What is Sugar?

• Sugar is a simple carbohydrate that provides a source of instant energy and is easily absorbed by the body.
• Sugar is naturally available in carbohydrate-rich foods such as rice, noodles, bread, pasta and edible roots. It is also present in fruits as fructose and in milk as lactose.
• Besides being available in its natural form, sugar is also added into food during preparation or processing.
• Intake of additional sugar is unnecessary as it can be obtained from carbohydrate- rich foods.
• On food labels, sugar may be listed as sucrose, fructose, sorbitol, mannitol, corn syrup, honey, malt, malt extract, maltose, rice extract, molasses, golden syrup and inverted sugar.

What is The Recommended Intake of Additional Sugar?

• The World Health Organisation (WHO) recommends that additional sugar be limited to not more than 10% of our daily energy consumption. Therefore, the average amount of additional sugar intake for adults inclusive of hidden sugar should not exceed 10 teaspoons a day (50g) (2003)
• Additional sugar refers to monosaccharides and disaccharides which are added into food and beverages during preparation of food and food manufacturing.

What is The Pattern of Sugar Intake in Malaysia?

• According to the Malaysian Adult Nutrition Survey (MANS) 2002/2003, the average adult in Malaysia consumes 7 teaspoons of sugar a day comprising 4 teaspoons of table sugar and 3 teaspoons of sweetened condensed milk added into beverages. This 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.

What is The Pattern of Sugar Production in Malaysia?

• Data indicates that the distribution of sugar in Malaysia has shown a steady increase over the years. Sugar distribution for domestic usage has increased from 651,973.12 metric tons in 2004 to 806,381.88 metric tons in 2009 while distribution of sugar for industrial purposes has risen from 306,895.34 metric tons in 2004 to 474,801.16 metric tons in 2009. This data concludes that there has been a yearly increase in sugar consumption among Malaysians. This trend may be attributed to the low price of sugar as a commodity.

What Are The Detrimental Effects of Excessive Sugar Consumption?

• Excess sugar intake contributes to extra calories.
• Prolonged and continued intake of excess sugar on a daily basis can lead to weight gain, resulting in obesity. This can cause serious health implications if compounded by a diet high in fat and a physically inactive lifestyle.
• The National Health and Morbidity Survey (NHMS) III in 2006 reported that 29.1% of Malaysian adults were overweight while 14.0% were obese. These figures were significantly higher than those reported in NHMS II, 1996, i.e 16.0% were overweight and 4.0% were obese.
• Obesity and overweight heighten the risk for various chronic illnesses such as diabetes, hypertension and heart disease.
• The prevalence of diabetes amongst people aged 30 years or more rose from 8.3% in 1996 (NHMS ii) to 14.9% in 2006 (NHMS III).
• Sugar is also associated with dental caries. Data from the Ministry of Health Malaysia suggested a dental caries prevalence of 76.5% amongst children aged 5 years (2005) and  80.9% amongst those aged six years old (1997) respectively.

What are the recommendations of the Ministry of Health Malaysia for reducing the intake of foods and beverages high in sugar?

Key Recommendation 1

• Consume foods low in sugar.

How To Achieve

• Choose desserts or cakes low in sugar.
• Replace desserts such as kuih and cakes with healthier alternatives such as fruits.
• Eat foods high in sugar less frequently.
• Avoid eating sugary foods between main meals and bed time.
• Make it a habit of checking the sugar content on the ingredient list of packaged food products. If sugar is listed at the top of the ingredient list, it probably constitutes a major portion of the said product.

Key Recommendation 2

• Consume beverages low in sugar.

How To Achieve

• Drink plain water instead of sweetened beverages such as carbonated drinks or syrup and cordials.
• Limit the intake of sugar or sweetened condensed milk or sweetened filled milk to 1 teaspoon for each cup of beverage.
• Request for less sugar or sweetened condensed milk or sweetened filled milk when ordering your drink.
• Check the sugar content on labels of beverages.
• Consume sweetened beverages such as carbonated drinks, cendol and air batu campur (ABC) sparingly.
• Avoid drinking sweetened beverages between main meals and before bed time.

(Source: Malaysian Dietary Guidelines 2010)

What Are The Benefits of Lower Sugar Consumption On Health?

• Cutting down on sugar consumption can indeed save costs and enhance the quality of health.

Sugar and its effect on individual health :

• 1 teaspoon of sugar provides 20 calories. If an individual consumes 7 teaspoons of sugar a day, his total caloric intake from sugar would equal to 140 calories. If unused, these 140 calories are converted into 20 grams of fat in the body. Assuming that this pattern of sugar intake continues each day and the resultant excess energy is unused for a month, the fat store increases to 600 grams. If continued for a year, it increases to 7.2 kilograms of fat stores in the body! This calculation does not take into account the amount of fat derived from oily foods and foods that are rich in coconut milk and fats that we consume daily.
• To burn off the equivalent of 140 calories from 7 teaspoons of sugar, one would have to jog or walk uphill for 20 minutes or perform aerobic exercises for 30 minutes, cycle for 40 minutes or engage in normal household chores such as sweeping, washing, cooking or cleaning for an hour.
• If the amount of added sugar consumed is limited to 3 teaspoons a day (assuming 1 teaspoon sugar is added to every cup of beverage and consumed 3 times a day), an excess storage of 80 calories a day or 560 calories a week or 2240 calories a month can be avoided, thus preventing an accumulation of 300 grams of fat a month, or 600 grams in 2 months or 3.6 kilograms a year.

