Walking down a busy street on a warm, sunny afternoon
after a tiring day, you’re craving something refreshing.
Suddenly, you see it: a colorful bubble tea shop, beckoning you in.
You order your favorite flavor, excitedly watching as
the server fills the cup with chewy tapioca pearls,
quick swirl of flavour, ice, and sweet, milky tea.
You take that first satisfying sip, completely unaware
of the dangers lurking within each delicious gulp.
But did you know that beneath this innocent looking
cup of bubble tea, the wildly popular drink that
has taken the world by storm, lies a silent killer?
Whether it's the sweet deception of sugar content, the unsuspecting
chewy choking hazards, or another hidden danger lying in wait...
Maybe bubble tea isn't as refreshing as we thought.
May 2020.
An 18-year-old teenager in China developed
an insatiable craving for bubble tea.
The weather was getting hot in Shanghai, and for an entire month,
she unknowingly set herself on a dangerous path downing the icy
drinks, sometimes even drinking two of the sweet beverages a day.
The girl felt increasingly more thirsty over the days, and
continued to drink more bubble tea as well as some soft drinks
to quench this newfound thirst, but something was feeling off.
She was getting nauseous and uncomfortable, having to make
bathroom trips more often, until one day she collapsed in her home.
The teenager’s unconscious body was found by her worried
family, and rushed to Shanghai's Ruijin Hospital.
When medical staff measured her blood sugar, they found it
dangerously high, having skyrocketed to 25 times the normal
level due to the massive sugar intake from her bubble tea habit.
The teenager, dubbed “Bubble Tea Girl” by the internet, had
slipped into a coma from hyperglycemia— high blood sugar levels.
But was this just a freak accident, or is this
a more common situation than we might think?
The summer prior to Bubble Tea Girl’s hospitalization, a 16-year
old boy in Hangzhou was going through a similar predicament.
Xiao Ying was hurried into the ER with a high fever,
and his blood sugar levels measuring 124 millimoles
per liter— about 20 times higher than average.
The teenager had a daily habit of drinking bubble tea, and had
suddenly started to feel extremely thirsty, even though he was drinking
excessive amounts of water, feeling restless, and quite nauseous.
By the time he lost consciousness, the situation was dire.
In the hospital, his worried parents revealed that the
teen drank milk tea and soda daily, and, since he ate
copious amounts of snacks like fried food and barbecue, but
still felt hungry, they had just assumed he was growing.
Both teenagers were diagnosed with a condition called diabetic
ketoacidosis, or DKA for short; a serious condition when there’s not
enough insulin being produced in your body to help lower the extreme
amounts of sugar in the blood, in order to process it to energy.
Without enough insulin, the body starts
breaking down fats as an emergency fuel source.
The liver processes the fat into ketones, which normally only ever
happens when your body hasn’t had a meal for an extended period of time.
However, with DKA, fat is broken down
too rapidly for the body to process.
The ketones build up to dangerous levels in your bloodstream,
causing your blood to become more acidic and if untreated,
can lead to dehydration, a coma, and in severe cases, death.
Xiao Ying’s doctors pointed out that DKA was very
difficult to manage, transferring the teenager to the ICU.
However, the teenagers weren’t the only ones who got
their lives in jeopardy from drinking bubble tea.
Another bizarre case from 2019 in Zhejiang involves
a 14-year-old girl, dubbed “Xiao Shen”, experiencing
agonizing abdominal pain, severe bloating, and constipation.
When she finally dragged herself to the hospital after being
unable to eat or have a bowel movement for several days,
her painful ordeal alerted doctors to investigate the cause.
Dr Zhang Louwei, the primary physician on Xiao Shen’s case, was
shocked when he ordered an abdominal CT scan, and ended up discovering
small, circular objects filling the girl’s entire digestive system.
There were over 100 of the granular,
high-density shadows visible on the scan.
Incredulous, he questioned the girl about whether
she had somehow eaten anything indigestible recently.
Xiao Shen stammered that she had one glass of bubble
tea 5 days ago— it seemed that the shadows were tapioca
pearls lodged inside her gastrointestinal tract!
When Xiao Shen’s CT scan went viral, many health
professionals were skeptical about the case.
In an interview with Live Science, Dr Lina Felipez, pediatric
gastroenterologist, said that the ingredients in bubble tea like
tapioca, and common additives like guar gum, are “radiopaque”,
which means they wouldn’t show up on CT scans or X-rays.
And that a possible explanation might be an uncommon
additive in the bubble tea’s tapioca pearls that
could’ve helped them show up as shadows on the CT scan.
On the other hand, Dr Zhang suspected Xiao Shen hadn’t exactly been
honest about the amount of bubble tea she drank, in order to hide the
truth from her parents who were right there in his office with her.
He noted that she might have accumulated the amount of bubble tea
pearls over a period of time, that it was probably not only one cup.
For Xiao Shen’s treatment, he ended up prescribing
laxatives to expel the undigested pearls.
