Investigation

Malt drinks: Sweet silent killers

Most people, who may not want to be intoxicated, consume non-alcoholic drinks, especially the malt brands. They are good energy sources though, there are worries their sugar contents could significantly increase the risk of developing Type 2 diabetes. ISIOMA MADIKE, in this story, attempts to find out what the companies and the regulatory agencies are doing about this

A former Vice-Chancellor at the Benson Idahosa University (BIU), Benin, Edo State, Prof. Ernest Izevbigie, had on May 5, 2017, did the unthinkable. He had dragged the Nigerian Breweries Plc to a high court in Benin City for alleged deception.

Izevbigie, a professor of Biochemistry, had accused the company of purportedly inscribing “low sugar,” on the can of its premium malt drink, Amstel, a non-alcoholic drink, information he found out to be misleading.

The professor in his suit alleged that a laboratory test result had revealed that the product contained more sugar than the company claimed in the inscription on the brand. He then urged the court to order the company to tender a written apology as, according to him, he had been injured by the alleged deception. The inscription on the product, he told the court, was equally misleading to the public.

He said that the result of his clinical research was enough proof that the malt did not merit the “low sugar” label. When the biochemist subjected the drink to scientific and nutritional enquiry, he was startled at the result.

A cursory look at the nutritional table of a Can or bottle of Amstel Malta showed the total carbohydrate to be approximately 40g. This is by 12.1g per serving. A serving being 100ml, the total content of a Can being 33cl or 330ml, which equals 3.3 serving and the carbohydrate content of a Can is 39.9g (12.1 x 3.3). Izevbigie further discovered that when converted, it means that every 3.30ml can of Amstel Malta contains 97.7 per cent of sugar or approximately 98 per cent compared to an average product in the market without the “low sugar” claim.

When further converted to cubes, there are, he said, 9.97 cubes of sugar (4g=1 cube of sugar) 40g/4g= 10 cubes in every can of Amstel Malt drink which is 10 cubes of sugar per Can by mathematical computation.

He did a comparative analysis with other malt drinks, Maltina, also brewed by Nigerian Breweries and Malta Guinness, a product of Guinness Nig., which showed that a 33cl or 330ml can of the other malts contain 12.4g of carbohydrates per serving or 40.9 per cent of sugar per can or 10.2 cubes of sugar per can which has only two per cent more sugar compared to the “low sugar” Amstel Malt drink which is 10.0 vs 10.2 cubes of sugar per can.

This showed that the low sugar claim made by the company on its Amstel Malta bottle or can, has no statistical, mathematical, nutritional or clinical difference in content analysis of Amstel Malta and Maltina drinks to warrant and/or justify the claim of low sugar by the company. Izevbigie however, produced no report in court as his investigation was for his personal use.

But he argued that a low sugar malt drink is one that contains 2.5g/ serving of 100ml and Amstel Malt drink is not in that category as it does not contain less than 2.5g of sugar. According to him, the drink contained 10 cubes of sugar as against the 10½ to 10¼ cubes found in other malt drinks. He said: “I discovered during a routine medical examination that my blood sugar level was high, which was traced to my regular consumption of the said malt drink.

So, I argued that Nigerian Breweries Plc, makers of Amstel Malta declaration of low sugar on its product was factually and scientifically untrue and therefore deceitful. “The claim as I discovered was only intended to deceive me and other consumers that the product was safer and healthier, when in actual fact is saturated with sugar like other malt drinks.

I also discovered it was not a better substitute, especially for members of the public, who are either pre-diabetic or already leaving with the condition. “Their claim therefore misled me, friends and relatives, who relied on the erroneous advice I gave to them on the malt, the consequence of which was a worsening of our diabetic condition. They had no choice but to believe me because of my studies in Growth Biology and Nutrition.”

Saturday Telegraph however, gathered that before 2013, there was no government regulation on what should be the sugar content of low sugar malt drink. So, it is difficult to establish the basis for which the National Agency for Food & Drug Administration & Control (NAFDAC) gave approval for the company to advertise its malt as low sugar. Amstel Malta was launched in 1994 and the low sugar campaign for the brand which followed the launch was premised on the fact that Amstel Malt drink contained the lowest sugar among other malt brands in the Nigerian market right from when it was launched. Meanwhile, Nigerian Breweries told the court that in 2007, the Standard Organisation of Nigeria (SON) provides that malt drinks in the country shall have between 10 per cent and 16 per cent of sugar and within this range Amstel Malta has the lowest sugar.

