Posts Tagged ‘obesity’
PHAI’s Gottlieb and Wilking Co-author study in JAMA Pediatrics Showing that Fast Food Giants Confuse and Deceive Kids
Monday, March 31st, 2014
After much criticism and prodding, Fast food giants McDonald’s and Burger King agreed to depict healthier food options in advertising directed at children. Researchers at the Norris Cotton Cancer Center at Dartmouth-Hitchcock, along with the Public Health Advocacy Institute (PHAI) at Northeastern University School of Law, found that attempts to honor these pledges by depicting healthier kids’ meals frequently go unnoticed by children ages 3 to 7 years-old. In research published on March 31, 2014 in JAMA Pediatrics, these researchers found that one-half to one-third of children did not identify milk when shown McDonald’s and Burger King children’s advertising images depicting that product. Sliced apples in Burger King’s ads were identified as apples by only 10 percent of young viewers; instead most believed that the ads were depicting french fries.
Children in the study were confused by the images of food. One typical participant said, “And I see some…are those apples slices?”
The researcher replied, “I can’t tell you…you just have to say what you think they are.”
“I think they’re french fries,” the child responded.
“Burger King’s depiction of apple slices as ‘Fresh Apple Fries’ was misleading to children in the target age range,” said principal investigator James Sargent, MD, co-director Cancer Control Research Program at Norris Cotton Cancer Center. “The advertisement would be deceptive by industry standards, yet their self-regulation bodies took no action to address the misleading depiction.”
Mark Gottlieb, Executive Director of PHAI and an author of the study, observed that, “when young children believe they will be getting french fries with their meals because of deceptive or confusing advertising imagery, they may insist that the adult bringing them orders french fries instead of apple slices. Likewise, if advertising leads children to expect a sugary drink rather than milk, they may well end up getting the sugary drink. This has the effect of undermining the self-regulatory pledges that the companies made.”
Study author and PHAI Senior Staff Attorney Cara Wilking said she found it, “troubling that fast food giants would publicly make a self-regulatory pledge, fail to live up to the pledge, and receive no sanction from the relevant self-regulatory body. Such failures suggests that self-regulation is often more about public relations than about fulfilling the role of actual governmental regulation.”
Sargent and his colleagues studied fast food television ads aimed at children from July 2010 through June 2011. In this study researchers extracted “freeze frames” of Kids Meals shown in TV ads that appeared on Cartoon Network, Nickelodeon, and other children’s cable networks. Of the four healthy food depictions studied, only McDonald’s presentation of apple slices was recognized as an apple product by a large majority of the target audience, regardless of age. Researchers found that the other three presentations represented poor communication.
This study follows an earlier investigation conducted by Sargent and his colleagues, which found that McDonald’s and Burger King children’s advertising emphasized giveaways like toys or box office movie tie-ins to develop children’s brand awareness for fast food chains, despite self-imposed guidelines that discourage the practice.
While the Food and Drug Administration and the Federal Trade Commission play important regulatory roles in food labeling and marketing, the Better Business Bureau operates a self-regulatory system for children’s advertising. Two different programs offer guidelines to keep children’s advertising focused on the food, not toys, and, more specifically, on foods with nutritional value.
“The fast food industry spends somewhere between $100 to 200 million dollars a year on advertising to children, ads that aim to develop brand awareness and preferences in children who can’t even read or write, much less think critically about what is being presented.” said Sargent.
Bernhardt AM, Wilking C, Gottlieb M, Emond J, Sargent JD. Children’s Reaction to Depictions of Healthy Foods in Fast-Food Television Advertisements. JAMA Pediatr.2014;():. doi:10.1001/jamapediatrics.2014.140.
This study was funded by the Robert Wood Johnson Foundation’s Healthy Eating Research program.
