askST: What are chances of getting diabetes when one consumes soft drinks, bubble tea?

ST reader Serene Tan Lee Hua, troubled by the amount of soft drinks and bubble tea consumed here by young people, wrote to askST for advice. She wants to know the chances of getting diabetes if one consumes one to three cups of such drinks regularly, either daily or weekly and whether eating more vegetables and doing more exercise will help prevent the onset of diabetes.

She also asked how much sugar is in a cup of soft drink and bubble tea and the recommended sugar intake per day for people who are active and non active.

Mind&Body Editor Ng Wan Ching answers.

The relationship between consuming sugar-sweetened beverages, such as soft drinks, and diabetes is complex.

It is thought that taking too much sugar can lead to obesity, which in turn is a major risk factor for developing diabetes, said Dr Stanley Liew, specialist in endocrinology and consultant at the Raffles Diabetes & Endocrine Centre.

While studies have shown an association between the intake of sugar-sweetened beverages and diabetes, the exact risk is not that well quantified, said Dr Liew.

A review of data in the Western populations showed that if you were to take a sugary drink every day, you will be 18 per cent more likely to have diabetes in 10 years.

This risk may be greater in those with other risk factors for diabetes such as a family history of the condition, sedentary lifestyle, obesity and age, said Dr Liew.

While there is no data on bubble tea, it is the quantity of sugar in the drinks that matters, he added.

Eating more vegetables is a favourable dietary habit, but its ability to lower diabetes risk is not well studied, he said.

However, regular exercise and a healthy diet have been shown to lower the risk of diabetes. For example, the Diabetes Prevention Program in the US showed that modifying one's lifestyle can reduce the incidence of diabetes by 58 per cent after three years.

There have also been studies looking at the benefits of drinking more water and whether it protects against the development of diabetes. However, there is currently not enough evidence to recommend this to the public, said Dr Liew.

If you must have your drink and the sugar in it, here are some numbers.

In general a soft drink contains 11g to 13g of sugar per 100g. That is about 35g to 45g or 7 to 9 teaspoons (tsp) of sugar per can, said Ms Bibi Chia, principal dietitian at the Raffles Diabetes & Endocrine Centre.

Many of our Asian can and packet drinks also have similar sugar content. For instance, lemon green tea has 9.3g of sugar per 100g, she said.


A cup of bubble tea with pearls. PHOTO: BERITA HARIAN FILE

Bubble tea with pearls can have up to 330 kcal per cup. The cup size varies from about 400ml to 454ml per cup. It is not only high in calories, it is also high in sugar with about 30g to 40g per cup. This translates to about 6g to 9g of sugar per 100ml. (Editor's note: Readers may like to refer to this breakdown of sugar content in local drinks, addressed in a previous askST answer.)

Added sugar should contribute to no more than 10 per cent of dietary energy, said Ms Chia. This translates to approximately 40g to 55g or 8 to 11 tsp of sugar daily.

This limit includes sugar added to beverages as well as food such as cakes and candies.

For example, if you need 1,800kcal per day, you should limit your sugar intake to 45g per day.

The estimated energy requirement for someone more active would be higher but the recommended sugar limit is still 10 per cent of  energy requirement.

Research has shown that drinking sugary drinks is linked to type 2 diabetes, and the American Diabetes Association recommends that people limit their intake of sugar-sweetened beverages to help prevent diabetes, said Ms Chia.

In fact, the World Health Organisation guideline (March 2015) recommends that adults and children reduce their daily intake of added sugar to less than 10 per cent of their total energy intake. A further reduction to below 5 per cent or roughly 25g (6 tsp) per day would provide additional health benefits, said Ms Chia. As a guide, there is 25g of sugar in less than one can drink.

People with diabetes should also look at their total carbohydrate intake rather than only at the sugar content of the food they eat.

They should aim for about 50 per cent of their energy intake from carbohydrates and spread it out through the day, said Ms Chia.

One way of doing this is to have small frequent meals, she added.

With diabetes, it is encouraged that people limit added sugars as much as possible and get their carbohydrates from fruits, vegetables, whole grains and low fat dairy, said Ms Chia.

The recommended number of servings is based on your weight, activity level, diabetes medicines and goals for your blood glucose levels. Your dietitian or diabetes educator can work with you to make a personalised plan.

A general guideline is to have 45g to 60g of carbohydrates at each meal, and 15g to 20g of carbohydrates for each snack, said Ms Chia.

On an average, two slices of bread has 30g of carbohydrates, one cup of rice has 45g of carbohydrates and one small apple or a serve of fruit has 15g to 20g of carbohydrates, she added.

It would look somewhat like the menu below which has about 1,500kcal and 187g of carbohydrates.

Daily Menu by Bibi Chia

Breakfast

One bowl beancurd with less sugar (1 tbsp syrup) - 126 kcal
Carb - 15g

One piece plain chee cheong fan (101g) - 133kcal
Carb - 26g

Coffee (1 cup) with low fat milk (¼ cup)- 33kcal
Carb- 3g

Morning Snack

A small,whole apple with skin - 77kcal
Carb - 17g

Brown rice (2/3 cup) - 137kcal
Carb - 29g

Stir-fried spinach with Shitake mushroom (1 ½ cup) - 66kcal
Carb - 12g

Lunch

One piece pan fried salmon (90g) - 125 kcal
Carb - 0

One piece red plum (74g) - 27kcal
Carb - 6g

Afternoon snack

Low fat milk (1 cup) - 127kcal
Carb - 15g

Dinner

Brown rice (1 cup) - 137kcal
Carb - 29g

Stir-fried broccoli (1 cup) - 57kcal
Carb - 3g

Grilled chicken breast (90g) - 137 kcal
Carb - 0

Popiah (1 roll) - 188 kcal
Carb - 14g

Bedtime Snack

Wholegrain crackers (3) - 127kcal
Carb - 18g

wanching@sph.com.sg

More askST stories here.