Calories and sugars in boba milk tea: implications for obesity risk in Asian Pacific Islanders (2024)

Abstract

In the last several decades, obesity rates have reached epidemic proportions, and increases the risk for a host of comorbidities, including diabetes, cardiovascular disease, and certain kinds of cancers. Boba milk tea, first became popular in the 1990s throughout Asia, and has gained more popularity in the United States and in Europe since 2000. Currently, available nutrition data from online sites suggest this beverage contains high amounts of sugar and fat. One published nutrition study suggests that boba tea drinks are part of the larger group of sugar‐sweetened beverages (SSB) because these beverages are usually sweetened with high‐fructose corn syrup (HFCS). This study experimentally determined the sugar composition (sucrose, fructose, glucose, and melezitose) and calorific values of boba milk tea drinks and their components. Results suggested that boba drinks fit the US Dietary Guidelines definition of a SSB. One 16‐ounce boba drink exceeds the upper limit of added sugar intake recommended by the 2015 US Dietary Guidelines Advisory Committee. The high caloric and sugar content of boba beverages pose public health concerns as they have the potential to further exacerbate the childhood obesity epidemic. Nutrition education targeting Asian populations should give special attention to boba tea as a SSB. Also, prudent public health recommendations should be suggested for moderate consumption of these beverages. With the growing popularity of boba beverages in the United States, the findings from this study provide public health practitioners with valuable data on how boba beverages compare with other SSBs.

Keywords: Asian Pacific Islanders, boba, calorific value, obesity, saccharides, sugar‐sweetened beverages

Introduction

Boba milk tea, also known as bubble or pearl tea, first became popular in the 1990s throughout Asia, and has gained more popularity in the United States and in Europe since 2000 (Alexander ²⁰⁰¹). The origin of this beverage dates back to the 1980s in Taiwan, where a Taiwanese tea shop owner, Liu Han‐Chieh, and his product development manager, Lin Hsiu Hui, experimented with adding different ingredients such as fruit, syrup, and Tapioca ball in milk tea beverages (Chang ²⁰¹²). The central ingredient in this type of drink is “boba” or “pearl” balls. These boba balls are made of tapioca, which are boiled to produce a round chewy ball that is then added to hot and cold beverages such as tea, coffee, smoothies, slushies, and blended beverages. These beverages are usually consumed with a large straw, through which the tapioca balls are slurped and chewed.

Boba tea beverages are especially popular in large metropolitan areas with high concentrations of Asian American Pacific Islander (AAPI) youth and young adults (Rosen ²⁰¹⁵). Evidence of this drink's popularity in the United States is clear: a quick search on Yelp using the key words “boba tea” yields more than 200 listings of boba tea stores, just in the Los Angeles area alone (Yelp, ²⁰¹⁶). The popularity of boba tea has expanded to Europe, with boba stores now in metropolitan cities such as London (Townsend ²⁰¹⁴). In the United States, the popularity of boba is such that there is a designated page on Wikipedia to detail the history of boba tea, along with a listing of over 13 boba store chains, and descriptions of over 200 variations in boba drinks (Tea ²⁰¹⁶, Wikipedia, ²⁰¹⁶). As it has become so popular and commonplace, individuals can purchase their own boba ingredients and watch YouTube videos to learn techniques for how to make boba teas at home (Nuts, ²⁰¹⁶). There is even a boba school devoted to teaching the trade of making boba drinks to clients interested in opening a boba store (Wei ²⁰¹⁵).

Over the years, the original boba milk tea drink has expanded to consist of more variations and combinations. Internet blogs describe boba as more than just tea drinks; some have suggested that these are tea desserts (Rosen ²⁰¹⁵). The primary component in boba teas are the black tapioca “boba” balls, which are usually made from cassava starch, sweet potato, and brown sugar. Less commonly, white tapioca pearls are used, and these are made from cassava starch, caramel, and chamomile root and have a different flavor (Weil ²⁰¹²). In addition, other ingredients that are commonly added to boba drinks include jelly (Nata de coco) and egg pudding. Additionally, other variations in boba drinks include fruit smoothies and slushies, blended coffee and tea combinations.