Thursday, December 19th, 2013
December 19, 2013
The Public Health Advocacy Institute (PHAI) at Northeastern University School of Law, along with our partners at the Center for Digital Democracy and Berkeley Media Studies Group, today releases State Law Approaches to Address Digital Food Marketing to Youth. It is a first-of-its kind resource that provides an evidence base and action steps grounded in state law. State attorneys general and other stakeholders in children’s health and privacy can use it to put a stop to troubling digital marketing practices that deceive youth and their parents.
In addition to clear explanations of how digital marketing works and why it poses privacy and health risks to youth, key legal issues for state regulators are explored. These issues include personal jurisdiction over out-of-state food and beverage marketing and media companies; the interplay of federal and state laws regulating mobile marketing; and the application of state promotions laws to child consumers.
Key findings include:
- Research demonstrates that digital marketing is harder for children to identify than traditional television advertising, heightening the need for regulatory oversight.
- Nickelodeon, the biggest source of food ads seen by youth, has augmented its media empire through websites, mobile apps and programming that imports content from a popular YouTube channel. All of its digital platforms are ad-supported creating new opportunities for food and beverage companies to target youth.
- Digital campaigns are seamlessly woven into food packaging allowing marketers to target youth in supermarkets, convenience stores and fast food restaurants. Packaging often directs youth to digital marketing on mobile devices or online. State regulators have jurisdiction over unfair and deceptive marketing on food packages sold to consumers in their states.
- Mobile marketing elements are integrated into food and beverage campaigns. The legal landscape for state oversight of mobile marketing includes federal and state SPAM and telemarketing laws, and the emerging regulation of geolocation tactics.
- States are authorized to protect child privacy under federal law and have successfully done so, but teens are not covered by child privacy laws. State attorneys general can fill the teen privacy gap using their general consumer protection authority to ensure that company promises to protect privacy are honored and that teens are not duped into sharing personal information.
- Facebook remains the dominant social media platform for teens. Teens growing use of social media has resulted in them being less privacy savvy. Food companies exploit this by prompting teens to login to their websites and participate in promotions via Facebook thereby granting marketers access to vast amounts of personal information.
- Digital sweepstakes and contests are in widespread use by the food industry with children as young as 6 years old. Despite repeated enforcement actions by the Children’s Advertising Review Unit (a self-regulatory body); food companies continue to conduct digital promotions with children that exploit their inability to understand that a free means of entry exists or their odds of winning a prize. State attorney general action is needed to augment these self-regulatory efforts to protect children from predatory promotions.
Senior Staff Attorney, Cara Wilking, who was lead author of the report, noted that, “state attorneys general are in a unique position to leverage state law approaches to stop unfair, deceptive, or otherwise illegal digital marketing of unhealthy foods to our youngest and most vulnerable consumers.”
PHAI’s Executive Director, Mark Gottlieb, added, “there is a general failure to understand the disturbing marketing practices that are becoming commonplace in the digital marketing world. This report goes a long way toward closing the knowledge gap between those using powerful technology to sell junk to kids and those who have the responsibility to protect them.”
- Executive Summary
- Why Digital Marketing Is Different
- Packaging: Digital Marketing at the Moment of Truth
- Personal Jurisdiction
- Mobile Food & Beverage Marketing
- Facebook Advertising
- Incentives-Based Interactive Food & Beverage Marketing
- Appendix: State Law Profiles
Support for State Law Approaches to Address Digital Food Marketing to Youth was provided by the Robert Wood Johnson Foundations Healthy Eating Research Program (#69293).
PHAI researchers co-author article in AJPH describing how health advocates battling the food and beverage industry can learn by looking back at the smoking and health crisis of the late 1950s and early 60s
Thursday, November 14th, 2013
Richard Daynard, Lissy Friedman, and Mark Gottlieb have co-authored an article published today in the American Journal of Public Health, along with our research partners from Berkeley Media Studies Group (BMSG). The article is entitled: “Cigarettes Become a Dangerous Product: Tobacco in the Rearview Mirror, 1952–1965.”
