Fight Against Sugar Spreads to Sri Lanka

On 22 February 2016, CAP received a very unique and special guest who translated and republished CAP’s booklet How Sugar Destroys Your Health, in English and Sinhala and distributed 50,000 copies of the book free of charge to Sri Lankan consumers. Mr Channa De Silva, is the former Director-General of the Securities and Exchange Commission of Sri Lanka and graduated from Melbourne University and Harvard. His father-in-law is Dr A. T. Ariyaratne, the founder of Sarvodaya in Sri Lanka, a social movement based on Buddhist and Gandhian teachings and works in over 10 thousand villages in Sri Lanka.

This is only the beginning of Mr Channa’s fight against sugar in Sri Lanka. He plans to print another 50,000 copies for free distribution, this time including a Tamil edition. He also plans to organise a cyclothon, together with Sarvodaya, to spread the anti-sugar message throughout Sri Lanka. The event will move from the southern tip to the northern tip of Sri Lanka, carrying the fight sugar message over 300 km across the country. The entire event will take about 5 days to complete. The President of Sri Lanka will be invited to launch the campaign. He intends to campaign for a Sugar Tax to discourage the consumption of high-sugar products like soft drinks, candies, sweets, confectioneries and processed foods. 

The books are making a huge impact there. The Nutrition Division of the Health Ministry in Sri Lanka is going to launch a year-long campaign to reduce sugar consumption in Sri Lanka as a result of the consciousness raised by the book. And consumers are moving away from sweet foods like cakes and soft drinks. Doctors are beginning to see the huge amounts of sugar hidden in processed foods and the impacts they made on the health of Sri Lankans.

We reproduce below the Publisher’s Note from the Sri Lankan edition of the How Sugar Destroys Your Health book.

Let the fight against sugar start in Sri Lanka

The damage done by sugar in Sri Lanka is largely unknown because statistics are unavailable or are not well understood. The only thing visible is the destruction done by sugar through increasing incidence of diabetes along with its contribution to 60 other serious illnesses including dysfunctional kidneys and heart related problems. lnformed people know the country is in a health crisis due to sugar. Most people however are completely unaware about related health issues and consume sugar in large quantities.

As we are a nation of great hospitality Sri Lankans are more susceptible to high sugar consumption. As a result we are more exposed to sugar related health problems. We have created a culture where continuously feeding our children as an expression of love is now extended to our families, friends, colleagues, and even to those less well known to us thus creating a nationwide health hazard. This is aggravated by our love for sweets which has entered our mainstream culinary culture. It is time we change our food habits and replace unhealthy food with exercise and healthy living.

My deepest gratitude and appreciation goes to the Consumers Association of Penang for providing me with the rights to republish this booklet in Sri Lanka. I thank the leadership and the staff of the Consumers Association of Penang for their commitment to create a healthy population. I also thank the Diabetes Association of Sri Lanka for the assistance provided.

This republication in Sri Lanka is dedicated to all parents and this booklet is expected to be distributed free of any charge.

May we create a healthier nation and a happy population.

Channa de Silva
36/31 Edmonton Road, Colombo 6.
Contact: 2512 987, 0722369300

CAP calls for smoking ban to be extended to all public places

CAP fully supports the move by the Ministry of Health to ban smoking at all eateries.

The ban would be in line with Malaysia’s commitments under the World Health Organisation (WHO)’s Framework Convention on Tobacco Control, and with measures adopted by other countries the world over to curb smoking in public areas.

Most importantly, it could literally be a life-saver. In fact in India many states have banned smoking in all public places and statistics have shown a huge reduction in cigarette smoking. Most recently Beijing has now stubbed out smoking in public. 

According to the Health Ministry’s statistics, an estimated 100,000 Malaysians die from smoke-related illnesses every year. Here it is crucial to keep in mind that the deadly threat posed by cigarettes extends not only to the smokers themselves but to others exposed to the cigarette smoke as well.

This so-called second-hand smoke puts even non-smokers at greater risk of developing lung cancer, heart disease, stroke, and the lethal list goes on. For instance, lung cancer risk increases by 20-30 per cent in those who are regularly exposed to other people’s cigarette smoke.

A ban on smoking in all eateries is thus long overdue, especially since the 2011 Global Adult Tobacco Survey revealed that seven in 10 Malaysian adults were exposed to second-hand smoke when visiting restaurants.

