KUALA LUMPUR, May 4 — In response to the escalating diabetes crisis gripping Malaysia, health experts are urging the government to take bold action by banning advertisements for sugary drinks.

Highlighting the urgent need for such measures, CEO Khor Xin Yun of the National Kidney Foundation of Malaysia (NKF) emphasised that curbing the promotion of high-sugar beverages is essential to promoting healthier lifestyles and reducing the burden of diabetes-related diseases.

"Malaysia’s efforts to foster healthier living have seen policy changes such as increased taxes on sugar-sweetened beverages (SSB). Additionally, Malaysia may explore regulations such as banning advertisements for unhealthy drinks with high sugar content, akin to recent actions taken by Singapore. Alternatively, promoting food benefit programmes to encourage the consumption of fruits and vegetables is also under consideration,” she said.

Khor’s sentiments echo recent actions taken by neighbouring countries like Singapore, which have implemented bans on advertisements for unhealthy drinks with high sugar content. Such regulations aim to mitigate the influence of marketing strategies that promote sugary drinks as desirable lifestyle choices.

The urgency of banning sugary drink advertisements is underscored by the alarming rise in diabetes-related diseases across Malaysia.

Khor said that the number of prevalent patients on Renal Replacement Therapy, including haemodialysis and peritoneal dialysis, has increased significantly, from 34,272 in 2013 to 53,164 in 2022.

Among these patients, 51,256 are currently undergoing dialysis treatment, with 45,045 receiving haemodialysis and 6,211 undergoing peritoneal dialysis (2022 figures). The projection for end-stage kidney failure cases indicates a substantial increase, expected to reach 106,249 by 2040.

Additionally, the prevalence of Chronic Kidney Disease (CKD) cases has nearly doubled from 9.07 per cent to 15.48 per cent between 2011 and 2018.

Notably, diabetes mellitus remains the primary cause of end-stage kidney failure among new dialysis patients, accounting for 52 per cent of cases, followed by hypertension at 35 per cent.

Despite efforts such as the Kurang Manis pilot programme in Putrajaya, which encourages vendors to serve drinks with reduced sugar content, the response from the public has been lukewarm, with many residents unaware of the initiative.

Malay Mail also recently quoted health experts warning of a rise in sugar-related diseases in Malaysia, amidst a growing obesity epidemic in the country.

The prevalence of overweight among Malaysian adults stands at 50.1 per cent ranking us among the highest in Asean countries.

Khor said that to tackle the problem in Malaysia a whole-society approach was necessary.

"In addition to public health initiatives or campaigns, we need an all-societal approach and policies in addressing social determinants of health. These are non-medical factors that influence between 30-55 per cent of health outcomes according to the World Health Organisation (WHO).

"We must collaborate with a range of stakeholders such as community leaders, volunteers, schools, and universities while utilising both digital and physical mass media platforms to spread awareness and prevention efforts for diabetes,” she said.

Dr S. Inthirani, chairman of Kuala Lumpur Diabetes Malaysia, emphasised that banning ads for sugary drinks is crucial to complement existing efforts to promote healthier lifestyles.

"We need to address the pervasive influence of advertising that glamourises sugary beverages and contributes to the normalisation of excessive sugar consumption,” noted Dr Inthirani.

"By banning such ads, we can help shift societal norms towards healthier choices and reduce the prevalence of diabetes-related diseases.”

Food industry and labels

Dr Inthirani said Malaysia, unlike neighbours Singapore, needs to learn to read labels better. She also urged the government to reduce the price of health products and not make it unattainable.

Currently only the rich can afford healthy products.

"The market is flooded with a plethora of food options, numerous vendors, and a wide array of foods, making the food industry increasingly diverse and complex, particularly with stricter labelling requirements.

"But I don’t believe we’ve reached a point where reading labels is commonplace. While there’s some level of education, not everyone comprehends or even reads labels. So, for food vendors, although options are abundant, as I always say, it’s expensive for ordinary people to afford such food.”

"Neither the middle-income group nor the average person can afford it. Consider a bottle of healthy jam priced at RM15 compared to one filled with sugar at RM5. A regular orange juice costs RM10, while the sugar-free or naturally sweetened option is RM25.

"It’s unattainable for most and only for the wealthy. If they fall ill, they can afford treatment. So we need to increase the number of buyers by allowing the sellers to sell at lower prices. Currently, sellers maintain high prices due to their profit margins and the limited number of buyers,” she said.

Khor on the other hand said the government introducing the Healthier Choice Logo (HCL) initiatives and MyChoice by Nutrition Department — a nutrition labelling system was a way to encourage the manufacturers to produce healthier products.

"These initiatives aim to urge manufacturers to reformulate food products, motivate the food services industry to produce healthier food and beverages and assist the consumers in making the right food choices. This will create an environment that supports healthy eating and finally reduce the burden of non-communicable diseases in the country,” she said.

Meanwhile, Dr Sue Anne Toh of health startup NOVI Health in Singapore concurred with Dr Inthirani in that reading labels has been a part of Singapore culture and is important to read to know exactly what we’re consuming.

She said she felt awareness of diabetes and its related diseases was increasing but the information thereafter on what to do was lacking.

Over in Singapore, the government declared war on diabetes back in 2016 to rally a whole-of-nation effort to reduce the diabetes burden in the population.

It currently has adopted the Siu Dai or less sugar movement aimed at raising awareness of consuming less sugar in our drinks, as a collaboration between coffee shop associations in support of the government’s initiative.

Dr Toh echoed Khor’s point that an all-of-society approach is crucial. She believes that technological innovations have a role to play in tackling rising diabetes, in addition to government policies.

She adds that firms such as NOVI Health work with patients to develop tailor-made solutions that take into account the individual’s biological makeup.

"Sugar is also present in our daily intake, like rice, noodles, and bread in addition to sugary drinks. Leveraging the latest tech developments helps us not only provide more specific approaches for each patient, but also empowers them to take charge in managing their health journeys better. Solving diabetes requires more than a one-size-fits-all strategy,” she said.