BMSG’s press release appears below:
Nutrition advocates may be able to use lessons from tobacco control to help government move faster toward protecting the public from harmful food and beverage company products and marketing practices, say the authors of a new study published today by the American Journal of Public Health.
In a content analysis of public and internal documents, the authors, from Berkeley Media Studies Group and the Public Health Advocacy Institute at Northeastern University School of Law, examined national newspapers, tobacco industry documents and the Congressional Record and Congressional Index between 1952 and 1965 to learn how health harms from cigarettes were framed in the early days of anti-tobacco advocacy.
The study found that news coverage of tobacco focused primarily on its health harms — not who was responsible for addressing them. Much as nutrition advocates often see headlines today about sugary drinks, junk food or other products that fuel disease, pre-1965 conversations about cigarettes were typically disconnected from the industry that produced them.
As such, the personal responsibility rhetoric the tobacco industry became known for in the 1980s and beyond — rhetoric that food and beverage companies have borrowed and are using today to forestall government regulation and shift blame for their products’ health harms onto the consumers who buy them — was all but absent from both news coverage and industry documents. Instead, tobacco companies focused on raising doubts about cigarettes’ links to lung cancer. More than three-quarters of tobacco industry documents denied that cigarettes are harmful to health, with industry spokespeople claiming that the causes of cancer are complex and more research was needed. The industry also discussed cigarettes’ alleged benefits, such as a “feeling of well-being and refreshment.”
What little discussion there was of culpability identified both individuals and industry as sharing blame for the problem and, strikingly given today’s political discourse, called upon government to act.
“The backdrop for early tobacco control was wildly different from today’s political climate,” Lori Dorfman, the study’s lead author and director of the Berkeley Media Studies Group, said. “Profound distrust of the government has made it harder for public health advocates to make the case for protections from harmful products. In the 60s, a belief in government’s duty to act to protect public health was the norm.”
According to the study, government action was contested only in internal industry documents, not public discussion. News coverage and legislative documents questioned not whether the government should act, but how.
Nevertheless, once the dangers of cigarettes were established, actions were individually oriented and related mostly to providing consumers with more education and warnings about smoking’s health harms.
“We now take for granted how effective tobacco taxes and indoor smoking bans are,” study author and Public Health Advocacy Institute Director Mark Gottlieb said. “But moving tobacco control efforts from smoking cessation to industry regulation happened over the long haul.”
The study authors suggest that advocates now pushing for healthier food environments may be able to do the same, shifting attention from unhealthy foods and beverages to the companies that manufacture and market them. However, they will have to do so within a changed, and more challenging, political context.
Article abstract link: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301475
Ciation: Dorfman L, Cheyne A, Gottlieb MA, Mejia P, Nixon L, Friedman LC, Daynard RA. Am J Public Health. Published online ahead of print November 14, 2013. doi:10.2105/AJPH.2013.301475.
About Berkeley Media Studies Group
Berkeley Media Studies Group researches the way public health issues are characterized in the media and helps community groups, journalists and advocates use the media to advance healthy public policy. BMSG is a project of the Public Health Institute.
About Public Health Advocacy Institute
The Public Health Advocacy Institute (PHAI) is a legal research center focused on public health law at Northeastern University School of Law. PHAI’s goal is to support and enhance a commitment to public health in individuals and institutes who shape public policy through law. PHAI is committed to research in public health law, public health policy development; to legal technical assistance; and to collaborative work at the intersection of law and public health. Their current areas of work include tobacco control and childhood obesity.
Heather Gehlert, BMSG
(510) 704-3471, firstname.lastname@example.org
Monday, October 7th, 2013
by Cara Wilking, J.D.
Since 2008, national advertising for McDonald’s Happy Meals has not depicted soda as per a self-regulatory pledge made to the Children’s Food and Beverage Advertising Initiative (CFBAI). In a recent pledge with the Clinton Global Initiative (CGI) and the Alliance for a Healthier Generation, McDonald’s stated that it will not display soda company logos in the children’s section of its restaurant menu boards or otherwise promote or feature soda, but soda will remain on the children’s menu. This seems to be a huge public admission that McDonald’s has no plans to actually take soda off of its children’s menu. Almost five years after McDonald’s began implementation of its CFBAI pledge its in-store children’s menu offerings still do not match the Happy Meal combinations it advertises to the public.
