How Coca-Cola Shaped the International Congress on Physical Activity and Public Health: An Analysis of Email Exchanges between 2012 and 2014
2. Materials and Methods
3.1. Shaping the Evidence Base and Framing the Debate on Diet- and Public-Health-Related Issues
“We [Coke] have no involvement in the deliberations about the agenda, topic areas and speakers […] When we host scientific symposia in conjunction with an event like ICPAPH, our role is to invite the experts and reimburse them for their travel and expenses only. We do not have a role in their choice of topics or the information they choose to present” (Email 2).
“Do you think another major source of bias in these studies [epidemiological studies of body weight and mortality] is that most of them completely ignore physical activity, or if they mention it, use very flawed and inaccurate PA [physical activity] data? Why not a session addressing this specific point(s)” (Email 3).
“Obviously the key to all of this [referring to topic ideas for the 2014 ICPAPH] continues to be individual behaviour and motivation—Ideas?” (Email 3).
“Lastly—based on the brilliance of the IOC Consensus Statement—any thoughts/ideas catalysing around the 5 strategies that we can do a deeper dive on—focusing on PA [physical activity] and NCD prevention” (Email 3).
3.2. Promotion of Coke-Sponsored Research Networks and Health Initiatives
“Also thinking of a pre-conf [pre-conference workshop] on Ex [Exercise] is Medicine (or during the ICPAPH) if there’s the necessary time… With the global mix—it’s a great opportunity to drive awareness and hopefully support for more EIM in more countries. Currently up to 40 [countries]–only 167 to go” (Email 3).
3.3. Establish and Foster Relationships with Key Public Health Researchers and Leaders
“Hi Peter (cc Rhona). Rhona [Applebaum] and I just had a phone call and decided to have a session on ISCOLE in ICPAPH as part of our sponsorship agreement. The session will last for 90 min and I do suggest you two think about 4–5 speakers (10 min each) for the session” (Email 4).
“We will help with the travel… so full speed ahead” (Email 4).
3.4. Opposition Fragmentation and Destabilisation through Criticising Public Health Advocates
“First—yes, we helped to sponsor the 5th Congress [the 2014 ICPAPH]. We have been a major sponsor since this Congress started 10 years ago… Second—We knew it was only a matter of time before a miscreant would write a comment re [regarding] our sponsorship… And yes, we will continue to sponsor key health and PA [physical activity] congresses in the future. [We] have a few lined up already—including the European Congress on Sports Science the first week in July  in Amsterdam. We won’t let the bastards keep us down and the minority of agenda drivers must never win out over the majority of evidence-based researchers” (Email 5).
“The sponsorship [of Coke] was not only financial; Coca-Cola was everywhere—at side meetings, in the sponsors’ hall, giving away its products and propaganda. At a time when sweetened soft drinks are recognised by independent organisations as a major cause of the present uncontrolled obesity pandemic, which notably affects children and developing countries, such as China, India, and Brazil, this is worrying” .
“Companies whose profits depend, at least in part, on manufacturing or production, distribution, advertising or promotion, marketing, sponsorship, retailing or representing products and practices that when used as intended can be problematic or harmful to public health are explicitly excluded as sponsors for PHAA activities” .
Conflicts of Interest
- Moodie, R.; Stuckler, D.; Monteiro, C.; Sheron, N.; Neal, B.; Thamarangsi, T.; Lincoln, P.; Casswell, S. Profits and pandemics: Prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 2013, 381, 670–679. [Google Scholar] [CrossRef]
- United Nations Human Rights Council. Report of the Special Rapporteur on the Right of Everyone to Enjoyment of the Highest Attainable Standard of the Physical and Mental Health; 26th Session, Agenda Item 3; Grover, A., Ed.; United Nations: New York, NY, USA, 2014. [Google Scholar]
- Chan, M. WHO director-general addresses health promotion conference. In Proceedings of the 8th Global Conference of Health Promotion, Helsinki, Finland, 10–14 June 2013; Available online: https://www.who.int/dg/speeches/2013/health_promotion_20130610/en/ (accessed on 16 May 2019).