Currently, available nutrition data on boba drinks are from popular press or online sources, but there's a paucity of published research to document the nutritional quality of these beverages. Online nutrition facts data from large boba chains suggest this beverage contains high amounts of sugar and fat (Weil ²⁰¹²). A search on the internet for calorific value of boba drinks found that a 16‐ounce serving of boba milk tea contains between 200–450 calories, depending on the type of boba beverage and what additional ingredients are included (FatStraws, ²⁰¹⁵; Weil ²⁰¹²; Carey ²⁰¹⁵). One published nutrition study conducted by Taiwanese researchers Chan and colleagues suggests that boba tea drinks are part of the larger group of sugar‐sweetened beverages (SSB) because these beverages are usually sweetened with high‐fructose corn syrup (HFCS; mainly HFCS‐55) (Chan etal. ²⁰¹⁴). Other than this study and a plethora of online articles about the nutritional quality of boba tea drinks, there is still a lack of knowledge about the calorific values or sugar source of these boba drinks. Therefore, the purpose of this study was to analyze the sugar composition (sucrose, fructose, glucose, and melezitose) and calorific value of boba milk tea drinks. The findings of this study have important implications for public health as knowledge of the nutritional composition of boba drinks will allow public health researchers to evaluate whether this beverage should be classified as a SSB, and if so, how these beverages influence health and obesity in the United States

Material and Methods

Results and Discussion

Figure1 shows representative chromatograms for saccharides extracted from the tapioca balls and the jelly (Nata de Coco). The large peak area for the fructose in Figure1A strongly suggests that high‐fructose corn syrup was the sweetener in the pudding. The jelly (Fig.1B) is sweetened with cane or beet sugar, as demonstrated by the sucrose band dominating the chromatogram. According to the 2010 Dietary Guidelines for Americans, sugar‐sweetened beverages (SSBs) are defined as, “liquids that are sweetened with various forms of sugars that add calories. These beverages include, but are not limited to, soda, fruit‐ades and fruit drinks, and sports and energy drinks” (USDA, ²⁰¹⁰). Based on the experimentally determined sugar composition presented in Figure1, the boba milk tea beverage fits the US Dietary Guidelines definition of a sugar‐sweetened beverage.

Table1 summarizes the amounts of each detected saccharide for every ingredient in a boba beverage, with reported values as averages of triplicate measurements. The assays in Table1 are scaled and reported for a typical serving size of 473mL (16 US oz) of milk tea, 60g of tapioca, 50g of jelly, and 80g of egg pudding. The calorific values are reported in food calories (kcal) and represent the pooled energies from protein, fat, and saccharides for each component, as determined by bomb calorimetrically. Calorific values may slightly overestimate metabolizable energy due to the inclusion of insoluble fiber and unavailable carbohydrates in the measurements (Maynard ¹⁹⁴⁴; Livesey ²⁰⁰²; Zou etal. ²⁰⁰⁷; Trivedi ²⁰⁰⁹). Table2 reports the total saccharide and calorific values for different combinations of boba beverage ingredients. Results indicate a 16 ounce (473mL) single serving of a boba drink with milk tea and tapioca “boba” balls containing 299 calories and 38 grams of sugar.

The 2010 Dietary Guidelines recommend that no more than about 5–15% of the total daily calories come from added sugar and solid fats in the diet (DGAC, ²⁰¹⁰), whereas the American Heart Association suggests Americans to limit added sugars to not more than 150kcal/day for men and 100kcal/day for women (Johnson etal. ²⁰⁰⁹; AHA, ²⁰¹⁵). After applying the Atwood factor (Maynard ¹⁹⁴⁴; Zou etal. ²⁰⁰⁷) to the pooled saccharide measurements, the amount of calories and added sugar in this boba milk tea beverage contains the entire quantity of the recommended maximum daily intake of sugar for men (38g) (DGAC, ²⁰¹⁰) and over 150% for women (25g) (Johnson, 2009). When combined with the additional ingredients in the beverage, the pooled saccharides easily exceed the recommended maximum daily intake of sugar for all populations. A large 32 US oz (946mL) serving of boba milk tea that includes jelly and egg pudding supplies more than 250% and 384% of the recommended maximum daily intake of sugar for men and women, respectively.