In July of 2011, I wrote about the fact that McDonald’s CFBAI pledge had not translated into its healthier options becoming its most popular or commonly sold options (a fact later confirmed by McDonald’s). At that time, meal combinations with french fries and a 12 oz. soda were the most popular Happy Meal combinations. Two years later, soda is still on the children’s menu. In order to truly improve the nutritional profile of the meals it actually sells, McDonald’s needs to do the same thing with beverages that it did with its french fries. Change the default. When a parent orders a Happy Meal the clerk should ask, “milk, apple juice or water.” Its CGI pledge does not accomplish that and evinces a potentially huge disconnect between what McDonald’s advertises and what it is actually selling to children and their parents.
Thursday, August 29th, 2013
In response to a recent study finding that nationally televised fast food television advertisements to children by McDonald’s and Burger King from 2009-2010 focused primarily on toys, movie tie-ins and branding, CARU Director Wayne Keeley stated that “[b]oth companies have always respected CARU’s recommendations by discontinuing the challenged ads, and pledged to take into account CARU’s recommendations in their future advertising,” and went on to note that there haven’t been any recent cases involving either of the two companies.
A look at CARU case reports tells a different story. Since 2005, McDonald’s Corporation has been cited by CARU six times for violations of its premium guideline. Just one of these cases, from Sept 2012, was decided in McDonald’s favor. The most recent CARU case against the company in December 2012 found the premium guideline had been violated. Each time McDonald’s pledged to take CARU guidelines into consideration in future advertisements. Burger King also was found to have violated CARU’s premium guideline in 2011.
Monday, August 26th, 2013
Cheeseburger Bills or Common Sense Consumption Acts (CCAs) were spearheaded by the National Restaurant Association as well as the American Legislative Exchange Council (ALEC) and have been enacted in 26 states. Media coverage and legislative debates about CCAs were dominated by themes of personal responsibility and the need for tort reform to protect businesses from frivolous litigation. A recent study just published in the Food and Drug Law Journal by PHAI’s Cara Wilking, J.D. and Richard A. Daynard, J.D., Ph.D. analyzes the
25 CCAs enacted between 2003 and 2012, and found they go well-beyond tort reform. Key findings from “Beyond Cheeseburgers: The Impact of Commonsense Consumption Acts on Future Obesity-Related Lawsuits” include:
- The majority of CCAs (16 states) may be interpreted to confer broad civil immunity for claims seeking to recover for health harms stemming from long-term consumption of food.
The CCAs enacted in nine states (Alabama, Colorado, Georgia, Idaho, Illinois, Michigan, Missouri, Oklahoma and Tennessee) impose a limitation on the kinds of cases government attorneys can bring by specifically referencing governmental entities when defining the reach of the statute.
- Six states (Alabama, Georgia, Kentucky, Texas, Oregon and Washington) explicitly protect the authority of governmental entities to enforce certain food-related laws.
- Thirteen states impose substantial procedural barriers such as heightened pleading requirements and stays of discovery for covered obesity-related claims.
- All states had laws to guard against frivolous litigation in place prior to the enactment of CCAs.
The health harms of tobacco are well-known and linked to corporate misconduct. In the late 1990’s, tobacco litigation brought by State Attorneys General resulted in individual settlements by four states to recover smoking-related Medicaid costs. Forty-six states and territories negotiated the Master Settlement Agreement securing annual payments of several billion dollars in perpetuity as repayment for smoking-related healthcare costs.