It also claimed to have declared on its label the carbohydrate content which is 13.7g/100ml while Izevbigie, according to the company, wrongly used 12.4g in his analysis. The carbohydrate difference between Maltina and Amstel Malta in each unit of package (330ml) is 5.28g with Amstel Malt drink lower in carbohydrate, it further stated.

The company equally claimed it had earlier on October 7, 2011, explained the basis of the low sugar claim on Amstel Malta. Nigerian Breweries however, lost the case because, according to the court, it found out that the product is within the level of standard approved by SON and that its carbohydrate level is only slightly and insignificantly lower than that of other brands.

The judgement read in part: “I find the argument of the company lame because it should have advertised lower sugar than others by whatever level. It did not do that rather it states “LOW SUGAR”.

I am satisfied from Izevbigie’s evidence which is not strenuously denied by the company.” Aside the low sugar malt drinks, the high content of sugar in the regular malt drinks, is also disturbing. But with the competition, a number of the brewing companies may have adjusted their strategy as a result of the complaints. They now play up health as one of their unique selling propositions to retain or increase their market share.

They have also been developing new marketing approaches to reach consumers, some of it are promotional campaigns based on health messages. They are equally repackaging to plastic bottles, paper pack containers to capture consumers’ attention. Price has not been much of an issue as there is no remarkable difference in the prices of the products. Some of the popular malt brands in market are Maltina, Amstel, produced by NB Plc, Malta Guinness, Malta Guinness low sugar, Dubic Malt and Guinness Malta herb, from the stable of Guinness, Grand Malt and Beta Malt produced by Intafact Beverages Limited, formerly SabMiller, a subsidiary of Abinbev Beverages. Others include Malta Gold, Hi-Malt, Maltex, Vitamalt and Maltonic.

They all are contenders for market share in the malt drink market and this has helped to stiffen competition in the marketplace. However, some brands such as Maltina, Amstel, Malta Guinness (regular) and Malta Herb appear to have taken over the large chunk of the market. These brands have succeeded in dividing customers along taste line. According to consumers, who spoke to Saturday Telegraph, “the introduction of new malt drinks is yet another example of how the marketplace responds when the public changes its mind.” Incidentally, this is what consumers have mistaken, as they are increasingly seeing malt brands as healthy alternative to alcoholic drinks.

The producers seemed to have responded to this by playing up this mind-set among consumers to developing and positioning their products along this line. They have also developed several marketing campaigns to capture more people with consumers falling for the tricks. For instance, Lilian Nwaka told Saturday Telegraph that she preferred the low malt drinks because of the danger in taking more sugar that may eventually cause problems for her. She said: “I didn’t want to have diabetes; that was why I preferred low malt drinks. I understood it to contain less sugar and that, I thought, was good for my age.

But now, I know better.” Another customer, Jennifer Eromosele, also said: “One of the adverts had promised to keep consumers trimmed if they take it continuously. And because people laugh at my plum size, I decided to go for that brand. I have remained loyal to it ever since.” Emmanuel Nwaghodoh, who is somewhat addicted to malt drinks because “I don’t take alcoholic drinks”, said he struggled to stop drinking any malt brand after learning from the experience of one professor who sued Nigerian Breweries for “deceit” after its advert misled him and others.

“The man’s action was a great lesson because I had always believed there is less sugar in malt drinks. And since I don’t take alcohol, I thought they are best for me. I have since realised the quantity of sugar being pumped into my system and I have said never again.

If many realised like I have now, that we are drinking to fuel diabetes which kills us gradually, they would learn to avoid them permanently until the regulatory agencies do the needful,” Nwaghodoh, who is not happy that he had been deceived for long, said. A middle aged woman, who prefers to be anonymous, put it succinctly: “The claims on low, less or zero sugar by these companies are false. The producers of the malt drinks are dishonest.

There is actually heavy content of sugar in malt drinks, especially. Some that may have less sugar add other addictives that could be worse than sugar. NAFDAC should tell us the truth; many are dying in piece meal without knowing it.”

For Angela Davies, a journalist and blogger, “my brands are Maltina and Malta Guinness. I’m kind of addicted to them. I started drinking them when I realised, according to what people told me, of their promises of vitamins and body nourishments as well as acting as blood boosters or blood tonics.”

A distributor of malt drinks, Matthew Ebuloku, said he used to sell more of the low sugar brands. He pointed out that other malt drinks which consumers see as having less sugar but not positioned as one also did well in the market. Ebuloku said: “Many people, especially those not well informed, usu-ally rely on what others say about a particular brand to make their choices. So, they take these drinks without really understanding the implication of the sugar contents in them. Others take them to show that they do not drink alcohol. In a way, they do that to satisfy current lifestyle.

