Sports drink

Sports drinks are non-caffeinated functional beverages designed to help athletes replenish water, electrolytes, and energy before, during, and especially after exercise. They are categorized by osmolarity into three main types: isotonic, hypertonic, and hypotonic. Isotonic drinks have salt and sugar levels similar to human blood, hypertonic drinks contain higher concentrations, and hypotonic drinks have lower concentrations. Most commercial sports drinks are isotonic, typically containing 13 to 19 grams of sugar per 250-milliliter serving.

A 2012 investigative report found limited evidence supporting the effectiveness of commercial sports drinks for athletic performance. A 2021 systematic review indicated that hypotonic carbohydrate-electrolyte solutions with lower sugar and low-to-moderate sodium are generally best for maintaining hydration during continuous exercise, as they cause smaller reductions in plasma volume compared to hypertonic, isotonic, or water alternatives. Consuming these drinks excessively or without need can harm health or performance, and ingredients like sugar may be unsuitable for certain conditions.

Regulation

The U.S. Food and Drug Administration (FDA) does not distinguish between sports drinks and energy drinks. In July 2024, the FDA revoked authorization for brominated vegetable oil (BVO), a stabilizer used in fruity and citrus-flavored beverages, due to potential health risks. By 2024, few U.S. drinks still contained BVO; PepsiCo removed it from Gatorade in 2013, and Coca-Cola from Powerade in 2014. BVO was most common in citrus-flavored drinks.

Uses

Athletes lose water and electrolytes through sweat and energy expenditure during training. People may use sports drinks for fluid replacement, carbohydrate loading, or nutrient supplementation.

Contrary to popular belief, studies show these drinks do not prevent hyponatremia (low blood sodium), likely because their sodium content is only 20 to 30 meq/L. Sports drinks provide calories from sugar to improve performance and endurance, but benefits depend on factors like quantity ingested, absorption time, and carbohydrate type. Evidence suggests they may improve performance compared to a placebo. A 2019 meta-review found that dairy milk may offer comparable or superior recovery benefits—such as muscle protein synthesis, glycogen replenishment, and rehydration—compared to carbohydrate-electrolyte alternatives.

Potentially harmful health effects

Sports drinks are sugar-sweetened beverages (SSBs), with a recent study showing they make up about 26% of total SSB consumption among adolescents. Potential harms from drinking them without prolonged exercise include weight gain, diabetes, and dental erosion, as they are high in calories and sugar.

Commercial sports drinks contain about two-thirds the sugar of a typical soda. Energy drinks, often confused with sports drinks, usually contain high caffeine and other supplements; moderate caffeine is not harmful and may aid endurance, but large amounts can have adverse effects. Health studies note that energy drink labeling is often insufficient, leaving consumers unaware of ingredients.

Cardiometabolic health

High SSB consumption in children aged 8 to 14 increases obesity risk, and the sugar in sports drinks still exceeds recommended daily limits for children. Epidemiological studies and clinical trials link SSBs to weight gain, type 2 diabetes, and coronary heart disease, regardless of body weight. Reducing SSB consumption supports better cardiometabolic health at individual and population levels.

In the 19th and early 20th centuries, athletes sometimes drank low-alcohol beer to replenish water, minerals, and energy, as boiled water in brewing was safer than unknown water sources. However, studies show even low ethanol doses decrease endurance performance by inhibiting liver glucose output and impairing psychomotor skills like reaction time and balance. Since the first modern Olympics, fluid intake during sports has varied due to scientific disagreement over sports drink use.