaling a preference for sugar-sweetened beverages over water (FNRI, 2023).
This pattern matters because sugary beverages are strongly linked to adverse health outcomes. Soft drinks, sweetened fruit juices, and flavored teas deliver rapidly absorbable free sugars and liquid calories that do not produce the same satiety as solid food, encouraging excess energy intake. Regular consumption is associated with obesity, type 2 diabetes, cardiovascular disease, and kidney disease (Nguyen & Malik, 2025), and these drinks also undermine dental health. A systematic review found higher risks of dental caries and tooth erosion with a clear dose–response relationship, the more sweetened beverages consumed, the greater the damage (Valenzuela et al., 2021).
Policy solutions can help shift population behavior. Epidemiological and decision-modeling studies indicate that taxation and other regulatory interventions can meaningfully reduce sugar-sweetened beverage intake and contribute to improvements in obesity, diabetes, and related chronic diseases (Alcaraz et al., 2021). Such measures, alongside education and environmental changes, can create a supportive context for healthier choices (Nguyen & Malik, 2025).
Practical guidance remains essential, especially during extreme heat. The Department of Health advises choosing water over coffee or alcohol, both of which can worsen dehydration (PhilStar, 2025). In very hot conditions, the DOH–Cordillera Administrative Region recommends drinking up to three liters of plain water daily and avoiding sugary beverages altogether (DOH-CAR, 2025).
Behavior change is most successful when it feels achievable. “Change is more sustainable when it starts small and progresses gradually rather than stopping abruptly,” Dr Gasapos suggested. Replacing even one sugary drink per day with water, sparkling water, or water infused with fruit slices can produce meaningful reductions in sugar intake over time. Environmental cues matter as well: keeping water visible and easily accessible (e.g. carrying a bottle, drinking before meals, placing a glass on the desk) helps make hydration the default choice. For those with strong cravings or who find plain water unappealing, he recommends gradually diluting sweet drinks or using unsweetened flavored water to retrain taste preferences, making lower sweetness feel normal rather than restrictive.
Proper hydration remains a fundamental yet often overlooked pillar of good health, especially as scientific evidence continues to highlight water’s essential role in supporting vital physiologic functions. Public health efforts must continue to promote water as the primary beverage of choice while reducing reliance on sugary drinks that contribute to rising rates of chronic disease. Bottom line: choose water over sugar, because the only thing your drink should raise is your hydration, not your health risks.
References
Widjaja Lukito. (2022). Current evidence in water and hydration science. Annals of Nutrition and Metabolism, 77(Suppl. 4), 1–6.
Perrier, E. T., Armstrong, L. E., Bottin, J. H., Clark, W. F., Dolci, A., Guelinckx, I., Iroz, A., Kavouras, S. A., Lang, F., Lieberman, H. R., Melander, O., Morin, C., Seksek, I., Stookey, J. D., Tack, I., Vanhaecke, T., Vecchio, M., & Péronnet, F. (2021). Hydration for health hypothesis: A narrative review of supporting evidence. European Journal of Nutrition, 60, 1167–1180.
Food and Nutrition Research Institute. (2023). 8th National Nutrition Survey: Fluid Intake of Filipinos. Department of Science and Technology – FNRI.
Nguyen, M., & Malik, V. S. (2025). Rising global burden of sugar-sweetened beverage consumption—urgent need for action. The American Journal of Clinical Nutrition, 122(5), 1149–1150.
Valenzuela, M. J., Waterhouse, B., Aggarwal, V. R., Bloor, K., & Doran, T. (2021). Effect of sugar-sweetened beverages on oral health: A systematic review and meta-analysis. European Journal of Public Health, 31(1), 122–129.
Alcaraz, A., Pichon-Rivière, A., Palacios, A., Bardach, A., Balan, D. J., Perelli, L., Augustovski, F., & Ciapponi, A. (2021). Sugar-sweetened beverages attributable disease burden and the potential impact of policy interventions: A systematic review of epidemiological and decision models. BMC Public Health, 21, Article 1460.
PhilStar. (2025, March 10). DOH: Drink water, not coffee, amid extreme heat. The Philippine Star.
Department of Health – Cordillera Administrative Region. (2025). Public advisory on hydration. DOH‑CAR.
Staying hydrated may seem like a simple daily habit, but its impact on the body is far-reaching. In an interview, Dr Lech Aldrin Gasapos, a primary care and occupational health physician, emphasized that hydration is not just about quenching thirst, it is a cornerstone of physiological stability. “Adequate hydration is fundamental to circulation; it preserves intravascular volume and blood pressure homeostasis that supports cardiac output and tissue perfusion,” he said. He added that hydration supports thermoregulation through sweating and heat dissipation and enables the kidneys to filter blood effectively to clear metabolic waste while keeping electrolytes in balance. “These are just a few of the physiological benefits of proper hydration,” he noted.