The concern over SSBs is derived from mounting evidence which links intakes of added sugars from SSBs with increased body weight, type 2 diabetes, metabolic disease, and a host of other obesity‐related comorbidities (Malik etal. ²⁰¹⁰; Bray and Popkin ²⁰¹⁴). As a result, the most recent 2015 Dietary Guidelines Advisory Committee (DGAC) issued even stronger and more specific guidelines with regards to added sugar. In the report, DGAC suggests limiting added sugars intake to below 10% of total energy intake (USDA, ²⁰¹⁵). Based on a 2000 calorie diet, this equates to not more than 200 calories per day (50 grams or 12.5 teaspoons of sugar). The findings suggest that one 16‐ounce boba beverage with just milk tea and boba easily exceeds the upper limits of these most recent DGAC recommendations. As seen in Table2, this is a “basic” boba beverage; other added ingredients that accompany this beverage, such as jelly and egg pudding, can result in total calories well above 16% of total energy intakes; a larger size boba beverage with all the ingredients exceeds 500 calories, and contributes to 25% of total daily calories. As evident from Table3, most of the different categories of SSB, including boba drinks, exceed these guidelines, and thus increase individuals' risk of obesity.

In the last several decades, obesity rates (defined as a body mass index (BMI) range between 25–29.9kg/m², whereas obesity is having a BMI of 30kg/m² or higher) have reached epidemic proportions, with two of every three adults and one of three children being either overweight or obese (Flegal etal. ²⁰¹²). Childhood obesity (defined as above the 95^th percentile based on CDC age‐ and gender‐specific growth charts) has more than doubled in children and quadrupled in adolescents. The percentage of children aged 6–11years in the United States who were obese more than doubled, from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19years who were obese quadrupled, from 5% to nearly 21% over the same period. (CDC, ^2015a) More than one third of children and adolescents were overweight or obese in 2012 (CDC, ^2015c). Obesity results in a host of comorbidities such as diabetes, cardiovascular disease, and certain kinds of cancers (CDC, ^2015b). Children who are obese during adolescence are more likely to struggle with obesity and other chronic diseases during their adult years, ultimately resulting in a shortened life span. Treating obesity‐related health conditions has been estimated to cost $190 billion a year for the nation (Cawley and Meyerhoefer ²⁰¹²).

Among adolescents, increasing attention has been focused on addressing the consumption of SSB as a risk factor for obesity. It is well documented in the health literature that SSB contributes a significant amount of sugar, total calories, and has been suggested to result in higher rates of obesity, cardiovascular disease, diabetes, and gout (Swinburn etal. ²⁰⁰⁴; James and Kerr ²⁰⁰⁵; Hu and Malik ²⁰¹⁰; Harvard, ²⁰¹²). The most common types of SSB in the current US food supply are sodas, juices, and energy drinks. This study establishes boba beverages as yet another type of SSB, and these results have important public health implications with regards to the obesity epidemic. Sugar‐sweetened beverages do not displace calories from food; instead, they provide “add‐on” calories and thus increase total caloric intake, resulting in weight gain over time, and thus higher obesity risk. The high dietary glycemic load from SSBs due to fructose, in the form of HFCS or sucrose, can increase the risk for hepatic insulin resistance, visceral fat deposition, and elevated triglyercerides and cholesterol (Bray and Popkin ²⁰¹⁴). Furthermore, recent research suggests that drinking about 1 L or the equivalent of two 16 ounce SSBs per day for 6months can induce features of metabolic syndrome and fatty liver (Bray and Popkin ²⁰¹⁴).

Given that boba drinks have similar calories and sugar content as other SSBs, this is a significant public health concern, particularly among Asian youth who may be consuming these boa tea beverages daily, in addition to other SSBs such as sodas and energy drinks. Although there are no available published data on boba consumption among youth in California, it is estimated that about half of children, teens, and adults drink at least one serving of SSB daily (Keihner etal. ²⁰¹²). Overconsumption of these SSBs and boba tea can likely contribute to higher rates of overweight among Asian youth, further contributing to the current obesity epidemic.

