SUGAR has been described as the enemy of health. Unfortunately, many do not realise the hidden dangers of sugar and that it is the consistent link to the surge of obesity, globally.
Over the past 50 years, excessive sugar intake has more than tripled worldwide since the consumption of processed foods and sweetened beverages increased..
Sugar is available in one form or another in the majority of foods and sugar-sweetened beverages.
High levels are also present in sugar-sweetened beverages, sugary snacks and sweets, even growing up milk for toddlers. To make it worse, the food industry has included 10 types of sugars into their products, in different names that confuse consumers.
These sugars go by these names — high fructose corn syrup, maltodextrin, maltose and dextrose, among others. When people read the nutrition label, they may not know that these are added sugars.
It seems that the temptation of sugar is deeper than just the sweet taste.
A study published in the British Journal of Sports Medicine revealed that refined sugar has a similar effect on the brain as illegal drugs such as cocaine.
Based on their studies on rats, researchers found there are significant similarities between eating sugar and drug-like effects such as bingeing, craving, tolerance, withdrawal, dependence and reward.
However, some scientists have refuted this claim by saying there are no studies on humans to determine if sugar is addictive.
Whether sugar is as addictive as cocaine or not, the over-consumption is alarming. It has led the World Health Organisation to limit the intake of free sugars to less than 10 per cent of total energy intake. A reduction to less than five per cent provides additional health benefits.
These free sugars include glucose and dextrose, fructose, household sugar (sucrose), as well as malt sugar (maltose) and also sugars that are found in honey, syrups, fruit juices and fruit juice concentrates. Free sugars are added to food by consumers themselves, and also found in many processed foods.
REDUCE SUGAR CAMPAIGN
Three years ago, WHO issued further recommendation in its fight against sugar. It has called for governments to introduce subsidies for fruits and vegetables and tax of unhealthy foods, with a particular target on sugary drinks.
Malaysia will impose tax on soft drinks and juices on July 1 this year. A 40 sen tax per litre will be imposed on soft drinks with more than 5g of sugar or sugar-based sweetener per 100ml. This will include carbonated drinks, or flavoured and other non-alcoholic beverages. Juices and vegetable-based drinks which contain over 12g of sugar per 100ml will also be taxed 40 sen per litre.
While the tax will be imposed for the first time, the Health Ministry has taken the initiative to encourage the public to reduce sugar intake since 1997. It has launched the first Kempen Kurangkan Gula (Reduce Sugar Campaign) with the theme “1 Sudu Dah Cukup, Kurang Lebih Baik” (One spoon is enough, less is better).
The campaign was aimed at educating the public on the effects of high sugar intake. At the same time, food operators and food industry are encouraged to prepare food and beverages with low sugar content.
For this year’s campaign, the theme is “Kurang Gula, Cegah Obesiti (Reduce Sugar, Prevent Obesity) focusing on the association between high level of sugar intake with poor diet quality and obesity.
Health Ministry senior assistant director, non-communicable disease section, Dr Khairul Hafidz Alkhair Khairul Amin, says sugar is one of the main contributors to the obesity epidemic in this country.
Malaysians need to be aware that excess sugar intake contributes to extra calories. When the extra calories are not used as energy, mainly through physical activities, they will be stored as fat. Over time it will lead to weight gain and obesity.
To avoid the extra calories, it is recommended that we consume less than 200 kilocalories or the equivalent of 10 teaspoons of sugar in a day. This should also include sugar added to prepared foods and drinks as well as hidden sugars in processed foods.
Dr Khairul Hafidz Alkhair says consumption of beverages that have high sugar content such as carbonated drinks, juices and cordials should be avoided. Carbonated drinks contain between six and seven teaspoon of sugar per serving.
“We also need to monitor the use of sweetened creamer or condensed milk as they are high in fat and sugar. Each glass of teh tarik has up to three tablespoons of condensed milk which is equivalent to three tablespoon of sugar. Watch out for kuih because they also have high sugar content.”
Based on the National Health and Morbidity survey, the rates of obesity for those aged 18 and above have increased to 17.7 per cent in 2015 compared to 4.4 per cent in 1996. The rate of overweight is at 30.3 per cent. A report on Tackling Obesity in Asean, published in 2017, declared Malaysia as the most obese country in Southeast Asia.
Recently, Deputy Health Minister Dr Lee Boon Chye revealed that obesity-related cancer is an emerging problem as it is associated with as many as 13 types of cancer, including breast, colorectal, uterine, kidney, head and neck, esophageal, pancreatic, endometrium, prostate, gall bladder and thyroid.
According to data from the National Cancer Institute, an obese individual has two to four times risk of endometrial and esophageal cancers and two times risk for liver and kidney cancers.
Diabetes is also a major public health concern as Malaysia has the highest rate of the disease in Asia and one of the highest in the world. Based on NHMS 2015 data, diabetes increased from 11.5 per cent in 2006 to 17.5 per cent in 2015, or an estimated 3.5 million Malaysian adults.
Uncontrolled diabetes affects every major organ system in the body, causing heart attacks, strokes, nerve damage, kidney failure, blindness, and infections that can lead to amputations.
Dr Khairul Hafidz Alkhair admits that it is not easy to change people’s mind and behaviour when it comes to reducing sugar despite the implementation of the campaign for the past 22 years. However, he says the campaign should continue to raise awareness on the importance of reducing sugar intake which can prevent obesity.
“As an icon, my role is to educate as much as possible on the dangers of obesity, which is the cause of non-communicable diseases including diabetes, cardiovascular diseases and certain types of cancer.
“I will raise awareness on the need to manage weight and prevent obesity through social media especially Twitter. I will provide tips on how to reduce intake of sugar in your daily diet because it is one of the ways to prevent obesity.”
It is estimated that 73 per cent of the total deaths in the country were due to non-communicable diseases, and half of the number were caused by cardiovascular diseases.
To combat the problem, the Health Ministry has established the National Strategic Plan for Non-Communicable Diseases 2016-2025 focusing on the prevention and control of cardiovascular diseases, diabetes and cancer, with an aim to reduce the burden of treatment costs.
WAYS TO SLASH SUGAR
THE average Malaysian adult consumes four teaspoons of table sugar and three teaspoons of sweetened condensed milk added into beverages everyday, according to the Malaysian Adult Nutrition Survey 2002/2003.
The total amount of added sugar exceeds the recommendation of the World Health Organisation and Malaysian Dietary Guidelines that suggest a total daily intake of not more than 50g.
The Health Ministry’s senior assistant director non-communicable disease section, Dr Khairul Hafidz Alkhair Khairul Amin, says that based on the Malaysia Dietary Guidelines, there are various ways to reduce sugar intake in your diet.
These steps include :
1. Choose or prepare kuih and cakes with less sugar;
2. Replace sweet dessert such as kuih and cakes with healthier options such as fruit;
3. Consume foods containing sugar very sparingly;
4. Avoid consuming sugary foods between meals and close to bedtime;
5. Choose water rather than carbonated and non-carbonated sugary drinks (such as soft drinks, syrup, cordial);
6. Check nutrition information panel on labels of beverages for sugar content;
7. Limit intake of table sugar or sweetened condensed milk or sweetened condensed filled milk;
8. When ordering drinks, ask for less sugar or less sweetened condensed milk or condensed-filled milk.