

By Joachim Ng
It was an up-down ride last year with two accolades that sent us to the clouds and a thunderbolt that brought us down to earth again. Ipoh White Coffee secured 10th spot while Roti Canai of Malaysia snatched a crown, but in another listing Ipoh was placed only 465th.
Ipoh White Coffee did very well in the “Top 39 Coffees in the World” 2024 listing by international food travel guide TasteAtlas, and Roti Canai of Malaysia was crowned the No. 1 Best Rated Bread in the World. However, the 2024 Oxford Economics Global Cities Index gave a ranking of merely 465 for Ipoh, out of 1,000 global cities. The index is based on five categories: economics, human capital, quality of life, environment, and governance.
Which category do you think we are weakest in? It is most likely the quality of life. Although Perak scored yet another stunning victory with Tourism Perak’s report that the State had achieved its target of 8.4 million tourists in 2024, the claim raised doubts. Many questioned its validity in view of Ipoh’s poorly maintained infrastructure, pothole-riddled roads, and derelict buildings marring the landscape.
Nevertheless, this year may bring even more foreign tourists, as Ipoh has been named by London-based Time Out lifestyle magazine as one of top eight must-visit cities in Asia for 2025. What if foreign tourists become more discerning? Will something about Ipoh, Perak, and Malaysia as a whole trip them up?
Famed as a “city of eating” yet Ipoh’s diverse fare of local delicacies from various cultures hasn’t been investigated with a scanning probe microscope. If we were to do it, we shall find that Ipoh is far behind the “good health” trend, as the renowned taste of Ipoh dishes is remarkable only by standards that excludes proper nutrition. Malaysians eat more than necessary, and most of us will end up eating hospital food much sooner than we think.
Let’s discuss the soaring cost of bad health. Government hospitals are perennially overcrowded and private hospitals, patronised by middle- and high-income folks, are never short of patients. Many patrons use medical insurance to pay for treatment but with the sustained growth in volume of admissions, the number of claims has shot up. This is now resulting in an average 10% annual rise in premiums. Over five years, policy holders will find they are paying 50% more.
Another cause of premium jumps are the higher charges imposed by hospitals for medical checkups, surgeries, medicines, and rooming because of more expensive equipment that are imported such as magnetic resonance imaging, X-ray, computed tomography scan, and ultrasound machines.
Middle incomers have reached a crossroads and large numbers are terminating their policies. They will get treatment in government hospitals instead. Once their domain, the low-income patients find themselves competing for ward space with the middle incomers.
What’s the cost to you personally? The Government has to spend lots more on public health facilities, as the annual economic burden of diabetes is about RM4.4 billion. The Government can only provide extra funding to public hospitals by cutting back on many other services. This cutback will soon hit you and your family, including a likely reduction in the education budget.
The root of this problem? Insurers have explained that the main factor behind soaring premiums is the high prevalence of diseases like diabetes which is one of the major killers in Malaysia.
The National Health and Morbidity Survey 2023 stated that one in six Malaysian adults are diabetic, and that’s 3.6 million people aged 18 years and above. Diabetes can lead to limb amputation, blindness, kidney failure, heart failure and nerve damage.
Malaysians are also getting obese, with the prevalence of overweightness among adults standing at 50.1 percent. In Malaysia, 9.7% of deaths are due to obesity as an attributing risk factor. Resulting illnesses include heart disease, stroke, cancer, and diabetes.
Available statistics also show that 65 out of 100 Malaysian children are at risk of being obese by 2035. It was only 36 out of 100 in 2020. Overweight children have a greater risk of high blood pressure, high bad cholesterol, fatty liver, and Type 2 diabetes.
Last September, Prime Minister Datuk Seri Anwar Ibrahim disclosed that Malaysia has the highest number of diabetes cases in Southeast Asia. In view of the disclosure the Consumers Association of Penang last November urged the Government to compel manufacturers to clearly indicate the amount of sugar in their products by showing the number of teaspoonfuls of sugar contained.
Diabetes is a disease that results when the body is unable to digest glucose broken down from sugars found in food and convert it into energy. With less glucose absorbed by the cells, more glucose accumulates in the blood. High glucose (blood sugar) levels will cascade down to damage your blood vessels, eyes ,feet, heart, nerves, and kidney.
How is refined white sugar linked to diabetes? It is due to its impact on blood sugar levels and the body’s insulin response. Insulin is a hormone produced by the pancreas that cells need to take in glucose.
Refined sugar has a high glycemic index, meaning it is quickly absorbed into the bloodstream. This causes a rapid spike in blood sugar levels, prompting the pancreas to release a large amount of insulin to help cells absorb the sugar. Over time, repeated spikes can lead to insulin resistance with cells becoming less responsive to insulin, causing higher blood sugar levels. Chronic insulin resistance is a major risk factor for developing Type 2 diabetes, as well as cancer as we shall discuss at the end.
Refined sugar is calorie-dense but lacks nutrients like fibre, protein, or healthy fats that slow sugar absorption. This can lead to weight gain, particularly visceral fat (fat around the abdomen), which is strongly associated with insulin resistance and diabetes. Excessive consumption of sugar puts stress on the liver and raises triglyceride levels that increases the risk of diabetes and cardiovascular disease.
Unless you are prepared to spend years in hospital as a small price for consuming only sweetened foods, the maximum amount of added sugar in all your meals is this: 25g per day (100 calories, 6 tsp).
To put that into perspective, one 12-ounce (355-mL) can of high-sugar drink contains 140 calories from sugar, while a regular-sized energy bar contains 120 calories from sugar.
Based on a study by the Health Ministry, the average Malaysian takes 26 teaspoons of sugar per day – more than 4 times the recommended maximum.
According to a 2023 survey by world mapping website Landgeist, Malaysia is one of three Asian countries where the sugar consumption is over 40 kilograms per capita. Bahrain at 44.3kg is the highest, followed by Lebanon (43.4kg) and Malaysia (41.6kg).
The Health Ministry’s declared “war on sugar” has been lost because of in-fighting. Although there is a 50 sen per litre tax on premixed sugary beverages to discourage excessive sugar intake, there is also a subsidy for sugar manufacturers to lighten their cost burden so that the price of sugar remains low. Malaysia has one of the lowest controlled sugar prices in the world, hence driving higher consumption.
The left hand of the Government is boxing with the right hand, and you are the collateral damage with diabetes taking you down to the hospital floor. But if the ambulance goes past the diabetes ward, it could be taking you to the cancer ward.
Yes, we are also losing the war on cancer and it’s largely due to our food and drinks. Both cancer and obesity are linked to elevated levels of insulin. When insulin rises to abnormally high levels and remains elevated in a condition known as insulin resistance, it can promote the growth of tumours directly and indirectly.
Ipoh City Council and the Perak State Government must stride out boldly by stopping the practice of having sugar added to nearly every meal and too many drinks. We can make the silver city glitter as one of the top 3 most desirable health cities in the world. The next article on Feb 1 will show how Ipoh can reach this greatest of all heights.