Between 2008 and 2010, adult obesity rates increased in a total of 16 U.S. states, 11 of which are CCA states. The CCA states of Alabama, Louisiana and Tennessee are among the top five states with the highest rates of obesity, diabetes and hypertension. The current medical cost of adult obesity in the U.S. is estimated at $147-$210 billion per year, $61.8 billion of which is paid for by Medicare and Medicaid (Levi et al. 2012). The twenty-sixth CCA was passed in North Carolina in 2013 and they continue to be introduced in state legislatures. “A close analysis of CCAs reveals that the real point of the CCA proponents was not to prevent frivolous litigation, from which industry already had plentiful protection, but rather to limit legally and factually sound tobacco-style litigation, which might eventually have harmed industry’s bottom line and forced it to change its practices,” said Cara Wilking, J.D.
“Beyond Cheeseburgers: The Impact of Commonsense Consumption Acts on Future Obesity-Related Lawsuits” was published in the Food and Drug Law Journal and is reproduced with the permission of the Food and Drug Law Institute.
This research was supported by award #2R01CA087571 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
Tuesday, July 30th, 2013
Update: July 30, 2013
At this point, the Supreme Court of NY County (March 11, 2013) and the Supreme Court, Appellate Division, First Dept. (today) have ruled that the sugary beverage serving size cap in New York is invalid. The case name is: In re New York Statewide Coalition of Hispanic Chambers of Commerce, et al. v. New York Dept. of Health and Mental Hygene, et al..
Clearly, I was mistaken in my prediction (see original post below) that the measure would survive a legal challenge. While the City will seek review by the Court of Appeals of the State of New York (the state’s highest court), this has clearly turned into an uphill battle for Mayor Bloomberg and the City at this point.
Interestingly, the beverage industry has (so far) successfully relied on a case brought by the tobacco industry in the 1987 to successfully the stop the NY Health Council from taking steps to regulate smoking in public places. At that time, it was politically impossible to get the state legislature to enact smoking restrictions in public indoor areas and limit smoking in restaurants. Such a measure was viewed as an extreme infraction on smokers’ rights. In that case, Boreali v. Axelrod, the court held that for several reasons, only the legislature was suited to enact such a restriction. Those same reasons are cited in today’s decision reinforce the impression that many of the same societal changes and setbacks experienced in tobacco control are playing out around obesity prevention policy.
- In Boreali, the Court found that the administrative health agency took economic issues into account by exempting restaurants and bars from smoking bans. Economic concerns are beyond the scope of a health agency’s legal authority. In today’s decision, the fact that NYC exempted convenience stores and bodegas was interpreted as an economic concession (despite the City’s strong arguments to the contrary).
- In Boreali, the fact that the state legislature had previously rejected smoking bans suggested that it was inappropriate for a health agency to go ahead and do an end-run around a matter previously before the legislature. Likewise, in today’s decision the Court found that the NY City Council has “targeted” sugary beverages in the past, so this subject matter should be off-limits to the Board of Health.
- In Boreali, the Court ruled that the fact that the health agency was drafting a new type of restriction was evidence that it was “writing on a clean slate” rather than tweaking or otherwise perfecting an existing restriction that was clearly within its purview. Same thing here. It was a new and innovative regulation which, according the this Court’s reasoning, is why it ought to be handled by a legislative body rather than an administrative agency.
- Finally, the Court in Boreali found that a simple no-smoking rule did not involve expertise in health matters. In today’s decision, too, the Court found that a simple beverage size ban did not require health expertise and, therefore, is beyond the scope of authority granted to the Board of Health.
Under today’s ruling, any one of these four factors could invalidate agency action. Such strict application of Boreali may ultimately represent chilling new limits on the powers of health boards in New York state.
While analysts may disagree over whether the Court’s decision today was a well-reasoned one, and it may yet be subject to further appellate review, it is important to note that it is basically a dispute about New York law and not a fundamental legal problem with placing limits on serving sizes for sugary beverages that is at issue.
