Are flavored sparkling waters bad for you?

by Kaiser Permanente |
Glass of sparkling water

People can’t seem to get enough of sparkling water these days. In fact, it exploded into a $29 billion global industry in 2020.1 With no calories or sweeteners, bubbly drinks may seem like healthy no-brainers. But are these sparkling waters actually good for you?

According to Sean Hashmi, MD, physician and regional director of weight management and clinical nutrition for Kaiser Permanente Southern California, there are a few things to keep in mind about your favorite sparkling drinks — particularly if they’re flavored.

Are sparkling waters healthy to drink?

Even though carbonated waters have zero calories, they aren’t necessarily healthy. To get its fizz, sparkling water is made by adding pressurized carbon dioxide into water. This carbonation may, in fact, make you hungrier and cause you to eat more.

"One study found that carbon dioxide in drinks caused the hunger hormone ghrelin to shoot up, leading to overeating and weight gain in rats," says Dr. Hashmi. In the same study, carbonated drinks also increased ghrelin levels in humans.2

But many other issues arise when flavor, like lemon or grapefruit, is added to sparkling water. "To add the fruity taste, these bubbly waters typically use artificial sweeteners like stevia, aspartame, and sucralose to make it sweet," says Dr. Hashmi. It doesn’t matter if the sweeteners have zero calories or are made from a plant, he explains. "These artificial sweeteners are problematic because they are about 200 to 20,000 times sweeter than sugar."

"When you drink something that’s 20,000 times sweeter than sugar, it may cause cravings for unhealthy sweets — which can be difficult to overcome," says Dr. Hashmi. It can even change your taste buds, making naturally sweet foods taste different. "When you go to eat an apple or strawberries, these naturally sweet and delicious fruits don’t taste sweet anymore," he explains.

Beyond that, zero-calorie artificial sweeteners may increase your risk for heart disease, weight gain, and other health issues, says Dr. Hashmi: "According to one study, people who consume higher amounts of artificial sweeteners, over several decades, have a dramatically higher risk of stroke and dementia."3

Are "natural" sparkling water flavors healthier?

If you read the ingredients of most fruity carbonated waters, they likely list water and something like "natural flavors," but no artificial sweeteners. That’s where things get complicated.

"The word ‘natural’ is a bit of a misnomer," says Dr. Hashmi. "This is something the food industry uses to get us to buy products — and it makes my job very difficult because people think natural means healthy."

The reality is that food chemists make "natural flavors" in a lab, re-creating specific tastes by extracting substances from plants or animals. That’s why they’re still labeled "natural." Unlike squeezing a lemon wedge into your carbonated water, however, natural flavors are only meant for taste, not nutrition.4,5 But companies can use the catch-all term to make their ingredient list look simple and healthy.

Regardless of how it’s listed on the label, or whether the sweetener is made from a plant, these zero-calorie artificial sweeteners may not be good for your health.

What’s a healthier way to add flavor to water?

"At the end of the day, your good old plain water is still the absolute best drink for you," says Dr. Hashmi. If you really must have it carbonated, he recommends plain carbonated water.

"If you want to add flavor to your water, add the fruit yourself," Dr. Hashmi says. Put in lemons, limes, berries, whatever you like. Same goes for carbonated water. If you want flavor in your bubbles, add fruit to plain seltzer water.

And if it doesn’t taste as sweet as your go-to fruity sparkling water, just give it time. "You can change your taste buds in 7 to 10 days by changing what you eat," says Dr. Hashmi. If you give up the artificial sweeteners for 7 to 10 days, fruit will start to taste sweeter — and your water with strawberries will taste even better.

Bottom line: "Don’t rely on artificial sweeteners or sugar substitutes," says Dr. Hashmi. "Nature is sweet enough as is."

If you have questions about artificial sweeteners or sugar substitutes, talk to your doctor.

"Sparkling Water Market Size, Share & Trends Analysis Report By Product (Natural/Mineral, Caffeinated), By Distribution Channel (Hypermarket & Supermarket, Online), By Region, And Segment Forecasts, 2021–2028," Grand View Research,, April 2021.

Dureen Eweis et al., "Carbon Dioxide In Carbonated Beverages Induces Ghrelin Release and Increased Food Consumption in Male Rats: Implications on the Onset of Obesity," Obesity Research & Clinical Practice, September–October 2017.

Matthew Pase et al., "Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia," Stroke, May 2017.

4 "CFR – Code of Federal Regulations Title 21," U.S. Food and Drug Administration,, April 1, 2020.

Casey Seidenberg, "What Does ‘Natural Flavors’ Really Mean?," Washington Post,, July 25, 2017.