- Mialon, M.; Swinburn, B.; Sacks, G. A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information. Obes. Rev. 2015, 16, 519–530. [Google Scholar] [CrossRef]
- Brownell, K.; Warner, K. The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died: How Similar is Big Food? Millbank Q. 2009, 87, 259–294. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Savell, E.; Gilmore, A.B.; Fooks, G. How does the tobacco industry attempt to influence marketing regulations? A systematic review. PLoS ONE 2014, 9, e87389. [Google Scholar] [CrossRef] [PubMed]
- French, S.; Morris, P. Assessing the evidence for sugar-sweetened beverages in the aetiology of obesity, a question of control. Int. J. Obes. 2006, 30, S37–S39. [Google Scholar] [CrossRef][Green Version]
- Malik, V.S.; Popkin, B.M.; Bray, G.A.; Despres, J.P.; Hu, F.B. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010, 121, 1356–1364. [Google Scholar] [CrossRef] [PubMed]
- Popkin, B.M.; Hawkes, C. Sweetening of the global diet, particularly beverages: Patterns, trends, and policy responses. Lancet Diabetes Endocrinol. 2016, 4, 174–186. [Google Scholar] [CrossRef][Green Version]
- Taylor, A.L.; Jacobson, M.F. Carbonating the World: The Marketing and Health Impact of Sugar Drinks in Low- and Middle-income Countries; Center for Science in the Public Interest: Washington, DC, USA, 2016; p. 82. [Google Scholar]
- Hu, F.B.; Malik, V.S. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence. Physiol. Behav. 2010, 100, 47–54. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Sonestedt, E.; Overby, N.C.; Laaksonen, D.E.; Birgisdottir, B.E. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease? Food Nutr. Res. 2012, 56. [Google Scholar] [CrossRef][Green Version]
- Yang, Q.; Zhang, Z.; Gregg, E.W.; Flanders, W.D.; Merritt, R.; Hu, F.B. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Int. Med. 2014, 174, 516–524. [Google Scholar] [CrossRef][Green Version]
- Basu, S.; Yoffe, P.; Hills, N.; Lustig, R.H. The relationship of sugar to population-level diabetes prevalence: An econometric analysis of repeated cross-sectional data. PLoS ONE 2013, 8, e57873. [Google Scholar] [CrossRef][Green Version]
- Brand Finance. Always Coca-Cola: World’s Favourite Soda Tops Brand Ranking. Available online: https://brandfinance.com/news/always-coca-cola-worlds-favourite-soda-tops-brand-ranking/ (accessed on 12 May 2020).
- Fabbri, A.; Holland, T.J.; Bero, L.A. Food industry sponsorship of academic research: Investigating commercial bias in the research agenda. Public Health Nutr. 2018, 21, 3422–3430. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Barlow, P.; Serodio, P.; Ruskin, G.; McKee, M.; Stuckler, D. Science organisations and Coca-Cola’s ‘war’ with the public health community: Insights from an internal industry document. J. Epidemiol. Community Health 2018, 72, 761–763. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Galea, G.; McKee, M. Public-private partnerships with large corporations: Setting the ground rules for better health. Health Policy 2014, 115, 138–140. [Google Scholar] [CrossRef] [PubMed]
- Serodio, P.M.; McKee, M.; Stuckler, D. Coca-Cola—A model of transparency in research partnerships? A network analysis of Coca-Cola’s research funding (2008–2016). Public Health Nutr. 2018, 21, 1594–1607. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Steele, S.; Ruskin, G.; Sarcevic, L.; McKee, M.; Stuckler, D. Are industry-funded charities promoting “advocacy-led studies” or “evidence-based science”? A case study of the International Life Sciences Institute. Glob. Health 2019, 15, 36. [Google Scholar] [CrossRef]
- Stuckler, D.; Ruskin, G.; McKee, M. Complexity and conflicts of interest statements: A case-study of emails exchanged between Coca-Cola and the principal investigators of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). J. Public Health Policy 2018, 39, 49–56. [Google Scholar] [CrossRef][Green Version]
- Thacker, P. Coca-Cola’s secret influence on medical and science journalists. BMJ 2017, 357. [Google Scholar] [CrossRef][Green Version]
- Nestle, M. Unsavory Truth: How Food Companies Skew the Science of What We Eat; Basic Books: New York, NY, USA, 2018. [Google Scholar]
- Nestle, M. Food Politics: How the Food Industry Influences Nutrition and Health; University of California Press: Berkeley, CA, USA, 2007. [Google Scholar]
- Nestle, M. Soda Politics: Taking on Big Soda (and Winning); Oxford University Press: Oxford, UK, 2015; pp. 229–276. [Google Scholar]
- Nestle, M. Food Industry Funding of Nutrition Research: The Relevance of History for Current Debates. JAMA Intern. Med. 2016, 176, 1685–1686. [Google Scholar] [CrossRef]
- Sifferlin, A. Soda and Snack Food Companies Welcomed at Nutrition Conference. Available online: https://time.com/4531268/junk-food-nutrition-diet/ (accessed on 19 June 2020).