But that said, the real disagreement may be more about evolving norms surrounding sugary beverages than about administrative authority. As norms around tobacco use evolved over time, Boreali is increasingly seen as an example of the tobacco industry gaining a temporary victory at the cost delaying the protection of the public’s health. Perhaps today’s decision will be seen in a similar light in the not-too-distant future as norms around sugary beverages continue to evolve.
-Mark Gottlieb, J.D., Executive Director
Public Health Advocacy Institute at Northeastern University School of Law
Today the New York City Board of Health approved first-in-the-nation limits on the maximum size of sugary drinks served in restaurants, theaters, and sports venues. The vote was 8-0 in favor of adopting the regulation with one abstention. Grocery and convenience stores are exempt and diet drinks, juices, and drinks that are 50% of more milk (or milk substitute) are excluded.
While the measure drew ire from critics throughout the political spectrum, and has been inaccurately characterized as a “ban,” it has succeeded in invigorating the debate on the role of sugary drinks in obesity and the role of government to encourage mindful consumption. Such mindful consumption will begin 6 months from today when the new rule should go into effect.
In the meantime, there may be efforts by big drink stakeholders to challenge the regulation. One such group, New Yorkers for Beverage Choices, a group closely aligned if not controlled by the American Beverage Association, has hinted at such a challenge. The pro-business think tank, the Washington Legal Foundation, has published comments on the measure that suggest the basis for a legal challenge. A credible legal challenge could result in the granting of a injunction that could delay or derail the beverage size restriction. However, there appears to be little chance that such a challenge will lead to any measure of success.
The Washington Legal Foundation’s primary legal argument to oppose the measure is that it is the type of action that is normally reserved for legislation rather than rule-making by an administrative agency. The problem with that argument is that regulating serving sizes of sugary drinks in food establishments is clearly within the New York City Department of Health and Mental Hygiene’s authority to protect the public’s health under the City Charter’s sec. 558 and to engage in rule-making under sec. 1043. The Washington Legal Foundation public comments cite to a 1980s case, Boreali v. Axlerod. The case involved an early New York non-smoking rule that was overturned primarily because the state’s Public Health Council considered the economic impact of the restriction on businesses and offered waivers for those that could show financial hardship. This went beyond the Public Health Council’s legal authority to issue rules based solely on protecting health. Here, however, there is no waiver process and no consideration by the Board of Health of the economic impact this rule might have on businesses.
A second issue raised by the Washington Legal Foundation is that the problem of obesity is an important issue of concern to society and that dealing with such social issues is best left to legislative bodies rather than regulatory agencies. Citing again to the Boreali case, WLF suggests that this is a matter that it should only be addressed by elected officials and not agency appointees. Essentially, they are making a philosophical rather than a legal argument. Legally, this rule-making is very clearly within the agency’s purview.
In yesterday’s New York Times, an attorney who has previously represented New York restaurants suggested that the rule could be overturned on Constitutional grounds. This would be a reference to the Commerce Clause (Art. I, Sec. 8, Clause 3 of the U.S. Constitution) which grants Congress the power to regulate commerce among the states. If a state or, as in this case, a political subdivision of a state, passes a law or rule that substantially affects interstate commerce, it is possible that a court would find that the Commerce Clause reserved that power to Congress and the law or rule would be found to be unconstitutional. However, in this instance, there is virtually no argument that could be made that the beverage size rule could affect interstate commerce any more than the cup size could be found to be a form of free speech that the rule unconstitutionally restricts. Neither argument is credible enough to argue in a court room.
There is virtually no chance that the rule will be successfully challenged. Either threats of litigation will not materialize or, if they do, will be quickly dismissed. That result will encourage other communities to replicate the courageous action taken in new York City by Mayor Bloomberg and the Board of Health.
-Mark Gottlieb, J.D., Executive Director
Public Health Advocacy Institute at Northeastern University School of Law
Friday, March 8th, 2013
Food companies used viral digital marketing tactics, such as “tell-a-friend” web campaigns, to induce children to share e-mail addresses of their friends and spread brand advertising of unhealthy foods among their peers. Even very young children are targeted by these campaigns, which may be considered unfair and deceptive and in violation of state consumer protection laws.