“And the malt drink producers have equally found inventive ways of breathing new life into old-time brands by updating the products and appealing to new consumer groups. Specifically, the Muslim population and some Christian groups that forbid the drinking of alcohol may have inadvertently triggered the growth of the market.” Meanwhile, the regulatory bodies, NAFDAC and SON, only announced new regulations, stipulating new guidelines for sugar content and labelling for malt drinks after Izevbigie had won his case against Amstel Malt drink. In the new directive, which is said to be in line with the international standard, only malt drinks containing less than 2.5g of sugar could be labelled Low Sugar, and between 2.5g and below 9g should be classified Light Sugar.

This change in regulation nullified all ‘Low Sugar’ claims in the market. Following this, Guinness Nigeria made the bold choice to temporarily discontinue low sugar variant and launched what is the very first light sugar malt drink in Nigeria.

But malt drinks are not the only drinks with sugar that is harmful for consumption by the Nigerian populace. Other soft drinks, which had acidic contents and addictives, were exposed when for nine years a civil law case went on against Coca Cola Bottling Company, manufacturers of Fanta and Sprite that impacts directly on health and lives. The Chairman/Chief Executive, Fijabi-Adebo Holdings Ltd. and EFAD Ltd (UK), Dr. Emmanuel Ayodele-Fijabi Adebo, had in 2007, bought about N12 million worth of Fanta and Sprite drinks from Coca Cola Bottling Company of Nigeria Ltd, and exported same to the United Kingdom. However, on reaching England, under Health and Safety regulations, the authorities tested the products and found them to contain “poisonous levels of Benzoic Acid and Sunset addictives”.

They were therefore declared “unfit for human consumption”. The whole export consignment was consequently destroyed. Just like Izevbigie, Adebo consequently sued Coca Cola for negligence, breach of duty of care to its customers, and loss of earnings. The company was said to have offered only one defence in court: That Adebo did not tell them he was going to Export the Fanta and Sprite drinks to England; and that the products were indeed manufactured “FOR LOCAL CONSUMPTION ONLY”.

The presiding judge, who was not happy with such defence, also berated NAFDAC for not carrying out proper laboratory checks on ‘minerals’ production in Nigeria. Cancer was listed as one of the ailments that the Fanta and Sprite can cause, especially if taken with Vitamin C tablets. The court, therefore, ordered Coca Cola to henceforth add a WRITTEN WARNING on Fanta and Sprite bottles that “this product must not be taken with Vitamin C.”

Unfortunately, the Minister of Health, Prof. Isaac Adewole, in trying to defend the company had stated that the level of benzoic acid in Fanta and Sprite are in compliance with both the Codex and Nigerian Industrial Standards and thus safe for consumption. Many however, now argue that what the court prescribed for Coca Cola should apply to malt drinks manufacturers by given enough information on the sugar contents in the drinks and the possible consequences so that consumers could make informed decisions.

In a related circumstance, it was discovered recently by researchers that women who drank the sweetest soft drinks had a 78 per cent increased risk of endometrial cancer. The findings fit in with other research linking sugar intake, obesity and a lack of exercise with the endometrial cancer, which is said to kill more than 8,000 U.S. women a year. “Other studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity. Obese women tend to have higher levels of estrogens and insulin than women of normal weight,” said Maki Inoue-Choi, who did the study while at the University of Minnesota but now at the National Cancer Institute. The researchers were concerned about what sugar-sweetened beverages do with how insulin, which controls how the body uses sugar and affects other hormones such as estrogen.

“Increased levels of estrogens and insulin are established risk factors for endometrial cancer,” she said. Inoue-Choi and colleagues studied the records of 23,000 middle-aged women who had gone through menopause. Endometrial cancer is more common in women past menopause. The women had been taking part in a bigger study of diet, and regularly filled out questionnaires on what they ate and drank every day.

They were specifically asked about Coke, Pepsi and other cola drinks; caffeine-free versions of these drinks; 7-Up and similar sugar-sweetened sodas, and other sugary drinks such as lemonade or Hawaiian Punch. The women were also asked about sugar-free drinks such as Fresca, Diet Ginger Ale and other beverages. They were asked about cookies, brownies, doughnuts, candy and pies. The researchers arranged the women into five groups, called quintiles, from those who ate none of these things a week to those who ate 60 or more servings a week. The women showed one known pattern – those who were older, weighed more, who had late menopause or had a history of diabetes were at higher risk of endometrial cancer, which is diagnosed in nearly 50,000 U.S. woman every year.