- Eat Drink Politics. And Now a Word from Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food; Eat Drink Politics: Los Angeles, CA, USA, 2013. [Google Scholar]
- McKee, M.; Stuckler, D. Revisiting the Corporate and Commercial Determinants of Health. Am. J. Public Health 2018, 108, 1167–1170. [Google Scholar] [CrossRef]
- Katzmarzyk, P. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): Design and methods. BMC Public Health 2013, 13, 900. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Exercise is Medicine. Exercise is Medicine: A Global Health Initiative; Exercise is Medicine: Indianapolis, IN, USA, 2015; Available online: https://exerciseismedicine.org/ (accessed on 19 June 2020).
- Hessari, N.M.; Ruskin, G.; McKee, M.; Stuckler, D. Public meets Private: Conversations Between Coca-Cola and the CDC. Millbank Q. 2019, 97, 74–90. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Wayback Machine. Available online: https://web.archive.org/ (accessed on 19 June 2020).
- Russell, E. Exercise is medicine. Can. Med. Assoc. J. 2013, 185, E526. [Google Scholar] [CrossRef] [PubMed][Green Version]
- The Lancet. Physical Activity 2012. Available online: https://www.thelancet.com/series/physical-activity (accessed on 27 May 2020).
- De Sá, T.H. Can Coca Cola promote physical activity? Lancet 2014, 383. [Google Scholar] [CrossRef]
- Nestle, M. Food company sponsorship of nutrition research and professional activities: A conflict of interest? Public Health Nutr. 2001, 4, 1015–1022. [Google Scholar] [CrossRef][Green Version]
- Sacks, G.; Swinburn, B.A.; Cameron, A.J.; Ruskin, G. How food companies influence evidence and opinion—Straight from the horse’s mouth. Crit. Public Health 2017, 28, 253–256. [Google Scholar] [CrossRef]
- Lukes, S. Power: A Radical View; MacMillan: London, UK, 1974. [Google Scholar]
- Lukes, S. Power: A Radical View: The Original Text with Two Major New Chapters; Palgrave Macmillan: London, UK, 2005. [Google Scholar]
- Nye, J. Soft Power: The Means to Success in World Politics; Public Affairs: New York, NY, USA, 2004. [Google Scholar]
- Fuchs, D. Commanding heights? The strength and fragility of business power in global politics. In Proceedings of the Millenium Annual Conference on Facets of Power in International Relations, London, UK, 30–31 October 2019; p. 39. [Google Scholar]
- Miller, D.; Harkins, C. Corporate strategy, corporate capture: Food and alcohol industry lobbying and public health. Crit. Soc. Policy 2010, 30, 564–589. [Google Scholar] [CrossRef][Green Version]
- Zierath, J.R. Building Bridges through Scientific Conferences. Cell 2016, 167, 1155–1158. [Google Scholar] [CrossRef][Green Version]
- Clapp, J.; Fuchs, D.A. Corporate Power in Global Agrifood Governance; MIT Press: Cambridge, MA, USA, 2009; pp. 1–26. [Google Scholar]
- Mikler, J. Theorizing global corporations’ power. In The Political Power of Global Corporations; Polity Press: Cambridge, UK, 2018. [Google Scholar]
- Fuchs, D.; Di Giulio, A.; Glaab, K.; Lorek, S.; Maniates, M.; Princen, T.; Røpke, I. Power: The missing element in sustainable consumption and absolute reductions research and action. J. Clean. Prod. 2016, 132, 298–307. [Google Scholar] [CrossRef]
- Fuchs, D.; Glaab, K. Material Power or Normative Conflict: Determinants of the Interaction Between Global and Local Agrifood Governance; Münster, U., Ed.; GESIS—Leibniz Institute for the Social Sciences: Mannheim, Germany, 2010. [Google Scholar]
- WHO Framework Convention on Tobacco Control. Guidelines for Implementation of Article 13 of the WHO Framework Convention on Tobacco Control (Tobacco Advertising, Promotion and Sponsorship). Available online: https://www.who.int/fctc/guidelines/article_13.pdf (accessed on 27 May 2020).
