Sugar highs and waistline woes: Malaysia’s sweet tooth gets a Ramadan reality check

As the afternoon bleeds into evening, Putrajaya Ramadan bazaar comes alive, with hungry crowds weaving between stalls offering mouth-watering treats to break their fast. Ramadan, a month of restraint, reflection and devotion for Malaysia’s 21 million Muslims is also a time for feasting, with bazaars sprouting up nationwide, becoming community kitchens during this sacred period. Beyond traditional fare like murtabak, roti john and kuih, newer sugar-laden delights have been gaining popularity – exacerbating health concerns in one of Asia’s most obese nations. At the bazaar, vendors selling jars of sugary drinks – fruit juices, condensed milk-laced concoctions and vibrantly coloured syrups – acknowledge the risks but insist moderation is key. “After a whole day of fasting, I think it’s good to have some sugar to regain energy,” Rohana Majid, a government employee, told This Week in Asia. “It’s not a daily thing, just an occasional treat.” Doctors increasingly disagree. One in five Malaysians has diabetes, according to the health ministry, costing the healthcare system billions annually. Malaysia leads Southeast Asia in obesity and diabetes rates, with former health minister Zaliha Mustafa linking the issue to unhealthy eating habits. “Malaysians like to eat delicious, sweet foods and are at risk of developing NCDs,” Zaliha said in November 2023, commenting on the rise of non-communicable diseases, which can cause damage to important organs such as the kidneys, eyes and heart. Sweet business Malaysia’s 34 million people consumed about 1.8 million tonnes (2 million tons) of sugar in the 2023-24 financial year, according to the US Department of Agriculture, up from about 1.5 million tonnes (1.67 million tons) in 2021-22. It is the world’s seventh-largest importer of raw sugar, spending US$1.14 billion on raw sugar imports in 2023, while earning just US$140 million from its own sugar exports. Efforts to curb sugar consumption, including a sugar tax introduced in 2019 and raised to 90 sen (20 US cents) per litre in 2025, have had limited success. The tax targets high-sugar carbonated drinks, milk-based beverages and fruit juices, with revenue funding public health measures, including diabetes treatment and expanded dialysis services. Despite this, sugary drinks like bubble tea remain immensely popular, with Chinese chain Mixue opening more than 300 outlets nationwide. Dietitian Nurul ‘Aqilah Hasan Ashaari told This Week in Asia that many Malaysians were unaware of the dangers of excessive sugar consumption. “If we follow WHO’s recommendations, sugar intake should not exceed 10 teaspoons per day,” she said. “For people living with diabetes, we advocate avoiding it as much as possible – even occasional consumption can exceed daily needs.” Nurul ‘Aqilah has urged her compatriots to reach for healthier alternatives, citing a recent recipe for fried tempeh by Malaysian content creator Khairul Amin Kamarulzaman, popularly known as Khairulaming, which calls for a dash of sugar in the traditional Indonesian recipe. “I do think there’s a lot of unnecessary sugar in many of his dishes,” Nurul ‘Aqilah said. On social media, critics called kidney specialist Rafidah Abdullah a “killjoy” for suggesting breaking fast with plain water instead of sugary drinks during Ramadan. But she persisted. “If you have diabetes, it will lead to all kinds of other problems,” Rafidah said in a social media video posted on March 8. “Eighty per cent of amputations stem from diabetes-related ulcers,” she said, adding that 84 per cent of Malaysians under 30 were unaware they had the disease. Malaysia’s attachment to food – often a source of national pride – complicates efforts to address the sugar crisis. Disputes with neighbouring countries over culinary heritage, like Indonesia’s claim on rendang, highlight the deep cultural significance of Malaysian cuisine. Chef Syamil Azizi, who often shares insights on the inner workings of the culinary world on social media, argues that while lifestyles have shifted from labour-intensive farming to sedentary desk jobs, traditional diets, rich in carbohydrates and sodium, have not evolved. For years, a wide variety of rice dishes sustained Malaysia’s paddy farmers working in the fields, while salted fish replenished lost sodium after long hours in the sun. “Within one and a half generations, our lifestyle changed completely,” Syamil told This Week in Asia. “But the cuisine did not.” NCDs such as diabetes, heart disease and cancer cost Malaysia’s public healthcare system 12.4 billion ringgit (US$2.8 billion) annually, with another 51.8 billion ringgit lost in productivity, according to a December report from the World Health Organization and Malaysia’s health ministry. At the human level, this translates to a rising reliance on dialysis treatment, with some 51,000 Malaysians currently undergoing treatment – a figure that is projected to double by 2040 without intervention. For 33-year-old Azizul Hakim Abdullah, diabetes has been life-altering. “I love travelling, going on foodie trips and sampling delicacies,” the video editor told This Week in Asia. “But now I am hooked up to a dialysis machine three times a week.” Long hours at work fuelled his unhealthy habits, including snacking and drinking energy drinks, Azizul said Any travel now requires him to find a nearby dialysis centre, costing him money and three to four hours for each session. “Half a day a week, lost to this,” he lamented.

Sugar highs and waistline woes: Malaysia’s sweet tooth gets a Ramadan reality check

Sugar-laden delights have become an integral part of many diets in one of Asia’s most obese nations, despite the growing health risks