We have been hearing a lot lately about the negative effects of sugar containing sports drinks, and for good reasons. Diets high in added sugar are associated with increased risk of obesity, type 2 diabetes, and heart disease. Sports drinks are designed to be used during athletic performance, but we have begun consuming them like beverages throughout the day. This adds significant sugar to our diets and is the reason for such strong stances on sports drinks by groups like the American Academy of Pediatrics, American Dental Association, and the American College of Sports Medicine. Carbohydrates are neither inherently good nor bad, but there are some important aspects to sugar containing sports drinks we should consider.

First is that water alone is completely adequate in the vast majority of cases. Studies have shown that electrolyte-containing drinks are only beneficial in intense prolonged performance (greater than 60 min) or in extreme heat[1]. Anyone who has played spring ball on turf fields in the Texas heat understands what that means. In practices and even shorter league games, water would be the best dugout hydration. Zero-sugar sports drinks could be used here as well, especially in the heat or if your player sweats heavily. In the Texas sun, if we include warmups and drills, a full 6 inning game, we might see a situation where a sports drink could be helpful, but water is still likely the best choice initially. If we do make use of a sports drink, chugging three Gatorades before the game is likely not the best practice, neither is drinking them while playing MLB The Show at home on the Xbox.

There are lots of concerns about sports drink use during games, due to the “sugar crash” that could cause reduced performance, endurance, and focus. What research is showing us is that sugar crash happens in people at rest, due to the body sensing the spike in sugar, releasing insulin, and a significant drop in blood glucose levels (think the after-Thanksgiving Meal nap). We can see this with carbohydrate loading >90 minutes before athletic performance. However, carbohydrate supplementation (sipping sports drinks) during exercise eliminated exercise-induced hypoglycemia and improved time-to-exhaustion (TTE) by 22%[2]. This shows that sports drinks, when used appropriately, do in fact improve performance in high intensity exercise or in extreme heat conditions.

Sugar, in the form of glucose and sucrose, is in these sports drinks for a very important reason. Yes, we can discuss glycogen depletion and replacement, and energy needs; but the most important is likely sugar’s ability to help the body absorb electrolytes quickly and efficiently. Our body’s will absorb sodium without glucose, but in the gut, with glucose present, the body can rapidly and efficiently absorb sodium through what we call the sodium-glucose transporter (SGLT1). It is a transporter that uses glucose and sodium to rapidly pass into the blood stream and be utilized. It also increases absorption of water as well. All things an athlete in intense and heated environments need quickly. So, the small amount of glucose in the sports drinks is absorbed quickly and the muscles use that for energy before it can cause a spike in blood glucose or insulin caused sugar crash.

Now, if we have identified that sugar containing sports drinks are beneficial, then what kind of sports drink should we be using? I believe that answer depends on many factors but let’s take 10–13-year-olds playing travel baseball in Texas.  There isn’t any need for super high electrolyte containing drinks in this situation, but sugar containing sports drinks could be helpful in the right scenario. All of that said, we should focus on water, water, water. Water should really be the initial choice for rehydration across the board here. Sugar free electrolyte drinks are probably ok as well. But save that sugar containing sports drink for intense exercise and heat, like in intense games, multiple games, tournaments, etc. And when you do reach for a sports drink (notice I said one and not 3-4 sports drinks) look for ones that contain 6-8% (some experts even recommend less for youth athletes) mixed source sugars (fructose, sucrose, or glucose but preferably a blend), like Gatorade or Powerade.

Takeaways:

1. Water is the best sports drink for most situations and probably initially in all situations.
2. In exercise lasting less than 60 minutes – water only or sugar free sports drinks (Biosteel, etc)
3. In exercise lasting 60-90 minutes or intense heat – Sports drinks with 6-8% sugar (Gatorade, Powerade, etc).

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[1] Currell K, Jeukendrup AE. Superior Endurance Performance with Ingestion of Multiple Transportable Carbohydrates. Medicine & Science in Sports & Exercise. 2008;40(2):275-281. doi:10.1249/mss.0b013e31815adf19

[2] Prins PJ, Noakes TD, Buga A, et al. Carbohydrate Ingestion Eliminates Hypoglycemia & Improves Endurance Exercise Performance in Triathletes Adapted to Very Low & High Carbohydrate Isocaloric Diets. AJP Cell Physiology. Published online January 9, 2025. doi:10.1152/ajpcell.00583.2024