Published on 9 April 2024

    If a cup of bubble tea is your go-to thirst quencher, you may be at risk of developing a host of health issues.

    Indulging in a refreshing cup of bubble tea on a scorching day is a delightful treat. However, considering its high sugar content, you might want to think twice about making it a daily habit.

    A 20-year-old woman in Taiwan was found to have over 300 kidney stones after being admitted to the hospital for fever and severe lower back pain. She told the doctors that she often relied on bubble tea and other sweetened beverages instead of water to hydrate herself.

    This is not the first time a bubble tea lover has suffered from serious health issues. In 2019, a 14-year-old in China reportedly experienced severe constipation due to more than 100 undigested bubble tea pearls in her abdomen.

    While instances of such severity are uncommon, they prompt the question: Can excessive consumption of bubble tea lead to illness?

    The short answer is yes, according to experts from National University Hospital (NUH). The more sweeteners, creamer and toppings like tapioca pearls the drink contains, the more health risks it poses.

    Health risks from drinking too much bubble tea

    Dr Leanne Leong, Consultant with the Division of Nephrology at NUH’s Department of Medicine, explained that the boba in bubble tea are commonly made from tapioca starch. These are usually soaked in sugar syrup before being added to sucrose-sweetened milk tea.

    “These tapioca pearls increase the calorie content of bubble tea and its glycaemic index (GI). Together, these will contribute to obesity and worsening diabetes plus blood pressure control, which are common causes of chronic kidney disease,” said Dr Leong.

    GI is a numerical scale that measures how quickly and significantly a carbohydrate-containing food raises blood glucose levels.

    Most bubble tea also contain caffeine. When consumed in large quantities, blood pressure may rise and lead to an increased risk of kidney disease, warned Dr Matthew D’Costa, Consultant with the Division of Nephrology, Department of Medicine, NUH.

    Additionally, Ms Yong Xin Nee, Principal Dietitian at Dietetics, NUH, cautioned that excessive bubble tea consumption can result in increased levels of phosphate from the milk as well as oxalate from tea in the urine. This potentially raises the risk of kidney stone formation, especially if it replaces plain water intake.

    Filled with calories and sugar 

    1 ½ t ea spoons o f 2 p ea r l s 1 cup o f b u bb le m i l k te a 2 b owls o f w h it e M il k t e a 8 o f * 1 bo w l of rice = 20 4 calorie s t ea sp o o n s ri c e* su g a r su g a r o f s c oops

    For individuals who have pre-existing conditions such as diabetes and obesity, experts advise limiting — or totally avoiding — the sweetened beverage. This is because a cup of bubble tea with pearls can contain more than eight teaspoons of sugar and takes up a substantial proportion of the recommended daily calorie intake.

    The Health Promotion Board (HPB) recommends just eight to 11 teaspoons of sugar per day for adults. For children and teenagers, the HPB recommends less than five teaspoons of sugar per day. And the recommended calorie daily intake is 2,200 calories for men and 1,800 calories for women.

    Dr Martin Lee, Senior Consultant with the Division of Nephrology, Department of Medicine, NUH, shared, “The sugar in bubble tea can worsen diabetes, which may then cause kidney damage and eventual kidney failure. Diabetes is one of the leading causes of kidney failure in Singapore and is not confined to older people.”

    Is there a healthier way to drink it?

    Given the health risks associated with excessive sugar intake, would opting for bubble tea with less sugar help? Dr Leong pointed out that while reducing the sugar level in bubble tea can reduce its overall caloric content to some extent, that may not be significant as the boba pearls are usually soaked in sugar.
    According to HPB, an average drink at 50 per cent sugar with no toppings still contains around five teaspoons of sugar.

    What about switching to artificial sweeteners when drinking bubble tea? Dr Leong cautioned that such sugar substitutes have been linked to metabolic risk factors such as diabetes and obesity in some studies. “Consensus from interventional studies suggests that substituting natural sugars with artificial sweeteners alone is likely insufficient to result in significant weight loss. There is still a need for caloric restriction and regular exercise,” she said.

    Moderation is key when consuming bubble tea. “There is no need to totally stop drinking bubble tea, which may trigger further cravings and increase the likelihood of bingeing on it later,” said Dr Leong.

    C h o os e y o u r b u bb l e t ea w i s el y In d ulgent f a v ourite s He a l t h i er al t ernati v e s Mi lk (100 per 366 cal o ries, 40g suga r 160 calories, 35g sugar Fresh milk tea with pearls (no sugar) 217 calories, 15.6g sugar P as si onf r u i t (100 per ce n t s u gar ) Black tea wi thout pe a rl s (n o s u ga r ) 0 calories, 0 sugar P ear l s 141 calories, 7g sugar Wh i te pea r ls ( k onja c ) 45 calories, 8g sugar Co c onu t J ell y 124 calories, 30g sugar A iyu je l ly ( no su g a r ) 31 calories, 7g sugar tea Smart bubble tea stategies Opt for milk tea with fresh low-fat milk rather than creamer. Opt for plain teas like green, black or oolong. Seek out beverages with the Healthier Choice symbol on the menu. Avoid beverages without customisable sweetness levels or toppings. Limit yourself to one cup of bubble tea each week. wi thout p ea r l s wit h pearls c e n t s u gar) Opt for a smaller cup or choose 25 per cent sugar. Le ss i s m o r e . t ea

    Thirsty? Opt for plain water

    In general, it is recommended to drink plain water as your main source of fluid. “Drinking enough plain water helps dilute urine, which reduces the chance of developing kidney stones,” said Dr Lee.

    However, those with existing kidney, liver and heart conditions should seek their doctor’s advice on how much fluid intake is safe for them. “Patients with advanced kidney disease, liver disease and heart failure are at an increased risk of fluid excess, if they consume large quantities of fluids. Such patients are encouraged to discuss with their physician on their appropriate amount of fluid intake,” Dr D’Costa said.

    Experts also emphasised the importance of undergoing regular screening for chronic conditions such as diabetes, hypertension and high blood cholesterol as well as having their kidney function assessed by their primary healthcare provider. “Regardless of bubble tea intake, the Singapore population has a higher incidence of chronic conditions such as kidney disease and diabetes compared to other countries,” said Dr D’Costa.

    In consultation with Dr Martin Lee, Senior Consultant, Division of Nephrology, Department of Medicine, NUH; Dr Leanne Leong, Consultant, Division of Nephrology, Department of Medicine, NUH; Dr Matthew D’Costa, Consultant, Division of Nephrology, Department of Medicine, NUH; and Ms Yong Xin Nee, Principal Dietitian, Dietetics, NUH.

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