The sugar and total caloric content of boba drinks is particularly concerning with regards to obesity rates in Asian youth as research suggests that “Asian countries have a low prevalence of obesity, yet high rates of obesity‐related diseases.”(Choo ²⁰⁰²) A study conducted by Chiu and colleagues found that South Asians and Chinese develop diabetes at lower ranges of BMI than their white counterparts (Chiu etal. ²⁰¹¹). Other studies suggest that Asian populations' BMI cutoff point to be lower than the international BMI cutoff point that was recommended by World Health Organization (WHO) (Low etal. ²⁰⁰⁹). Asians have different body build and muscularity than the white population, leading Asians to have a lower BMI (by about 2–3kg/m²) (Deurenberg etal. ²⁰⁰²). Therefore, WHO proposed lowering BMI cutoff point to 23–27.5kg/m² as overweight and ≥27.5kg/m² as obese (Shiwaku etal. ²⁰⁰⁴). Jih and colleagues investigated the prevalence of overweight and obesity of AAPI in California using the lower BMI and found there was an increase number of AAPI overweight and obese that met the new WHO Asian BMI criteria (Jih etal. ²⁰¹⁴). As the Asian BMI criteria are not currently used in national‐ and state‐wide health surveys, it is likely that the Asian obesity rates are underreported, and thus at greater risk for obesity‐related chronic diseases.

Therefore, prudent public health recommendations suggest moderate consumption of these beverages. Additionally, healthier alternatives are advised when ordering boba drinks, such as choosing boba tea without the milk, requesting lower sugar options (half sugar or one‐third sugar are available), or leaving out additional ingredients such as pudding, jelly, and tapioca. These alternatives can reduce the overall caloric value of the boba tea beverages, thus fitting better within the Dietary Guidelines for added sugars.

There are several limitations to this study. First, boba beverages were purchased from one retail boba store, and thus our analysis cannot be generalized to all boba beverages. As each boba store uses different ingredients and different methods for making boba drinks, this adds to the challenge of being able to generalize these findings to all boba drinks. Additionally, the scope of our study was limited to analysis of boba milk tea with a few additional ingredients. We did not analyze other types of hand‐shaken boba beverages, such as tea‐only drinks, smoothies with boba, or juice boba drinks. Also, while these boba beverages contain tea, which have potentially beneficial antioxidants, we did not analyze the composition of tea in boba drinks, and therefore cannot draw any conclusions regarding the potential antioxidant benefits of boba beverages. Finally, our analysis was limited to determining total calories and carbohydrate composition in the boba milk tea beverages. Future studies should examine the composition of protein, fat, and antioxidants in boba beverages. Despite the limitations of this study, this is the first work to document the calorific value and sugar composition of boba beverages. These findings advance the nutrition literature and are an important first step in understanding how this beverage fits in the landscape of sugar‐sweetened beverages in the United States

Conclusion

This study is the first of its kind to document experimentally derived caloric value and sugar composition in boba milk tea. Our findings suggest that boba drinks fit the US Dietary Guidelines definition as a sugar‐sweetened beverage. Additional, one 16‐ounce boba drink exceeds the upper limit of added sugar intake recommended by the 2015 US DGAC. Given this important knowledge about the caloric value and sugar source of boba milk tea drinks, nutrition education targeting Asian populations should give special attention to boba tea as a SSB. Given that this popular beverage will only become more popular, recommendations from public health practitioners working in Asian communities should suggest moderate consumption of boba drinks, choosing options for less sugar, and not adding other ingredients such as pudding or jelly. As this work is the first to document the nutritional value of boba beverages, research on health risks associated with drinking boba beverages warrants further study. As our study was unable to determine how often boba tea can be consumed without increasing risk of obesity, this is also an important area for future research. With the growing popularity of boba beverages in the United States and around the world, the finding from this study is an important step toward understanding how boba beverages compare to other SSBs.

Conflict of Interest

None declared.

References