In addition, over 80 per cent of Malaysian respondents to the survey wanted 100 per cent smoke-free public places. This suggests that, contrary to the fears of restaurant and coffeeshop owners that their profits would take a hit, a ban would also make good business sense.

CAP therefore urges the Health Ministry to stand firm against attempts to stall or water down the ban on smoking in eateries. In fact, we believe it should go a step further and extend the ban to all public places. 

That would constitute a major contribution to safeguarding public health, for it would not only protect non-smokers from second-hand smoke exposure but may also help induce smokers to quit the habit.
According to WHO, smoking bans, by creating an environment where lighting up becomes more difficult and less socially acceptable, can play a part in bringing down smoking rates. It is, in short, high time for the public health scourge that is cigarette smoking to be snuffed out.

Press release, 2 June 2015

Avoid processed food to fight high blood pressure


According to the latest WHO data published in April 2011, hypertension deaths in Malaysia reached 1,251 or 1.22% of total deaths. Studies have shown that 1 in 3 or about 32.7% of Malaysians aged 18 years and above are suffering from hypertension.

Hypertension is a condition associated with increased risk for stroke, cardiac failure, renal failure and peripheral vascular disease.

Several factors and conditions may play a role in the development of high blood pressure including being obese, lack of physical activity, stress, smoking alcohol consumption and  consuming too much sodium in the diet.

In a recent study it was found that Malaysians consume 8.7 grams daily of salt which is 1.7 times higher  than the World Health Organisation’s recommendation of 5 grams a day. Table salt (sodium chloride) is the major source of sodium in the Malaysian diet. One teaspoon or 5g of salt provides 2,000 mg of sodium.

alt There are various reasons why Malaysians are consuming too much sodium

— Unhealthy modern eating habits which greatly rely on convenience foods (canned foods, instant foods, fast foods, hawker  foods) and processed foods (salty snacks, commercially prepared breads).
— Hidden sodium additives in processed foods. Some examples of these ingredients are monosodium glutamate or MSG (a flavor enhancer), sodium saccharin (a sweetener), sodium phosphates (emulsifiers stabilizers, buffers) sodium caseinate (a thickener and binder) and sodium nitrite (a preservative). There are over 40 types of sodium-based additives allowed in processed foods.
— Salty or hidden high-salt seasoning  added to food during cooking.
— Habitual and excessive intake of some local high salt foods like salted fish, salted eggs and salted vegetables.
— Modern food processing methods. Salt is sometimes added to canned and frozen fruits to prevent darkening of some fruits and to add to the flavor. For example canned and bottled citrus drinks are sometimes buffered with sodium citrate.

Excessive sodium intake has also been associated with a number of health conditions other than raised blood pressure. It also increases the risk of stomach cancer, it increases the rate of deterioration in kidney function of patients with renal disease; it is associated with urinary stones; and it may aggravate asthma and osteoporosis.


Although it is important that consumers are advised to consume less salt or choose low-salt foods, the widespread use of sodium in processed foods and foods prepared away from home or eaten outside is a major barrier to achieving any meaningful reduction in dietary sodium intake. Therefore there is a need to reduce the sodium content of processed foods and drinks.

As May 17 has been dedicated as World Hypertension Day and in view of the escalating number of hypertension cases among Malaysians  the Consumers Association of Penang calls on the government to:

— Make it compulsory for food manufacturers to label the amount of sodium on the labels of food products.
— Stop the advertisements of food products that contained high levels of sodium  such as instant noodles  during children’s television viewing hours.
— Launch a massive campaign to encourage consumers to engage in physical activities to avoid  being obese.

Meanwhile consumers are advised to:
— Avoid consuming processed food.
— Use less salt and seasonings in cooking at home, instead  use various natural herbs and condiments to add flavour to the food.
— Choose  food with less salt and sauces when purchasing foods away from home, either as takeaways or when dining out.
— Read the nutrition information panel (NIP) and find out the amount of sodium in foods intended to be purchase.

Press release, 16 May 2014

Diabetes Epidemic: Nip it in the Bud



CAP calls on the relevant authorities to take immediate steps to control the growing number of obese children in the country to control the diabetes epidemic that Malaysia is facing.