PHAI has prepared a legal issue brief on this topic for state attorneys general as well as stakeholders in children’s health and privacy. The brief explains the tactics that are used and suggests ways that they can be addressed, particularly under state law.
This work was supported by the Robert Wood Johnson Foundation’s Healthy Eating Research Program (#69293).
Wednesday, January 9th, 2013
[Adapted from Richard A. Daynard’s presentation to the 2013 Annual Meeting of the Association of American Law Schools’ Agriculture and Food Law section, January 5, 2013.]
Soda consumption is a major contributor to adolescent obesity.1 Fortunately, soda consumption has been declining recently,2 presumably as a result of adverse media attention and policy initiatives like the ban on most sugar-sweetened beverages in schools.
PepsiCo has decided to do something about that, and has designed its “Live for Now” campaign in an effort to reverse the decline in teenage soda consumption. The campaign takes advantage of known adolescent vulnerabilities which result from the facts that the inhibitory structures of their brains are not fully developed, hormonal changes further reduce inhibitions while lowering self-esteem, and their psychosocial development focuses on identity formation and social acceptance.3 As a result they tend to be impulsive, thrill-seeking, and “now”-oriented. While they may rationally balance perceived risks and benefits, doing so does not necessarily inure to their best long-term interests.
Pepsi’s Live for Now campaign, like the infamous Joe Camel campaign used by R.J. Reynolds, is designed to prey upon these adolescent vulnerabilities in an effort to reverse declining consumption trends as well as to market a particular product.
Unlike cigarette advertisers, Pepsi is free to take its campaign to the airwaves. It will do so in a big way when it will sponsor the Superbowl Halftime Show featuring Beyoncé, who recently entered into a $50 million endorsement deal with PepsiCo.
The Federal Trade Commission could bring an enforcement action under its unfairness jurisdiction, and state attorneys general and private attorneys could seek injunctive relief under state consumer protection laws.
But little is likely to happen unless public outrage is focused on this campaign, and unless regulators and judges learn more about the biological and developmental underpinnings of faulty adolescent decision-making.
1. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; 357: 505–508.
2. Strom, S. (2012). “Soda Makers Scramble to Fill Void as Sales Drop.” The New York Times, May 15, 2012.
3. Pechman, Cornelia, Linda Levine, Sandra Loughlin, and Frances Leslie (2005), “Impulsive and Self-Conscious: Adolescents’ Vulnerability to Advertising and Promotion,” Journal of Public Policy & Marketing, 24 (Fall), 202-221.
Research assistance by Brendan Burke and Cara Wilking
Support for this research was provided, in part, by the National Cancer Institute (2R01CA087571).
Tuesday, July 24th, 2012
by Cara Wilking, JD
As part of its 2012 Olympic Games marketing blitz, the Coca-Cola Company has assembled a “Coca-Cola 8-pack of Athletes” to “serve as Coca-Cola ‘Ambassadors of Active Living’ to help encourage and inspire people to lead active, balanced lives.” This group includes Jessica Long, a 2012 U.S. Paralympic Swimming Team nominee. Ms. Long was born with fibular hemimelia, a condition of the lower legs, and became a double leg amputee at 18 months old. Ms. Long’s athletic achievements are undeniable and her seamless inclusion in the marketing campaign is in line with equality and dignity for all. The tragic reality of lower limb loss, however, is that the majority of people suffering from non-traumatic lower limb loss are diabetic, and it is not medically appropriate for diabetics to consume sugar-sweetened beverages.
From what has been released of the campaign so far, the “Coca-Cola 8-Pack of Athletes” promotes full-sugar Coca-Cola. Ms. Long is no exception. Her commercial, entitled “Home,” shows her swimming as a child in her grand-parents’ backyard pool and moves through a range of global swim competitions. The commercial ends with Ms. Long drinking from a bottle of full-sugar Coca-Cola. Cans of full-sugar Coca-Cola are shown next to the tagline “Open Happiness” and an announcer says, “Support our athletes with the Cola-Cola Olympic Series Collector’s Cans.” In other words, “Buy Coke!”
