Side Effects of Drinking Too Much Lemonade

Imagine coming home from work and quenching your thirst with a glass of ice-cold lemonade. It's light, refreshing and bursting with flavor. But did you know that lemonade benefits your health? That's right — the key is to enjoy it in moderation and skip the sugar.

This summer favorite is loaded with ‌vitamin C, flavonoids and phytochemicals‌ that support health and wellbeing. Its nutritional value, though, depends on the ingredients used. You can make your own lemonade and substitute sugar for stevia, use a lemonade mix or purchase ready-made lemonade.

According to the USDA, ‌organic lemonade‌ provides the following nutrients per serving (approximately one cup, or 7.6 ounces):

• 120 calories
• 31 grams of carbs
• 30 grams of sugars

In this case, lemonade was made with filtered water, organic lemons, organic lemon juice, organic apple juice, organic cane sugar and natural flavors. One serving (about one cup) of ‌lemonade made with a powdered mix‌ contains:

• 37 calories per serving
• 9.4 grams of carbs
• 9.2 grams of sugar

Depending on the ingredients used, this beverage ‌can exceed 30 grams of sugar per serving‌. Store-bought varieties are typically the highest in sugar, which serves as a preservative.

The American Heart Association (AHA) warns that ‌each gram of sugar has four calories‌. If you go overboard, the calories will add up. As AHA points out, women should not exceed 25 grams of sugar per day. Men, on the other hand, should limit their daily sugar intake to 36 grams per day.

However, this doesn't necessarily mean that lemonade is unhealthy. If you ‌prepare it at home and skip the sugar‌, you'll get a healthful beverage. Most recipes call for water, lemon juice or whole lemons and other fruits. Lemons and their juice are chock-full of nutrition, offering large doses of citrus flavonoids, vitamin C, potassium and other bioactive compounds.

A review published in ‌Oxidative Medicine and Cellular Longevity‌ in March 2019 assessed the ‌potential health benefits of citrus flavonoids‌. These include ‌quercetin‌, ‌naringenin‌, ‌hesperidin‌ and other antioxidants. The flavonoids in citrus fruits improve insulin response and glycemic control, suppress inflammation and protect against oxidative stress. Additionally, they help in the prevention and treatment of heart disease.

These phytochemicals exhibit hepatoprotective, lipid-lowering, anticarcinogenic and hypoglycemic properties, as the review authors point out. They also protect against kidney damage and regulate lipid metabolism. ‌Hesperidin‌, one of the most important flavonoids in lemons, has been found to lower blood pressure, improve liver function and prevent some types of cancer.

Lemons are also an ‌excellent source of vitamin C‌, or ascorbic acid. One small lemon offers 34 percent of the daily recommended intake of this nutrient. Depending on the recipe, you could get your daily vitamin C from lemonade alone.

Your body needs this water-soluble vitamin to synthesize collagen and L-carnitine, according to the National Institutes of Health. Vitamin C also acts as an antioxidant, scavenging free radicals. Furthermore, it ‌boasts diuretic properties‌ and may help reduce fluid retention.

A December 2015 review published in ‌Frontiers in Physiology‌ states that ascorbic acid supports the proper functioning of the nervous system and helps maintain ‌homeostasis‌, the body's ability to maintain its temperature, fluid levels, carbon dioxide levels and other biological processes that are essential for survival.

Beware, however, that ‌commercial lemonade‌ may not contain real lemons. This beverage is often made with lemon juice concentrate, powdered lemonade mix and other synthetic ingredients that have little nutritional value — not to mention the extra sugar and empty calories. Homemade lemonade is your best choice.

But what happens when you drink too much lemonade? This beverage is likely safe for most people, but it may cause adverse effects when consumed in large amounts. Heartburn, tooth decay and weight gain are all potential side effects.

An occasional glass of lemonade is unlikely to harm your health. Too much of it, on the other hand, can ‌irritate mouth sores and cause tooth decay‌ in the long run, as the American Dental Association (ADA) points out.

The same source states that lemon juice is more acidic than soda, powdered fruit drinks, sports drinks, flavored tea, orange juice and apple juice. Therefore, it's more erosive and poses greater risks to your teeth. Too much lemonade or lemon juice ‌can damage the teeth enamel‌, leading to decay, stains, pain and increased sensitivity. In rare cases, acidic beverages may cause abscesses and tooth loss.

The ADA recommends limiting the consumption of freshly squeezed lemonade, lemon juice, orange juice and sour candies. It also suggests ‌using a straw and waiting an hour before brushing your teeth‌ after drinking acidic beverages or eating acidic foods. The same goes for soft drinks and sports beverages.

If you have acid reflux or gastroesophageal reflux disease (GERD), lemonade can worsen your symptoms. GERD treatment aims to reduce acidity in the stomach.

Citrus fruits, such as lemons, oranges or grapefruit, ‌are highly acidic and‌ ‌may intensify heartburn‌. Carbonated beverages, garlic, onions, chocolate, coffee, tomato, fried foods and spicy foods have similar effects if you have GERD.

Citrus fruits may also cause migraines in those who are prone to this condition, as reported by the Physicians Committee for Responsible Medicine. A June 2012 review published in the journal ‌Food and Toxicology Research‌ has found that citrus fruits exacerbated headaches in 11 percent of migraine patients. Only 7 percent reported coffee as a migraine trigger.

As the researchers point out, citrus fruits, coffee, red wine and certain foods contain natural compounds that inhibit SULT1A enzymes, which in turn, ‌may worsen migraines‌.

A healthy person is unlikely to experience these side effects after eating lemons or drinking lemonade. However, if you're prone to migraines, GERD or acid reflux, consider limiting citrus juices. Banana smoothies, peach juice, pear juice, unsweetened ice tea and flavored soy milk are a safer choice.

If you love lemonade, enjoy it in moderation. Follow ADA's recommendations to keep your teeth strong and healthy. Replace sugar with stevia or fruit puree to reduce your calorie intake. If you're not on a diet, you may add raw honey to lemonade for extra flavor.