By Anahad O'Conner, The New York Times, August 9, 2015
Coca-Cola, the world’s largest producer of sugary beverages, is backing a new “science-based” solution to the obesity crisis: To maintain a healthy weight, get more exercise and worry less about cutting calories.
The beverage giant has teamed up with influential scientists who are advancing this message in medical journals, at conferences and through social media. To help the scientists get the word out, Coke has provided financial and logistical support to a new nonprofit organization called the Global Energy Balance Network, which promotes the argument that weight-conscious Americans are overly fixated on how much they eat and drink while not paying enough attention to exercise.
“Most of the focus in the popular media and in the scientific press is, ‘Oh they’re eating too much, eating too much, eating too much’ — blaming fast food, blaming sugary drinks and so on,” the group’s vice president, Steven N. Blair, an exercise scientist, says in a recent video announcing the new organization. “And there’s really virtually no compelling evidence that that, in fact, is the cause.”
Health experts say this message is misleading and part of an effort by Coke to deflect criticism about the role sugary drinks have played in the spread of obesity and Type 2 diabetes. They contend that the company is using the new group to convince the public that physical activity can offset a bad diet despite evidence that exercise has only minimal impact on weight compared with what people consume.
This clash over the science of obesity comes in a period of rising efforts to tax sugary drinks, remove them from schools and stop companies from marketing them to children. In the last two decades, consumption of full-calorie sodas by the average American has dropped by 25 percent.
“Coca-Cola’s sales are slipping, and there’s this huge political and public backlash against soda, with every major city trying to do something to curb consumption,” said Michele Simon, a public health lawyer. “This is a direct response to the ways that the company is losing. They’re desperate to stop the bleeding.”
Coke has made a substantial investment in the new nonprofit. In response to requests based on state open-records laws, two universities that employ leaders of the Global Energy Balance Network disclosed that Coke had donated $1.5 million last year to start the organization.
Since 2008, the company has also provided close to $4 million in funding for various projects to two of the organization’s founding members: Dr. Blair, a professor at the University of South Carolina whose research over the past 25 years has formed much of the basis of federal guidelines on physical activity, and Gregory A. Hand, dean of the West Virginia University School of Public Health.
Records show that the network’s website, gebn.org, is registered to Coca-Cola headquarters in Atlanta, and the company is also listed as the site’s administrator. The group’s president, James O. Hill, a professor at the University of Colorado School of Medicine, said Coke had registered the website because the network’s members did not know how.
“They’re not running the show,” he said. “We’re running the show.”
Coca-Cola’s public relations department repeatedly declined requests for an interview with its chief scientific officer, Rhona Applebaum, who has called attention to the new group on Twitter. In a statement, the company said it had a long history of supporting scientific research related to its beverages and topics such as energy balance.
“We partner with some of the foremost experts in the fields of nutrition and physical activity,” the statement said. “It’s important to us that the researchers we work with share their own views and scientific findings, regardless of the outcome, and are transparent and open about our funding.”
Dr. Blair and other scientists affiliated with the group said that Coke had no control over its work or message and that they saw no problem with the company’s support because they had been transparent about it.
But as of last week, the group’s Twitter and Facebook pages, which promote physical activity as a solution to chronic disease and obesity while remaining largely silent on the role of food and nutrition, made no mention of Coca-Cola’s financial support. So far, the social media campaign has failed to gain much traction: As of Friday, the group had fewer than 1,000 followers on Twitter.
The group’s website also omitted mention of Coke’s backing until Dr. Yoni Freedhoff, an obesity expert at the University of Ottawa, wrote to the organization to inquire about its funding. Dr. Blair said this was an oversight that had been quickly corrected.
“As soon as we discovered that we didn’t have not only Coca-Cola but other funding sources on the website, we put it on there,” Dr. Blair said. “Does that make us totally corrupt in everything we do?”
Coke’s involvement in the new organization is not the only example of corporate-funded research and advocacy to come under fire lately. The American Society for Nutrition and the Academy of Nutrition and Dietetics have been criticized by public health advocates for forming partnerships with companies such as Kraft Foods, McDonald’s, PepsiCo and Hershey’s. Dietitians have also faced criticism for taking payments from Coke to present the company’s soda as a healthy snack.
Critics say Coke has long cast the obesity epidemic as primarily an exercise problem. “The message is that obesity is not about the foods or beverages you’re consuming, it’s that you’re not balancing those foods with exercise,” Dr. Freedhoff of the University of Ottawa said.
Now, public health advocates say, Coca-Cola is going a step further, recruiting reputable scientists to make the case for them.
Dr. Hill, the nonprofit’s president, is a co-founder of the National Weight Control Registry, a long-term study of people who have lost weight, and has served on committees for the World Health Organization and the National Institutes of Health. The American Society for Nutrition refers to him as “a leader in the fight against the global obesity epidemic.”
Barry M. Popkin, a professor of global nutrition at the University of North Carolina at Chapel Hill, said Coke’s support of prominent health researchers was reminiscent of tactics used by the tobacco industry, which enlisted experts to become “merchants of doubt” about the health hazards of smoking.
Marion Nestle, the author of the book “Soda Politics” and a professor of nutrition, food studies and public health at New York University, was especially blunt: “The Global Energy Balance Network is nothing but a front group for Coca-Cola. Coca-Cola’s agenda here is very clear: Get these researchers to confuse the science and deflect attention from dietary intake.”
Funding from the food industry is not uncommon in scientific research. But studies suggest that the funds tend to bias findings. A recent analysis of beverage studies, published in the journal PLOS Medicine, found that those funded by Coca-Cola, PepsiCo, the American Beverage Association and the sugar industry were five times more likely to find no link between sugary drinks and weight gain than studies whose authors reported no financial conflicts.