Economic implications for food vendors :

• 1 teaspoon of sugar weighs 5 grams. Hence, 1 kilogram of sugar equals 200 teaspoons of sugar.
• 1 kilogram of sugar costs RM1.65 or between 0.8 cent to 1 cent per teaspoon.
• Assuming that a food dealer cuts the amount of sugar added to beverages from 4 teaspoons to 1 teaspoon, it would result in a cost reduction of 3 cent per cup of beverage. With the same reduction rate, the amount of cost savings for 500 cups of beverages would amount to RM15 (3 cent x 500 cups) a day, or RM450 (RM15 X 30 days) a month and a staggering RM5400 (RM450 X 12 months) a year!

What are the steps taken by the Ministry of Health Malaysia to educate the public on reducing sugar consumption ?

• The Ministry of Health Malaysia has carried out several initiatives to educate the public on the importance of reducing sugar in their diet including the Healthy Lifestyle Campaign which kicked off in 1991. This ongoing campaign has been sustained and periodically strengthened through the implementation of healthy eating promotion activities.
• In 1988, the Reduce Sugar Consumption Campaign was launched and carried out intensively. Various activities were carried out in conjunction with this campaign including an awareness drive with the slogan “Stop at 1, Less is Better” which was primarily targeted at food stall operators. Discussions were also held between the Ministry of Health and hotels, restaurants, canteens, coffee shops, franchise eateries and caterers to promote the campaign. As a result of the discussions, the food industries had agreed to reduce the sugar content in their commercial food and beverages. This is evident in the increased availability of products with reduced sugar in the market today. Efforts are also underway to ensure the availability of a wider range of products with reduced sugar in the market.
• Consistent with these efforts, legal provisions have also been introduced under the Food Regulations (1985) to allow “low sugar” and “sugar free” labelling on food products. According to the revised regulations, foods “low in sugar” refer to food products with a sugar content of not more than 5 grams per 100 grams of food, whereas “sugar free” denotes products with a sugar content of not more than 0.5 grams per 100 grams or 100 ml of food. Under these regulations, it is also mandatory to declare the sugar content on labels of instant beverages.
• A media campaign titled ‘5M’ was launched in 2007 to promote healthy eating with “Reduce sugar” being one of its key recommendations.
• Other initiatives of the Ministry of Health include public education through the media and several other settings such as the Nutrition Information Centre and also the Healthy Community Kitchen with centres in almost all the states. Efforts have also been taken to educate school children through programmes and activities in collaboration with the Ministry of Education through integration with subjects such as Physical Education and Health.
• Messages to promote reduced sugar intake have been the main component in the Malaysian Dietary Guidelines.
• Nutrition counselling services are also provided at health clinics to increase awareness and promote better dietary habits amongst the community, including reduced sugar consumption.  The face-to-face counselling sessions are conducted by trained nutritionists. Up to March 2010, 51 positions for nutritionists have been created for the purpose of providing counselling services and these services will be further consolidated with the placement of qualified nutritionists at all health clinics.

What is the goal of the “Reduce Sugar Consumption Campaign 2010”?

• The “Reduce Sugar Consumption Campaign 2010” is an ongoing initiative by the government to educate the public on the harmfulness of excessive sugar consumption. It also aims to encourage food vendors and manufacturers to produce food and beverages with less sugar, thereby promoting a healthy eating environment for all.
• The long term goal of this campaign is to create a healthy community which in turn, contributes to a prosperous nation.

Examples of sugar content in some foods and beverages

Sugar content in some local kuih

Source : Malaysian Dietary Guidelines, 2010

Examples of sugar content in instant beverages

Source : Nutrition Information Panel on Beverage Labels (Market Survey, January 2010)

Distribution of Domestic Sugar and Industry (Metric Tons), 2004-2009

Source : Ministry of Domestic Trade, Co-operatives and Consumerism, 2010

7 smart ways to reduce your sugar intake

• Drink plain water in place of sweetened beverages such as carbonated drinks, syrups and cordials.
• Limit your usage of sugar, sweetened condensed milk and sweetened filled creamer to 1 teaspoon for each cup of beverage.
• Avoid adding sugar into your cooking. Prepare kuih and cakes with less sugar.
• Avoid consuming sugary foods and beverages in between your main meals and before bed time.
• Eat fruits for dessert in place of sugary foods such as kuih, cakes and porridges.
• Read labels and avoid products that list sugar at the top of the ingredient list.
• Choose products labelled “low in sugar” and “sugar free”.

References

• Malaysian Dietary Guidelines 1999. National CoordinatingCommittee on Food and Nutrition, Ministry of Health Malaysia.
• Recommended Nutrient Intake, 2005. National Coordinating Committee on Food and Nutrition, Ministry of Health Malaysia.
• Strategy for the Prevention of Obesity Malaysia 2005.
• National Healthy Morbidity Survey III, 2006. Ministry of Health Malaysia.
• Malaysian Adult Nutrition Survey, 2002/2003. Ministry of Health Malaysia.
• Food Balance Sheet, FAO 2008.
• Malaysian Dietary Guidelines, 2010. Technical Working Group on the Malaysian Dietary Guidelines, Ministry of Health Malaysia.