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Dear Dr. Roach: What's better for your health: beer (light or full) or soft drinks (sugar or sugarless)? And why? -- W.C.G.
Answer: Neither alcoholic drinks nor sweetened beverages are on my list of recommended beverages. Alcohol has many toxicities, whether it's short-term or long-term use, and is a known carcinogen (cancer-causing substance). The Centers for Disease Control estimate that 178,000 deaths per year occur due to alcohol in the United States.
While "light" beer has slightly less alcohol and calories than regular beer and is therefore less toxic, I still can't recommend it for your health. People who enjoy beer or other alcoholic beverage should do so knowing that there is a health harm to it (even if it's small) and be sure that the harm is worth it to them.
Sugar-sweetened beverages like soft drinks are also a clear health hazard. I think of these as liquid candy, and they should be considered as an occasional treat at best. Beverages made with non-sugar sweeteners are associated with less weight gain, less liver fat, and less tooth decay. But the data show that "diet" sodas are still associated with increased risks of obesity, Type 2 diabetes, high blood pressure, and all-cause mortality.
Scientists remain unsure why this is. Changes in the microbiome may explain this, although there is still the possibility of confounding -- a type of error in interpreting the data due to unrecognized differences in those who choose "diet" sodas versus "regular." Water remains your best choice, with unsweetened tea or coffee being other healthy choices.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.