In November 2023, the Malaysian Ministry of Health launched a Sugar Advocacy Plan to combat excessive sugar consumption and reduce the prevalence of noncommunicable diseases (NCDs) in the country.

FDI commends this crucial initiative by the Ministry of Health to improve public health. To gain deeper insights into this effort, FDI interviewed its member, the Malaysian Dental Association, to discuss the advocacy plan and its implications for oral health.

Can you tell us about Malaysia’s sugar advocacy plan, its target audience, and the stakeholders involved in its implementation?

The health minister of Malaysia announced the launch of an Advocacy Plan in November 2023 to address the issue of excessive sugar consumption in the country.

"The plan comprises programmes for all age groups from children at pre-schools up to senior citizens. The plan will also include non-governmental organizations (NGOs), parents groups, village heads, parliamentary and state constituencies."(1)

The Malaysian Prime Minister, Datuk Seri Anwar Ibrahim, recently highlighted the critical need for ministries, government departments and the public to unite in reducing sugar intake, extending responsibility beyond the Health Ministry. Malaysia holds the record of having the highest number of diabetes cases in Southeast Asia, up from 11.2 per cent in 2011 to 18.3 per cent in 2019. He proposed in the 2024 Budget to increase the excise duty on sugary drinks from 40 sen to 50 sen per litre, with returns funding diabetic patient treatment and supporting haemodialysis centres.

A sugar advocacy plan encompassing educational initiatives and collaboration with food item manufacturers and traders emerges as a crucial step towards reducing sugar consumption and addressing the pervasive impact of noncommunicable diseases (NCDs) on public health.

This comprehensive approach will mitigate the root causes of widespread health issues, setting Malaysia on a path towards becoming a healthier and more resilient nation.

By implementing effective policies and fostering a united front against excessive sugar content, Malaysia can pave the way for a healthier future, mitigating the impact of NCDs and enhancing the overall well-being of its citizens.(2)

He had earlier instructed all ministries to practice reducing sugar consumption in every gathering. In his call on the people to reduce their intake of sugar in food, to avoid the risk of diabetes, Anwar also ordered all ministries to implement a campaign to reduce sugar in their diet.(3)

What motivated the decision to come up with this plan?

The prevalence of diabetes in Malaysia is the highest in Southeast Asia, recording a significant increase from 11.2 per cent in 2011 to 18.3 per cent in 2019. The government spends billions of dollars annually to tackle NCDs, which also have a great negative impact indirectly to the economy in terms of loss of productivity.

The Malaysian Dental Association may also have played a small part in highlighting the excessive consumption of added sugars to food and drinks since 2014 and 2015. During the FDI World Dental Congress in New Delhi and Bangkok respectively, the WHO experts gave seminars on the health risks of added sugars to food and drink. In 2015, the WHO publicly in press release and in their website recommended that sugars should constitute to about 10%(12 teaspoons of sugar) of total energy intake. When possible, it may be reduced to 5%(6 teaspoons of sugar) of total energy intake.(5,6,7)  In 2017, the Malaysian Dental Association carried out a campaign against excessive sugar intake that was publicized nationwide via the press, TV and social media. It was called “Operasi Sifar Gula: Operation Zero Sugar”.

Though we received some criticism from the nutritional health sector as to why dentists was advocating reduction of sugar intake to tackle obesity, diabetes and caries, it was well received by the public which may have started the ball rolling against excessive consumption of added sugars to food and drinks. We responded that though dentists treat the mouth and surrounding structures, we are also primarily interested in the health of the whole body as obesity and diabetes has a huge impact on the health of the mouth. The campaign featured a talk by the economic minister who spoke on, “The True Cost of Sugar”, a cameo by a top standup comedian and a world famous chef who cooked and spoke on how to reduce added sugar in foods.(4)

This plan is expected to reduce the impact on NCDs. Do you think it will also impact oral diseases?

Oral diseases especially dental caries and gum disease are NCDs. Reduction of added sugars to food and drinks will definitely reduce the incidence and severity of dental caries and gum diseases and will substantially improve oral health and therefore general health tremendously.

How does your NDA plan to leverage this advocacy plan?

We have already communicated our readiness to fully back the sugar advocacy plan with all the resources we have at our disposal. We will work closely with the Ministry of Health wherever possible. In our CSR projects in various parts of the country, we actively include advice to reduce the consumption of sugars to the various communities, villages and schools that we come into contact with.

Is there anything else that you would like to add?

Thank you for this wonderful opportunity to share with the FDI fraternity our Sugar Advocacy Plan. We hope that the thoughts, ideas and experiences we shared with you will be helpful and encouraging.

Editor’s note: This interview was edited according to FDI’s editorial guidelines. The views expressed are those of the interviewee.

References

1. Health Ministry launch sugar advocacy plan. New Straits Times. 2023 Nov. Available from:  https://www.nst.com.my/news/nation/2023/11/981706/health-ministry-launch-sugar-advocacy-plan. [Accessed: 31 May 2024]

2. Curb sugar intake to beat diabetes crisis. New Straits Times. 2023 Dec. Available from: https://www.nst.com.my/opinion/letters/2023/12/986500/curb-sugar-intake-beat-diabetes-crisis. [Accessed: 31 May 2024]

3. PM Anwar orders all ministries to implement campaign to reduce sugar consumption. Malay Mail. 2023 Nov 25. Available from: https://www.malaymail.com/news/malaysia/2023/11/25/pm-anwar-orders-all-ministries-to-implement-campaign-to-reduce-sugar-consumption/104154. [Accessed: 31 May 2024]

4. Curbing sugar intake to combat health crisis. Malaysiakini [Internet]. Available from: https://www.malaysiakini.com/letters/365707. [Accessed: 31 May 2024]

5. WHO. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. Available from:  https://www.who.int/publications/i/item/9789241549028. [Accessed: 31 May 2024]

6. WHO calls on countries to reduce sugars intake among adults and children. World Health Organization. 2015 Mar 4. Available from: https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children. [Accessed: 31 May 2024]

7. WHO. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. Available from: https://iris.who.int/bitstream/handle/10665/149782/9789241549028_eng.pdf?sequence=1. [Accessed: 31 May 2024]