A lot has already been said about the less-than-pleasant results of enjoying one’s bubble milk tea way too much, whether it’s that high sugar content or those calorie-rich tapioca balls that sabotage your diet.
But you might want to add one more thing to be wary of when having your daily dose of sweet, chewy pleasure: That cup you’re holding in your hand may contribute to gout.
"I see an average of four or five patients a month with gout," revealed Dr Victor Seah, an orthopaedic surgeon with a sub-specialty in foot and ankle, at Parkway East Hospital. These patients have shared with him that they consumed bubble milk tea on a regular basis, although the exact amount and frequency were undetermined.
SEVERE, SHARP AND BURNING PAIN
No longer regarded as “old people’s problem” as we’ve reported before, here’s aquick refresher on how gout works.
This excruciatingly painful condition that affects the joints is caused by high levels of uric acid in your blood.
Normally, uric acid in your blood gets filtered out by the kidneys and gets passed out as urine. But when the levels are too high, the uric acid can build up and form needle-like crystals in the joints, particularly the big toe.
A gout attack frequently starts with a tingling sensation, which rapidly progresses to severe pain. "It is a severe, sharp and sometimes, burning pain at the joints," said Dr Seah. "Some patients have described it as a sensation of being poked by many needles. The pain is constant and is painful even when resting." Ouch.
"Gout typically affects the big toe joint of the foot, but it can also affect the ankles, knees and even wrists and elbow joints," he said.
An attack may also bear these signs:
- Redness, warmth, swelling and pain can involve one or a few joints. The big toe, knee or ankle joints are most often affected.
- The pain starts suddenly, often during the night.
- There may be a fever.
The pain aside, uncontrolled gout can cause joint deformity, cartilage damage, arthritis, chronic pain and stiffness, said Dr Seah.
And it's not just the joints. The uric acid crystals may sometimes be deposited in the skin and soft tissues, Dr Seah pointed out. When this happens, the crystals can create painful lumps, ulcerations that can get infected, and even skin breakdown, he said.
"Uncontrolled gout can also cause kidney stones and in severe cases, cause kidney failure."
THE BUBBLE MILK TEA CONNECTION
So what’s the bubble tea connection? Isn’t gout typically caused by consuming too much red meat, nuts, seafood and beer?
It is true that those foods and drinks can be triggers for gout as they contain an amino acid known as glutamate. When digested, glutamate leads to the formation of purines, which are further broken down to become uric acid, explained Jaclyn Reutens, a clinical and sports dietitian as well as the founder of Aptima Nutrition and Sports Consultants.
Meanwhile, the fructose found in the tapioca pearls, sugar, syrup, honey, fruit flavourings, fresh fruit and fruit purees can also lead to the increased level of purines in the body when digested, she said.
Take sugar, otherwise known as sucrose, for instance. “Based on an estimation, a regular-sized to a large cup of bubble tea with pearls would contain 15g to 42g of sucrose, which comes up to 7.5g to 21g of fructose,” said Reutens.
That amount may be less than brown sugar bubble milk tea's 92g of sucrose but it's almost your day's limit of 45g to 55g as recommended by the Health Promotion Board.
You may not think much about those numbers until you hear about the extreme consequences of drinking too much bubble milk tea.
One such prominent example a while back was the 18-year-old bubble tea lover from Guangdong, China, who developed such a high level of uric acid crystals in his fingers and feet, that the doctor described them as having “turned to stone”.
Different people have different susceptibility to gout other than diet alone.
The teenager was unable to walk or use his hands from the debilitating pain and severe inflammation in his joints. “When the patient arrived, gout in all four of his limbs meant he was already unable to walk,” said Guangdong Second Hospital’s resident rheumatologist Zheng Shaoling in Southern Metropolis Daily.
The teenager was discharged about a week later but imagine all that trouble from drinking at least one cup of bubble milk tea every day.
If you have the habit of drinking a cup a day, should you be concerned about gout? "Different people have different susceptibility to gout other than diet alone," said Dr Seah.
Another factor is the amount of water that you are drinking. “Drinking more water can dilute the uric acid crystals and you will pass them out in your urine,” said Reutens. “Drink at least 2 litres of water a day and when you drink bubble tea, wash it down with two glasses of water.”
If you do experience a tingling sensation and suspect it's the beginning of a gout attack, immediately stop your intake of high-purine food and alcohol, advised Dr Seah. "Drink lots of water to increase the excretion of uric acid. Ice the swollen joints to reduce swelling and pain."
At the doctor's, you may be prescribed anti-inflammatories to treat the pain and inflammation as well as medications that increase uric acid excretion and reduce uric acid production in the body, said Dr Seah.
And limit your treat to once a week. “Too much bubble milk tea can also cause unnecessary weight gain. Ask for less or no sugar, and less or no pearls,” said Reutens.