Huh.
So are tapioca pearls really hard to digest?
They’re not supposed to be.
Tapioca is essentially a starch extracted from cassava root,
with negligible amounts of protein and other nutrients.
According to a 2009 comparative analysis studying
different crops, cassava is actually one of the most
easily digestible root vegetable-derived starches.
However, Xiao Shen wasn’t the only person who had difficulty
digesting bubble tea— in January 2020, a 13-year old boy in
China’s Henan province underwent emergency surgery to remove two
large lumps of undigested tapioca pearls from his intestines.
He had consumed just two cups of bubble tea, so
not exactly what you’d consider a copious amount.
And a CT scan for a separate case in Tainan,
Taiwan might have solved the CT scan mystery.
September 2017, an 18-year old girl got into a traffic accident.
Doctors in the emergency department of National Cheng Kung
University Hospital requested a non-contrasted CT scan
of the patient’s abdomen to confirm a liver laceration,
but accidentally stumbled across something else.
They had found bubble tea pearls clearly visible in the girl’s
stomach, and her duodenum—the first section of the small intestine.
They found out that the patient had drank a cup of bubble tea three
hours prior to the accident, and reported their findings in the
Journal of Acute Medicine due to the unusual circumstances, concluding
that boba pearls should be considered as a possible explanation
for the pearl-like lesions being visible in these types of scans.
Fortunately for Xiao Shen, the laxatives did work.
She was able to pass the pearls, ending her painful ordeal, instead
of having to undergo emergency surgery to remove the blockage as well.
After five days in a coma, hooked up on a ventilator
and dialysis machine, "Bubble Tea Girl" finally woke up.
She vowed to never drink bubble tea again,
losing 35 kilograms in under a month.
Thankfully Xiao Ying also recovered, promising to change
his lifestyle and dietary habits, and start exercising.
So, how do we actually know when how much is too much?
A typical 16 ounce cup of bubble tea contains 38 grams of
sugar— which exceeds the upper limit of added sugar intake
recommended by the US Dietary Guidelines Advisory Committee.
So, if you’re planning to have a cup of boba, you might want
to budget for it by lowering your sugar intake for other
things you plan to eat, and also ask for a lower amount
of sugar, which is an option in most bubble tea stores.
If you find that the chewy pearls cause some
indigestion, consider forgoing them or choosing another
topping in your drink, like pudding or grass jelly.
But, what happens if you’re trying bubble tea for the first time?
On April 29th, John Michael Race, a Texas-based TikToker was filming
himself in his car trying boba tea for the first time after he
found milk tea delicious and had to go back to the store for more.
John was referring to it as "bawbuh" and, with a confused chuckle,
shook the tapioca pearls, believing they were meant to dissolve.
Milk tea is so good, she said I had to try the bawbuhs in it this
time, so add the little, she said to shake it and I think they’re
supposed to dissolve, but I’m obsessed, you just poke a hole in it.
Oh my God I ch—ed on something!
My car!
Oh my God.
John's Tiktok video with the caption "you're supposed to chew
apparently" exploded overnight, now sitting at 19 million views.
While TikTokers were enthralled by the absurdity of the situation, and
his genuine surprise at choking on the drink, making memes and even
a musical remix on Twitter, was John's simple mistake so unexpected?
In 2019, a 19-year old college student in China was out
with her brother to visit their friends and hang out.
The siblings decided to stop by to get bubble tea— an obvious
choice to get an icy drink on the sweltering last day of June.
The duo headed to their friend’s house, talking and
laughing, when suddenly, three of the tapioca pearls
went down the wrong pipe, blocking the girl’s trachea.
Choking, the girl collapsed in front of her friend’s house,
leaving her stunned brother and friend to call for medical help.
On the way to the hospital, her hands were already turning
black from a lack of oxygen, and she fell into a coma.
Medical professionals tried resuscitating the girl as
soon as she arrived at the hospital, but it was too late.
But could a bubble tea sip truly pose a choking risk?
The Federal Institute for Risk Management in Germany wrote
a report about this in 2012, cautioning parents about the
aspiration accident risk, and how children, especially under
the age of four, could get the bubbles sucked into their lungs.
They advised that if they absolutely had to taste
it, a good solution would be to skip the straw.
So what about adults, like John?
John embraced his unexpected internet fame gracefully.
A couple days after his first TikTok, he ended up
filming a sequel—his second encounter with boba tea.
This time, there was no mess.
He smiles at the camera and offers a simple but critical advice to
his audience, a lesson he learned the hard way: "chew and swallow."
Chew and swallow.
The next time you're tempted to indulge in bubble
tea, remember—as always, moderation is key.
Being more mindful about what you consume, and how it
affects your body would help understand what works for you.
Otherwise you might find a bitter dose of reali-tea…
Wouldn’t that really suck?
If you’d like to find out how one woman invented boba tea by
complete accident, and how it became a worldwide sensation
despite its deadly history, click the video on your screen!