On its website, the new nonprofit promises to be “the voice of science” in discussions about healthy lifestyles and contends that the concept of energy balance provides “a new science-based framework” for achieving a stable body weight.
The group says there is “strong evidence” that the key to preventing weight gain is not reducing food intake — as many public health experts recommend — “but maintaining an active lifestyle and eating more calories.” To back up this contention, the group provides links to two research papers, each of which contains this footnote: “The publication of this article was supported by The Coca-Cola Company.”
In March, Dr. Hill, Dr. Blair, and Dr. Hand announced the creation of the organization in an editorial in the British Journal of Sports Medicine. They argued that the public and many scientists largely overlooked physical inactivity as a cause of obesity. They said they were creating the Global Energy Balance Network to raise awareness “about both sides of the energy balance equation.”
The editorial contained a disclosure that the group had received an “unrestricted education gift” from Coca-Cola.
In response to a request made under the state Freedom of Information Act, the University of South Carolina disclosed that Dr. Blair had received more than $3.5 million in funding from Coke for research projects since 2008.
The university also disclosed that Coca-Cola had provided significant funding to Dr. Hand, who left the University of South Carolina last year for West Virginia. The company gave him $806,500 for an “energy flux” study in 2011 and $507,000 last year to establish the Global Energy Balance Network.
It is unclear how much of the money, if any, ended up as personal income for the professors.
“As long as everybody is disclosing their potential conflicts and they’re being managed appropriately, that’s the best that you can do,” Dr. Hand said. “It makes perfect sense that companies would want the best science that they can get.”
The group’s president, Dr. Hill, also has financial ties to Coca-Cola. The company last year gave an “unrestricted monetary gift” of $1 million to the University of Colorado Foundation. In response to a request made under the Colorado Open Records Act, the university said that Coca-Cola had provided the money “for the purposes of funding” the Global Energy Balance Network.
Dr. Hill said he had sought money from Coke to start the nonprofit because there was no funding available from his university. The group’s website says it is also supported by a few universities and ShareWIK Media Group, a producer of videos about health. Dr. Hill said that he had also received a commitment of help from General Mills, as well as promises of support from other businesses, which had not formally confirmed their offers.
He said he believed public health authorities could more easily change the way people eat by working with the food industry instead of against it.
On its website, the group recommends combining greater exercise and food intake because, Dr. Hill said, “ ‘Eat less’ has never been a message that’s been effective. The message should be ‘Move more and eat smarter.’ ”
He emphasized that weight loss involved a combination of complex factors and that his group’s goal was not to play down the role of diet or to portray obesity as solely a problem of inadequate exercise.
“If we are out there saying it’s all about physical activity and it’s not about food, then we deserve criticism,” he said. “But I think we haven’t done that.”
But in news releases and on its website, the group has struck a different tone.
“The media tends to blame the obesity epidemic on our poor eating habits,” one recent news release states. “But are those french fries really the culprit? Dr. Steve Blair explains that you shouldn’t believe everything you see on TV.”
In the news release, Dr. Blair suggests that sedentary behavior is a bigger factor.
Most public health experts say that energy balance is an important concept, because weight gain for most people is about calories in vs. calories out. But the experts say research makes it clear that one side of the equation has a far greater effect.
While people can lose weight in several ways, many studies suggest that those who keep it off for good consume fewer calories. Growing evidence also suggests that maintaining weight loss is easier when people limit their intake of high glycemic foods such as sugary drinks and other refined carbohydrates, which sharply raise blood sugar.
Physical activity is important and certainly helps, experts say. But studies show that exercise increases appetite, causing people to consume more calories. Exercise also expends far fewer calories than most people think. A 12-ounce can of Coca-Cola, for example, contains 140 calories and roughly 10 teaspoons of sugar. “It takes three miles of walking to offset that one can of Coke,” Dr. Popkin said.
In one of the most rigorous studies of physical activity and weight loss, published in the journal Obesity, scientists recruited 200 overweight, sedentary adults and put them on an aggressive exercise program. To isolate the effects of exercise on their weight, the subjects were instructed not to make any changes in their diets.
Participants were monitored to ensure they exercised five to six hours a week, more than double the 2.5 weekly hours of exercise recommended in federal guidelines. After a year, the men had lost an average of just 3.5 pounds, the women 2.5. Almost everyone was still overweight or obese.
“Adding exercise to a diet program helps,” said Dr. Anne McTiernan, the lead author of the study and a researcher at the Fred Hutchinson Cancer Center in Seattle. “But for weight loss, you’re going to get much more impact with diet changes.”
But much like the research on sugary drinks, studies of physical activity funded by the beverage industry tend to reach conclusions that differ from the findings of studies by independent scientists.
Last week, the Pennington Biomedical Research Center in Louisiana announced the findings of a large new study on exercise in children that determined that lack of physical activity “is the biggest predictor of childhood obesity around the world.”
The news release contained a disclosure: “This research was funded by The Coca-Cola Company.”
Kelly D. Brownell, dean of the Sanford School of Public Policy at Duke, said that as a business, Coke “focused on pushing a lot of calories in, but then their philanthropy is focused on the calories out part, the exercise.”
In recent years, Coke has donated money to build fitness centers in more than 100 schools across the country. It sponsors a program called “Exercise is Medicine” to encourage doctors to prescribe physical activity to patients. And when Chicago’s City Council proposed a soda tax in 2012 to help address the city’s obesity problem, Coca-Cola donated $3 million to establish fitness programs in more than 60 of the city’s community centers.
The initiative to tax soda ultimately failed.
“Reversing the obesity trend won’t happen overnight,” Coca-Cola said in an ad for its Chicago exercise initiative. “But for thousands of families in Chicago, it starts now, with the next push-up, a single situp or a jumping jack.”
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