Scientific evidence aligns with these clinical observations. Water comprises roughly 50–80% of the human body, enabling cellular metabolism, nutrient transport, and the coordinated function of organ systems. Even mild dehydration impairs cognition, reduces alertness, and slows reaction time; physical performance likewise declines when fluid intake is insufficient, placing added strain on metabolic, cardiovascular, and renal processes. Emerging evidence suggests that chronically low water intake can disrupt metabolic stability over time (Widjaja Lukito, 2022), while inadequate hydration is associated with higher risk of kidney-related disorders, emphasizing the importance of maintaining sufficient fluid intake to support long-term renal health (Perrier et al., 2021). For most adults, aiming for roughly 2.5–3.5 liters of total water intake per day is a practical target that supports overall health and function (Widjaja Lukito, 2022).
Local data point to a sizable hydration gap. The 8th National Nutrition Survey by the Food and Nutrition Research Institute found that Filipinos consume an average of only 1,691 mL of fluid per day, well below common recommendations of about 2,000 mL or more depending on age and physiological needs. Adults reported the highest intake at approximately 1,976 mL daily, yet many still fall short of ideal hydration levels. Gaps are especially evident among vulnerable groups such as lactating mothers, who require higher fluid intakes to meet physiological demands. Notably, nearly one third of total caloric intake from fluids comes from soft drinks, signaling a preference for sugar-sweetened beverages over water (FNRI, 2023).
This pattern matters because sugary beverages are strongly linked to adverse health outcomes. Soft drinks, sweetened fruit juices, and flavored teas deliver rapidly absorbable free sugars and liquid calories that do not produce the same satiety as solid food, encouraging excess energy intake. Regular consumption is associated with obesity, type 2 diabetes, cardiovascular disease, and kidney disease (Nguyen & Malik, 2025), and these drinks also undermine dental health. A systematic review found higher risks of dental caries and tooth erosion with a clear dose–response relationship, the more sweetened beverages consumed, the greater the damage (Valenzuela et al., 2021).
Policy solutions can help shift population behavior. Epidemiological and decision-modeling studies indicate that taxation and other regulatory interventions can meaningfully reduce sugar-sweetened beverage intake and contribute to improvements in obesity, diabetes, and related chronic diseases (Alcaraz et al., 2021). Such measures, alongside education and environmental changes, can create a supportive context for healthier choices (Nguyen & Malik, 2025).
Practical guidance remains essential, especially during extreme heat. The Department of Health advises choosing water over coffee or alcohol, both of which can worsen dehydration (PhilStar, 2025). In very hot conditions, the DOH–Cordillera Administrative Region recommends drinking up to three liters of plain water daily and avoiding sugary beverages altogether (DOH-CAR, 2025).
Behavior change is most successful when it feels achievable. “Change is more sustainable when it starts small and progresses gradually rather than stopping abruptly,” Dr Gasapos suggested. Replacing even one sugary drink per day with water, sparkling water, or water infused with fruit slices can produce meaningful reductions in sugar intake over time. Environmental cues matter as well: keeping water visible and easily accessible (e.g. carrying a bottle, drinking before meals, placing a glass on the desk) helps make hydration the default choice. For those with strong cravings or who find plain water unappealing, he recommends gradually diluting sweet drinks or using unsweetened flavored water to retrain taste preferences, making lower sweetness feel normal rather than restrictive.
Proper hydration remains a fundamental yet often overlooked pillar of good health, especially as scientific evidence continues to highlight water’s essential role in supporting vital physiologic functions. Public health efforts must continue to promote water as the primary beverage of choice while reducing reliance on sugary drinks that contribute to rising rates of chronic disease. Bottom line: choose water over sugar, because the only thing your drink should raise is your hydration, not your health risks.
References
Widjaja Lukito. (2022). Current evidence in water and hydration science. Annals of Nutrition and Metabolism, 77(Suppl. 4), 1–6.
Perrier, E. T., Armstrong, L. E., Bottin, J. H., Clark, W. F., Dolci, A., Guelinckx, I., Iroz, A., Kavouras, S. A., Lang, F., Lieberman, H. R., Melander, O., Morin, C., Seksek, I., Stookey, J. D., Tack, I., Vanhaecke, T., Vecchio, M., & Péronnet, F. (2021). Hydration for health hypothesis: A narrative review of supporting evidence. European Journal of Nutrition, 60, 1167–1180.
Food and Nutrition Research Institute. (2023). 8th National Nutrition Survey: Fluid Intake of Filipinos. Department of Science and Technology – FNRI.
Nguyen, M., & Malik, V. S. (2025). Rising global burden of sugar-sweetened beverage consumption—urgent need for action. The American Journal of Clinical Nutrition, 122(5), 1149–1150.
Valenzuela, M. J., Waterhouse, B., Aggarwal, V. R., Bloor, K., & Doran, T. (2021). Effect of sugar-sweetened beverages on oral health: A systematic review and meta-analysis. European Journal of Public Health, 31(1), 122–129.
Alcaraz, A., Pichon-Rivière, A., Palacios, A., Bardach, A., Balan, D. J., Perelli, L., Augustovski, F., & Ciapponi, A. (2021). Sugar-sweetened beverages attributable disease burden and the potential impact of policy interventions: A systematic review of epidemiological and decision models. BMC Public Health, 21, Article 1460.
PhilStar. (2025, March 10). DOH: Drink water, not coffee, amid extreme heat. The Philippine Star.
Department of Health – Cordillera Administrative Region. (2025). Public advisory on hydration. DOH‑CAR.