- Public Health Association Australia. PHAA Sponsorship Protocol 2011; PHAA: Perth, Australia, 2011. [Google Scholar]
- Moorhead, G. Taste the Feeling of a Coke Shame Campaign. Available online: https://www.crikey.com.au/2016/03/14/taste-the-feeling-of-a-coke-shame-campaign/ (accessed on 28 May 2020).
- Wayback Machine. Capture: Coca-Cola Journey Our Commitment to Transparency. Available online: http://web.archive.org/web/20160203212716/http://transparency.coca-colacompany.com/transparency-search?noCache=true (accessed on 28 May 2020).
- American Society for Nutrition. Sustaining Partners. Available online: https://nutrition.org/our-members/sustaining-partners/ (accessed on 15 October 2020).
- American Society for Nutrition. Sponsors and Advertisers: Thank You to Our Sponsors of ASN’s Scientific Sessions at EB 2017. Available online: https://meeting.nutrition.org/2017/sponsors-advertisers/ (accessed on 15 October 2020).
- Hydration for Health. Breaking professional boundaries. In Proceedings of the 12th European Federation of the Association of Dietitians Conference, Berlin, Germany, 1–2 November 2019. Available online: https://www.hydrationforhealth.com/fr/conference-fr/other-congress-news-fr-1/list-other-congress-news/efad-2019-fr/#:~:text=On%20November%201st%20and,clinical%20practice%20and%20public%20health (accessed on 15 October 2020).
|Information and messaging||Frame the debate on diet- and public-health-related issues||Shift the blame away from the food industry, e.g., focus on individual responsibility, physical inactivity|
|Shape the evidence base on diet- and health-related issues||Fund research, including through academics, own research institutions and front groups|
Pay scientists as advisers, consultants or spokespersons
Participate in and host scientific events
Provide industry-sponsored education materials
Suppress or influence the dissemination of research
Emphasise disagreement among scientists and focus on doubt in science
Criticise evidence and emphasise its complexity
|Constituency building||Establish relationships with key opinion leaders and health organisations||Promote public–private interactions, including philanthropic, transactional and transformational relationships|
Support professional organisations through funding and/or advertising in their publications
Establish informal relationships with key opinion leaders
|Opposition fragmentation and destabilisation||Criticise public health advocates||Criticise public health advocates personally and publicly|
|Infiltrate, monitor and distract public health advocates, groups and organisations||Support the placement of industry-friendly personnel within health organisations|
|Start Date||Email Sender(s)||Relevant Email Circle Members||Topic|
|1||9 Feb 2012||Rhona Appelbaum, Peter Katzmarzyk (reply)||Rhona Appelbaum, Peter Katzmarzyk, Steven Blair, Kenneth Fox||Abstract submissions for ICPAPH 2012|
|2||8 Nov 2012||Rhona Appelbaum||Rhona Appelbaum, James Hill, John Peters||Coke’s PR messaging for ICPAPH 2012|
|3||20 Oct 2013||Rhona Appelbaum, Peter Katzmarzyk (reply)||Rhona Appelbaum, Peter Katzmarzyk, Timothy Church, Steven Blair||Research and session ideas for ICPAPH 2014|
|4||3 Nov 2013||Pedro Hallal, Rhona Appelbaum (reply), Peter Katzmarzyk (reply)||Pedro Hallal, Rhona Appelbaum, Peter Katzmarzyk||Planning of an ISCOLE session for ICPAPH 2014|
|5||13 June 2014||Rhona Appelbaum||Rhona Appelbaum, Peter Katzmarzyk, Timothy Church||Response to Dr. Hérick de Sá’s paper in the Lancet re: Coke’s sponsorship of ICPAPH 2014|
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Wood, B.; Ruskin, G.; Sacks, G. How Coca-Cola Shaped the International Congress on Physical Activity and Public Health: An Analysis of Email Exchanges between 2012 and 2014. Int. J. Environ. Res. Public Health 2020, 17, 8996. https://doi.org/10.3390/ijerph17238996
Wood B, Ruskin G, Sacks G. How Coca-Cola Shaped the International Congress on Physical Activity and Public Health: An Analysis of Email Exchanges between 2012 and 2014. International Journal of Environmental Research and Public Health. 2020; 17(23):8996. https://doi.org/10.3390/ijerph17238996Chicago/Turabian Style
Wood, Benjamin, Gary Ruskin, and Gary Sacks. 2020. "How Coca-Cola Shaped the International Congress on Physical Activity and Public Health: An Analysis of Email Exchanges between 2012 and 2014" International Journal of Environmental Research and Public Health 17, no. 23: 8996. https://doi.org/10.3390/ijerph17238996