“In contrast, women who ever smoked or experienced a greater number of live births were at lower risk of endometrial cancer,” the researchers wrote in the journal Cancer Epidemiology, Biomarkers & Prevention, which is published by the American Association for Cancer Research.

Those who drank sugary drinks had a higher risk of the most common type of endometrial cancer, called Type I endometrial cancer. The more they drank, the higher the risk, the researchers found.

“The risk was 78 per cent among women in the highest quintile of sugar-sweetened beverage intake,” they wrote. “It might not be anything special about sugary drinks,” the researchers said, adding, “it might be that women who drink a lot of such drinks have other unhealthy habits, too.” Inoue-Choi said it’s not clear why drinks and not other sweet foods showed an effect. “One possibility is that sugar from whole foods comes with other nutrients, such as fiber,” she said in an interview.

“Sugar from beverages doesn’t come with these nutrients.” Femi Fasanmade, a professor of Medicine & Endocrinology, who has been a clinical researcher in the fields of Endocrinology, Diabetology, Metabolism and Nutrition for about two decades now, has advised that the less refined sugar in the body system, the better for any individual. Sugar, Fasanmade added, is not an essential part of diet, so, it has to be taken in moderation.

“In terms of how much of it to take, there is no absolute amount to be recommended, but the less you take the better for your body system. In like manner, the less minerals or malt drinks, the better but there is no specific quantity that could be recommended. So, people should take limited quantity at any point in time.

“If an individual takes too much of sugar, such a person will put on weight, and with that he or she becomes pre-diabetic and finally diabetic. That arithmetic is simple. The simple way is to go natural; take natural foods. All those things that are artificial, coloured and shining in the stores, supplements and even alcohol, leave them alone.

They are not good for your health,” the professor advised. Another professor of Community and Public Health, who doubles as president, Federation of African Nutrition Society, Ngozi Nnam, appears to differ a little from the position of Fasanmade. Nnam told Saturday Telegraph that sugar remains an essential ingredient in the body system with its nutritional value because, according to her, it is a source of energy. Although the professor said as a nutritionist, she is not in a position to advise people not to eat food with sugar or to stop eating food that has sugar, she added that any individual who must take sugar must have self-control. She said: “When we take carbohydrate foods, it metabolises to sugar, and this take a process of digestion that converts it to sugar which is the end product. So, it takes a process for the carbohydrates to end up as sugar in the body.

That one is different from sugar from drinks and other beverages we take. In drinks, there is no process of digestion. When you drink, for instance, the sugar in it goes to the blood stream straight. “The implication is that it will hike up the sugar level in the blood thereby predisposing such a person to becoming diabetic because diabetes is simply no other than high blood sugar level in the body. When the sugar level in the blood is higher than normal, we say that the person is diabetic. We must realise that the metabolic system in the body drops as we get older. That is why children can take so much sugar and are not diabetic because their body system metabolises easily.

“But for an adult, the metabolic system drops and slows down. So, it is advisable at older age to reduce the intake of sugar. While the natural foods we take are different is because of the fibre nutrients in them which regulates the sugar; it has a way of slowing down the metabolic process so that the end product which is sugar could be going gradually into the blood stream and as such will not cause sudden hike in the sugar level.

That is why as nutritionists we advise that people should take their food with a lot of fibre from vegetable, legume and so on so that it can regulate the end product of digestion which is sugar in the blood stream.” Nnam, who is the immediate past president of the Nutrition Society of Nigeria, also said that the society is working with the industries to see that gradually they reduce the sugar level in drinks generally.

“It’s however, not going to be a sudden process because when people are used to a certain flavour, if it suddenly disappears, they will stop taking that drink. In fact, there are standards that are recommended for sugar level in products, so, we are working with them to see if they can gradually get to that standard. It’s not a one-off something; it is a gradual process.

“The standard we are talking about here is dependent on countries, it also depends on establishments, but the important thing is that it is not a oneoff process. And the standard I know is not in terms of cubes of sugar but percentage. For one to be in a state of good health the energy intake must be equivalent to the energy expenditure. But most times the energy we are taking from food is far more than the energy we are expending.

“The surplus of it is stored as adequate tissue or fat leading to obesity which is a risk factor for most of these non-communicable diseases like diabetes, hypertension and cardiovascular diseases. When you take too much sugar it is predisposing such individual to becoming obese and we don’t have the culture of taking exercise. So, the general advice is for people to reduce the intake

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