Studies have showed that childhood obesity levels in Malaysia are among the highest in Asian countries. Data from various research groups have indicated that as many as 15% of toddlers and preschool children in the country could be overweight and obese. Among primary school children, 30% of them could be overweight and obese. These statistics are not surprising as overweight children and youngsters are a common sight at public places.


Children who are overweight or obese face an increased risk of developing serious health conditions like type 2 diabetes, high blood pressure, and high cholesterol – all considered to be exclusively adult diseases in the past.


Overweight and obese children are also more likely to turn into overweight adults, and obesity in adulthood is more severe, in terms of consequences. Children who are obese are also more likely to have impaired glucose tolerance, decreased insulin resistance, suffer liver or gall bladder disease, gastro-esophageal reflux (GERD), sleep apnoea, breathing difficulties like asthma, joint problems, and musculo-skeletal problems.

According to the Malaysian Mental Health Association, in addition to medical problems, overweight children may also suffer psychological problems such as low self-esteem that stems from being teased or bullied by peers, develop unhealthy dieting habits and eating disorders such as anorexia nervosa and bulimia, be more prone to depression or are at risk for substance abuse.

According to experts, the “fat phenomenon” in our country can be attributed to a combination of poor eating habits, a diet high in calories, and a decline in physical activity, resulting in more caloric intake than is required by the body.

In addition, more meals eaten away from home, fewer family meals, and greater portion sizes may also have contributed to childhood overweight.

Furthermore, the boom in mobile entertainment devices and too much screen time has also contributed to children’s sedentary lifestyles. Children are now less physically active as children’s entertainment has changed from physical or outdoor activities to indoor video games and television. To further compound this problem, there is a lack of safe or conducive outdoor play areas, especially in urban areas.

The easily availability of food around the clock in the country also indirectly cultivates the unhealthy Malaysian habit of taking supper. Eating at night has been linked to weight gain.

Together with the mushrooming of fast food outlets which serve unhealthy foods also contributes to obesity. Fast foods which are high in fats and salt together with high-sugar soft drinks appeal to children. Continuous consumption of such foods increases their chances of getting diabetes.

Diabetes is one of the most common chronic conditions to affect children. It can strike children of any age even toddlers and babies. If not detected early in a child, diabetes can be fatal or it may cause serious brain damage. Yet diabetes in a child is often completely overlooked it is often misdiagnosed as the flu or not diagnosed at all.

The WHO estimated that more than 200 million people worldwide are living with diabetes and each year another seven million develop it.

In Malaysia, in spite of many campaigns against diabetes, its prevalence especially that of Type 2 diabetes has increased to epidemic proportions. At the current population of 28 million and at the prevalence rate of 15 percent it is estimated that there are 4.2 million diabetics in Malaysia.

The diabetes prevalence rate in Malaysia has risen much faster than expected, almost doubling in magnitude over the last decade. Diabetes does not only take a toll on the country’s resources, but also on the limbs (amputation), eyesight (blindness), kidney (failure), heart (failure) and nerve (damage) of its sufferers.

Surveys have shown that for every two known diabetics, there is at least one more that is undiagnosed and untreated until irreversible complications set in. Worse still, Type 2 diabetes is no longer seen as a disease of middle or old age — children as young as 10 years old suffering from diabetes (both Type 1 and Type 2) are not uncommon nowadays.

According to the World Health Organization (WHO), globally, obesity and overweight has more than doubled since 1980. Nearly 43 million children under the age of five were overweight in 2010. Close to 35 million of them live in developing countries while eight million in developed countries.

As November 14 is World Diabetes Day, CAP would like to call on the relevant authorities to take immediate action to address the growing obesity problem among the young as obesity will lead to diabetes in their adulthood. These measures should include:

— Impose a levy of taxes on unhealthy foods that has high sugar, sodium and fat content to discourage consumption of such foods.

— Food which are high in sugar, sodium and fat should carry health warning labels

— Have the traffic light system of food labels to indicate the unhealthy levels of sugar, salt and fats

— Prohibit the sale of supersized soft drinks

— Remove vending machines selling soft drinks, sweets and junk foods at public places such as schools and hospitals

— Educate Malaysians especially children the dangers of obesity and diabetes

 — Provide adequate recreational amenities in all residential areas. 

