A spoonful of sugar

A funny thing happened to me at dinner in Singapore the other day.

I was dining at Cloudstreet, a Michelin-starred restaurant co-owned by the Sri Lankan chef Rishi Naleendra and his Australian wife Manuela. After an excellent dinner, Rishi moved us to an elegant upstairs area where guests could enjoy coffee, digestifs and desserts.

 

I said yes to the digestifs but begged off the dessert saying that my doctor had told me that my sugars were on the verge of jumping out of control. I often try and explain this to Indian chefs but they rarely listen. “Array, just try a bit”, they usually say. “A few spoonfuls won’t hurt you.”

 

   But Rishi behaved much more responsibly. He apologised to his pastry chef who was ready with the first dessert and said to Manuela that, like many people he knew in Sri Lanka, I too was in danger of developing diabetes. “It is something that affects all of us,” he said to me sympathetically.

 

   I was impressed by, and grateful for, his concerns for my health. But it got me wondering: are we South Asians really at greater risk of developing diabetes?

 

   So, I looked it up. And I discovered that, on many parameters, we were actually much worse off than Sri Lanka. We have at least 77 million diabetics in India. In fact, one out of every six diabetics in the world is an Indian. According to one survey nearly 12 per cent of all Indians are diabetics.

 

   Why are so many of us diabetic? As far as I can tell, everybody has a theory but nobody can really tell. One theory is that it is a genetic predisposition but science still hasn’t found a definitive answer, and only has theories.

 

   Could it be because of our diets? Is it because we like sweets and consume so many carbohydrates? Till now, the prevalent view has been that while diabetics should cut down on their consumption of maida, sugar, rice etc. there is no evidence that indulging in those foods actually causes non-diabetics to develop diabetes.

 

   I asked my doctor, Ambrish Mithal, who had prescribed all those sugar-fighting pills for me. Dr Mithal said that while nobody had so far been able to find a direct biological link between eating sugar and getting diabetes, there was a view that excess sugar consumption led indirectly to diabetes. He sent me a review article from a medical journal that said that “diabetes is a complicated condition that develops due to a range of factors.”

 

   One of those factors was excess weight. And of course, eating too many carbs and sweets will make us fat, and therefore, more at risk of getting diabetes. But the article went further. There was a direct connection between sugar and diabetes, it said, because of fructose, a kind of sugar. The liver absorbs fructose without regulating the intake which could lead to a decrease in insulin sensitivity. When insulin sensitivity decreases, blood sugar becomes persistently high, leading to diabetes.

 

   Fructose is the sugar that became notorious when the global packaged food industry began using it. (It can be cheaper than table sugar.) There is evidence of a direct link between consumption of packaged foods and diabetes in America. This has contributed to the drive against packaged foods which not only cause obesity but have increased diabetes rates wherever they are extensively consumed.

 

"So if we can do without so much sugar, why do we consume it? Because we like the idea of sugar and most restaurants are happy to cater to our sweetness fetish."

   A decade ago, a study by the journal, Obesity, found that most colas and other bottled drinks in America contained high levels of fructose. Most popular colas got their sweetness from fructose (around 65 per cent). And this was as true of the Sprite-kind of ‘lemon’ drinks.

 

   But fructose is not the only villain. Studies link all sugar consumption to diabetes though the process by which this happens is not fully understood. The statistical evidence however, is compelling. A 2013 study found that whenever sugar became more available in societies, more people got diabetes. The study covered 175 countries and showed that every time another 150 calories of sugar per person per day became available, there was a one per cent increase in the diabetes rate. Another survey showed that sugary drinks increased the risk of diabetes.

 

   So, should we eat less sugar? Of course we should. And do Indians eat too much? I reckon we do. Speak to any Western food critic and they will tell you the same thing: they don’t eat dessert at Indian restaurants because it is just too sweet. Most Western puddings are far less sweet than our desserts.

 

   Mithai is a particular offender; it is loaded with sugar. I have always wondered why it needs to be so sweet and in recent years as places like the Bombay Sweet Shop, which sell less-sweet mithai, have succeeded, I have questioned why our halwais make everything so sweet.

 

   I asked Yash Bhanage, one of the partners at the Bombay Sweet Shop why halwais use so much sugar. Yash explained that apart from the fact that people seem to like very sweet ladoos (for instance) there were two other reasons.

 

   First of all, have you ever wondered how a boondi ladoo holds together? The answer is that the sugar binds it. Many halwais use sugar in all mithai as a simple binding agent. And secondly, sugar is a natural preservative. Top mithaiwallas will make their sweets fresh every day. But at most places, mithai is expected to last for a few days. So, the sugar content is upped to keep the mithai on the shelves for longer.

 

   Yash and the Bombay Sweet Shop team made a conscious effort to reduce sugar levels. For a start, they refused to keep mithai over a long period. Most of their stuff is made fresh and sold fresh. But they also found that if you made mithai less sweet, people didn’t really mind.

 

   Yash’s view is echoed by Sid Mathur of Khoya, the upmarket mithai company based in Delhi. Sid says that the mithai sold at Khoya is 30 per cent less sweet than the usual mithai you get elsewhere.

 

   So if we can do without so much sugar, why do we consume it? Because we like the idea of sugar and most restaurants are happy to cater to our sweetness fetish.

 

   Sid is also a restaurateur and a restaurant consultant and he says that in most cities (though more in Mumbai than in Delhi) nearly every table orders dessert. And people may waste the main course, but the dessert plates rarely return to the kitchen without everything on them having been gobbled up.

 

   That, by itself, is not particularly significant. The French like having three course meals that include dessert but they don’t have our kind of diabetes problem. So, perhaps it isn’t just that we eat dessert. It is that we eat more sugar than the French and that our mithai and desserts tend to be over-sweet. As the mithai experience demonstrates, we could do with less sugar in our sweets: we may not even notice. But chefs and restaurateurs are not willing to take that chance and keeping piling on the sugar.

 

   I don’t accept the new prescription of many health freaks that all sugar is poison. But given how rapidly the number of diabetics is growing in our society and that we don’t really need to over-sweeten mithai and desserts, perhaps it is time to cut back, at least a little.

 

   All good things taste sweeter when they are consumed in moderation.