The Best and Worst Beverages for Cardiovascular Health

By Yasaman Nourkhalaj, BS  and Sharon Brock, MS, MEd

When we think about heart-healthy nutrition, most of us think about the food we eat, such as increasing vegetables and whole grains and reducing red meat and other foods high in saturated fat. But even if your meals are optimized for heart health, if your beverages are filled with sugar and/or sodium, you may be hindering your cardiovascular health goals.

“Beverages can contain heart-healthy or heart-harmful components just like food, often in concentrated amounts that are easy to consume quickly without much thought. What you drink can matter just as much as what you eat for cardiovascular health,” says Andrea Krenek, PhD, RDN, a registered dietitian and postdoctoral fellow at the Stanford Prevention Research Center.

Are Beverages High in Sodium Bad for the Heart?

A high-sodium diet can raise blood pressure, which is harmful to our cardiovascular health. Although our bodies need sodium to function properly, when we consume too much, the excess sodium causes the body to retain more fluid in the bloodstream. This increases blood volume with extra pressure on blood vessel walls. The heart has to work harder to pump through this high-pressure system, resulting in high blood pressure (aka hypertension). Over time, high blood pressure not only taxes the heart but also damages blood vessels and overworks the kidneys, and the brain, leading to increased risk of heart attack, stroke, kidney disease, osteoporosis, dementia, and heart failure.

“Excess sodium intake is one of the most common dietary risk factors for heart disease. Cutting back on sodium is one of the most effective ways to lower risk of hypertension and other forms of cardiovascular disease,” says Dr. Krenek.

The American Heart Association recommends that healthy adults consume no more than 2,300 mg of sodium per day, and less than 1,500 mg for those with heart disease, hypertension, or at high risk of cardiovascular disease. Many adults in the U.S. consume more than 3,000 mg, and much of that comes covertly from beverages. Since beverages aren’t typically “salty,” we don’t think of them as having much sodium; however, sodium is added to beverages for the same reasons it is added to processed foods—to add flavor and as a preservative to increase their shelf life.

“Beyond being mindful of table salt added on top of foods or in recipes, sodium can sneak into many packaged food items,” says Dr. Krenek. “Checking food labels can help with maintaining a low-sodium diet. For example, a food item can be considered low-sodium when it contains 140mg or less per serving.”

Drinks with high sodium content to avoid:

•      Processed vegetable juices (some contain more than 900 mg per 12-oz can)
•      Hot cocoa mixes (some contain more than 170 mg per packet)
•      Soda (some contain more than 110 mg per 20-oz bottle)
•      Sports/Rehydration/Energy Drinks (some contain more than 250 mg per 20-oz bottle)

Are Beverages High in Sugar Bad for the Heart?

A diet high in sugar can increase triglycerides and LDL (“bad”) cholesterol while decreasing HDL (“good”) cholesterol, significantly raising the risks of arterial plaque buildup, heart attack, and stroke. Excess sugar intake can also contribute to high blood pressure through promoting insulin resistance, weight gain, and inflammation that strains blood vessels over time.

To reduce cardiovascular risk, the American Heart Association recommends limiting added sugars to no more than 100 calories per day (about 6 teaspoons or 25 grams) for most women, and no more than 150 calories per day (about 9 teaspoons or 36 grams) for most men.

Surprisingly, sugary beverages (i.e., soda, energy drinks, and sports drinks) are a bigger source of added sugar in the U.S. diet than sweets like cakes, cookies, and ice cream. One study by the American Heart Association showed that drinking multiple sodas per day increased triglycerides and lowered HDL (“good”) cholesterol. Another study linked sugar-sweetened beverages with increased risk of cardiovascular disease.

“Added sugars can also hide in many foods and beverages with many different names. A food is considered low in added sugars when it has less than five percent of the daily value and considered high when it has greater than 20 percent of the daily value,” says Dr. Krenek.

Drinks with high sugar content to avoid:

•      Soda/Sugar-sweetened juices (some contain more than 10 teaspoons of sugar per 12-oz can, which is more than the daily allowance of added sugar)
•      Alcohol (excessive consumption places stress on the liver and increases cardiovascular disease-related mortality )
•      Sports/Energy Drinks (Unless medically indicated, these can negatively impact blood pressure, blood sugar, and glycemic control)

What are the Best Beverages for Cardiovascular Health?

If you want to drink for cardiovascular health, Dr. Krenek points to three low-sodium and low-sugar options:

•      Prioritize Water: Water is the essential foundation of a heart-healthy diet, according to the American Heart Association. Whether plain, sparkling, or infused with fruit, water provides hydration without the downsides of added sugar or sodium.
•      Unsweetened Tea: Specifically, green and black teas have been shown in studies to promote cardiovascular health.

“Considering the different types of teas, unsweetened green tea has some of the strongest associations with reducing cardiovascular risks,” says Dr. Krenek. “Green tea offers sources of phytochemicals and antioxidants, like polyphenols and flavonoids, which can support lowering blood pressure, reducing inflammation, vascular health, and appropriate lipid levels.”

•      Coffee: Moderate consumption (no more than 3 cups a day) of filtered coffee can be part of a heart-healthy diet, as long as you don’t load it up with cream and sugar.

“Transitioning away from high-sodium or sugary drinks doesn’t have to feel restrictive,” says Dr. Krenek. “Adding fresh fruit, cucumbers, or lemon juice can make plain water more fun and interesting, along with so many flavors of sugar-free sparkling waters to explore or trying out unsweetened teas that can offer fruity, minty, rich, or fresh tones.”