Press release, 14 November 2013


Massive anti-sodium campaign needed to fight hypertension epidemic


Today is World Hypertension Day (WHD). It is a day designated by The World Hypertension League (WHL), which is made up of 85 national hypertension societies. Since 2006, the WHL has been dedicating May 17 of every year as WHD. It was initiated to increase awareness on hypertension which is the biggest single risk factor for cardiovascular diseases (CVDs).

CVDs are the number one cause of death globally where 1.55 million deaths every year are attributed to hypertension. By 2030, 23.3 million people would die from CVDs mainly from heart disease and stroke. This is a disturbing 34% increase from 17.3 million in 2008.

Malaysia is not spared from this global epidemic. Every day an average of 110 people are dying of heart disease and related diseases of the circulation. It is now the principal cause of death in the country, accounting for 16.5% of all deaths in Ministry of Health Hospitals in 2008.

Every year there are 38,000 new cases of heart disease in Malaysia. Six new cases of stroke occur every hour and stroke has become Malaysia's number-three killer after heart disease and cancer. One in 3 or about 32.7% of Malaysians aged 18years and above are suffering from hypertension.

In Malaysia, the prevalence of high blood pressure has increased in the past decade. In 1996, it was indicated that 33% of adults aged 30 years and above had hypertension. Ten years later, the figure has increased to 43%.



The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development. These include being obese, lack of physical activity, consuming too much salt in our diet, stress, smoking and alcohol consumption.

Essentially hypertension is also influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling.

A report published in the journal Hypertension projects that 280,000 to 500,000 lives would be saved by a 40% reduction in sodium intake to about 2,200 milligrams a day over 10 years.

According to The New England Journal of Medicine, since the early 1970s, Finland began a campaign to reduce salt intake. Since then, the daily consumption of salt dropped by 3000 milligrams a day with a corresponding decline in death rates from stroke and coronary heart disease of 75-80%.

In a recent study it was found that the consumption of salt among Malaysians was 8.7 grams (3,419mg of sodium) daily which is 1.7 times higher than the World Health Organisation’s recommendation of 5 grams of salt (2,000mg of sodium) a day.

Excessive sodium intake, besides raising blood pressure, also increases the risk of stomach cancer and kidney disease and may aggravate asthma and osteoporosis.

Table salt (sodium chloride) is the major source of sodium in the Malaysian diet. One teaspoon or 5g of salt provides 2,000 mg of sodium. However, sodium may also be present in food as food additives. It may be present as monosodium glutamate (MSG) (flavour enhancer), sodium bicarbonate (leavening agent), sodium nitrate and sodium benzoate (preservatives) and in many other commonly used sodium-based additives.

Salt acts not only as a flavour enhancer, but is used to also increase the shelf lives of food products, control fermentation and improve the functionality of foods.

According to the USFDA, about 75% of our salt intake comes from salt added to processed foods and salt added at food establishments. Eating processed foods and eating out is unhealthy.

CAP research found also over 40 sodium-containing additives used in processed foods.


The WHO Codex Alimentarius food standards allow 136 additives to be used in instant noodles out of which 24 are sodium salts. A packet of instant noodles alone contains over 1,000 mg of sodium, more than half the allowable daily intake of sodium.

Studies has shown that if one lowers the consumption of sodium in the diet the body starts to expect food to taste less salty, and that becomes the normal flavour of food. Lower sodium diets will regulate the salt taste receptors in about six weeks.

 In view of the escalating number of hypertension cases among Malaysians, the Consumers Association of Penang calls on the government to:

• Make it compulsory for manufacturers to show the amount of sodium on the labels of food products.
• Stop the advertisements of food products that contain high levels of sodium, such as instant noodles and fast foods, during children’s television viewing hours.
• Launch a massive campaign to encourage consumers to be aware of the dangers of high sodium intake, to use less salt and to avoid high- sodium foods.

Meanwhile consumers are advised to:

• Avoid processed foods with high sodium content.
• Use less salt and seasonings in cooking at home, instead use various natural herbs and condiments to add flavour to the food.
• Choose food with less salt and sauces when purchasing foods away from home, either as takeaways or when dining out.
• Read the nutrition information panel (NIP) and find out the amount of sodium in foods intended to be purchase.

Press release, 17 May 2013