If one of the goals of Coca-Cola’s “8-pack of Athletes” campaign is to inspire people, including those suffering from limb loss, to lead active lives, then why does the campaign promote a product diabetics are under doctor’s orders to avoid?
Sugar-sweetened beverages like Coca-Cola are associated with obesity-related diseases including Type 2 Diabetes. The Centers for Disease Control estimates that as many as 1 in 3 U.S. adults could have diabetes by 2050. The links between diabetes and limb loss are stark and tragic:
- Diabetes is the leading cause of non-traumatic lower limb amputation among adults in the United States.
- More than 60% of non-traumatic lower-limb amputates are people with diabetes.
- In 2008, more than 70,000 people with diabetes had a leg or foot amputated 
- Diabetes rates for people aged 20 years or older are:
- 7.1% of Whites (non-Hispanic)
- 8.4% of Asian Americans
- 12.6% of African Americans (non-Hispanic)
- 11.8% of Hispanics
- African Americans and Hispanics are almost 3 times as likely as non-Hispanic whites to suffer from lower-limb amputations, 
- Researchers estimate that the number of people in the United States with diabetes who are living with the loss of a limb will nearly triple by the year 2050.
As inspiring as Ms. Long’s journey is, for many people living with the loss of a limb there is no “happiness” to be found in a can of Coke—a fact the Coca-Cola Company seems to have overlooked.
 The Coca-Cola Company, Press Release, Coca-Cola Opens Happiness With Its New “8-Pack” of Athletes for London 2012 Olympic Games, May 17, 2011, http://www.thecoca-colacompany.com/dynamic/press_center/2011/05/eight-pack-of-athletes-for-london-2012-olympic-games.html; and The Coca-Cola Company, Move To the Beat of London, http://www.coca-cola.com/theolympics/en-US (last visited June 28, 2012).
 Coke 2012 Olympics Commercial: Jessica Long “Home”, YouTube.com, June 19, 2012, CocaCola, http://www.youtube.com/watch?v=jpFrYaL6N2w&feature=plcp (last visited June 27, 2012).
 Coke 2012 Olympics Commercial: Jessica Long “Home”, YouTube.com, June 19, 2012, CocaCola, http://www.youtube.com/watch?v=jpFrYaL6N2w&feature=plcp (last visited June 27, 2012).
 Vasanti S. Malik et al, Sugar-Sweetened Beverages, Obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk, 12 Circulation, 1356-1364 (2010).
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Press Release, Number of Americans with Diabetes Projected to Double of Triple by 2050, http://www.cdc.gov/media/pressrel/2010/r101022.html.
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011, at 1, http://www.diabetes.org/in-my-community/local-offices/miami-florida/assets/files/national-diabetes-fact-sheet.pdf.
 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011, at 8, http://www.diabetes.org/in-my-community/local-offices/miami-florida/assets/files/national-diabetes-fact-sheet.pdf.
 Diabetes Statistics, American Diabetes Association, http://www.diabetes.org/diabetes-basics/diabetes-statistics/?loc=DropDownDB-stats (last visited June 27, 2012).
 Living with Diabetes: African Americans & Complications, American Diabetes Association, http://www.diabetes.org/living-with-diabetes/complications/african-americans-and-complications.html (last visited June 27, 2012).
 National Limb Loss Information Center, Minorities, Diabetes and Limb Loss (May 2008), http://www.amputee-coalition.org/fact_sheets/multicultural/all_groups.pdf (citing Robert Preidt, Blacks, Hispanics Hospitalized More Often for Diabetes, Heart Disease, HealthDay: News for Healthier Living, August 15, 2006.
 Kathryn Ziegler-Graham et al, Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050, 89 Archives of Physical Medicine and Rehabilitation 422, 424 (March 2008).