"Tonic water" is a serious misnomer. While this bubbly drink starts as standard water with some carbon dioxide, fruit extracts, sugar, and quinine may all be added to boost flavor. Once those extras are all mixed in, just 4 ounces of this favorite cocktail mixer boasts an impressive 11 grams of sugar — the same amount in four ounces of Sprite (and that's just the problem).

A Tonic Problem — The Need-to-Know

Photo by Marissa Angell

Like some other liquid offenders (we're looking at you, fruit juice and coffee drinks) the sugar content is a major part of tonic water's dangerfood status. Nearly half of Americans chug drinks with added sugar (like soda and flavored "waters") daily, and studies suggest those drinks could contribute to weight gain and type 2 diabetes Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Malik, V.S., Hu, F.B. Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA. Current Diabetes Reports, 2012 Jan 31. . Not to mention all that sugar means calories, too — about 40 of them in 4 ounces (and that's before the liquor). One study found kids as old as 19 get 10 to 15 percent of their daily calories from sweetened drinks Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004. Wang, Y.C., Bleich, S.N., Gortmaker, S.L. Columbia Mailman School of Public Health, Department of Health Policy and Management, 600 West 168th St, 6th Floor, New York, NY 10032, USA. Pediatrics, 2008 Jun;121(6):e1604-14. . Meanwhile, calories from drinks may influence weight gain more than calories from food, and cutting out sugar-sweetened beverages can as much as double some dieters' chances of success Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. Chen, L., Appel, L.J., Loria, C., et al. Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. American Journal of Clinical Nutrition, 2009 May;89(5):1299-306. Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Tate, D.F., Turner-McGrievy, G., Lyons, E., et al. Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC. American Journal of Clinical Nutrition, 2012 Mar;95(3):555-63. . That may be, in part, thanks to the fact that sugar-sweetened drinks don't stimulate fullness the way food does Satiety scores and satiety hormone response after sucrose-sweetened soft drink compared with isocaloric semi-skimmed milk and with non-caloric soft drink: a controlled trial. Maersk, M., Belza, A., Holst, J.J., et al. Department of Internal Medicine and Endocrinology (MEA), Aarhus University Hospital, Aarhus C, Denmark. European Journal of Clinical Nutrition, 2012 Jan 18. doi: 10.1038/ejcn.2011.223. . Now, let's compare all that to other types of carbonated water, which are generally calorie-free and pretty similar to still water. And don't think switching to diet tonic water is the cure-all. One ten-year long study found that daily diet soft drink consumption (yup, that includes tonic water) was associated with an increased risk of stroke Diet Soft Drink Consumption is Associated with an Increased Risk of Vascular Events in the Northern Manhattan Study. Gardener, H., Rundek, T., Markert, M., et al. Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA. Journal of General Internal Medicine, 2012 Jan 27. . Plus, researchers have suggested calorie-free sweeteners may mess with the brain's ability to interpret how many calories we consume — causing us to eat more.

Gettin' Fizzy With It — Your Action Plan

This dangerfood is an easy one to swap out for a healthier alternative, though. For a cool and refreshing drink, choose seltzer and add a squeeze of lemon for flavor. Seltzer is usually straight water with bubbles — no additives. In a cocktail, again switch to seltzer and lemon (or other fruit) and add a splash of bitters to mimic the flavor of the quinine in tonic water. Quin-what? Quinine, what gives tonic water its distinctive flavor, is actually a chemical traditionally used to treat malaria and was added to fizzy water to help British officers survive during the Colonial period in malaria-ridden Africa and India. (Coincidentally, this is also when the gin and tonic was invented!) But quinine could prove especially problematic for anyone who needs to pass a drug test — the amount in one mixed drink can be detected as a marker for heroine use False positive urine drug screens from quinine in tonic water. Swift, R.M., Griffiths, W., Cammera, P. Brown University Program in Medicine, Providence, Rhode Island. Addictive Behavior, 1989;14(2):213-5. . Quinine's also been used as a home remedy for leg cramps, though it may prove dangerous for that purpose Should people with nocturnal leg cramps drink tonic water and bitter lemon? Brasić, J.R. Babies and Children's Hospital of New York, College of Physicians and Surgeons of Columbia University, USA. Psychological Reports, 1999 Apr;84(2):355-67. .

Our Favorite Alternatives to Tonic Water from Around the Web:

Homemade Tonic Water via Washington Post

How to Make Soda Water at Home via The Kitchn

Parsley Gin Julep via Delish

Gin Rickey via Delish

Sparkling Orange Water via Yummly