Posts Tagged ‘the coca-cola company’
PHAI Joins Center for Science in the Public Interest in Filing Lawsuit Against Coca-Cola for Deceptive Marketing
Wednesday, January 4th, 2017
BOSTON – Two non-profits that use litigation as a public health strategy have joined forces in a lawsuit accusing the Coca-Cola Company (“Coke”) along with the American Beverage Association (“ABA”) of misleading the public about the science that links heart disease, obesity, and diabetes to consumption of sugary beverages. For years, the Public Health Advocacy Institute at Northeastern University School of Law in Boston and the Center for Science in the Public Interest in Washington, DC relied on civil litigation as a tool to achieve policy change to benefit public health.
Download the Complaint here.
The lawsuit was filed today in federal court in the Northern District of California on behalf of a California non-profit, the Praxis Project, which has had to devote resources to correcting the misleading messages that Coke and the ABA have disseminated. These include spreading the notion that the main cause of obesity is lack of exercise or that “a calorie is a calorie,” regardless of whether it comes from Coke or from kale. The science, in fact, shows that sugary drinks such as Coca-Cola have been found to play a real role in the obesity crisis and that calorie intake is more significant than calorie expenditure in terms of the problems of obesity and overweight. The lawsuit also accuses Coke of failing to comply with its pledge to not market to children. The action alleges violations of California’s Business and Professional Code as well as negligent and intentional breaches of a special duty to protect the consuming public.
The plaintiffs seek a court order to enjoin Coke and ABA from denying the link between sugary drinks and obesity, diabetes, and cardiovascular disease and to stop any marketing to children. They also seek a court order for defendants to disclose and publish all research they have directly or indirectly conducted on the impact of sugary beverages on health and the impact of exercise on obesity vs sugary drink consumption. Furthermore, the plaintiff asks the court to order the defendants to fund a corrective public education campaign and place prominent warnings on their internet sites that consumption of sugary beverages can lead to obesity, diabetes, and cardiovascular disease.
The attorneys for the plaintiff include Maia C. Kats, litigation director of the nonprofit Center for Science in the Public Interest; Andrew Rainer, litigation director of the nonprofit Public Health Advocacy Institute; and Michael R. Reese of the law firm Reese LLP.
PHAI attorney Andrew Rainer considers this lawsuit to be about defending science from manipulation by those who seek to increase profit at the expense of public health. Rainer says, “the Public Health Advocacy Institute has joined in this complaint in an effort to prevent the distortion of science for corporate gain. Just as the tobacco industry manipulated and distorted science for decades to deny the dangers and addictiveness of cigarettes, and the oil industry works to systematically distort science to deny climate change, Coca Cola and the American Beverage Association are engaged in a campaign to deny the established science linking sugar-sweetened beverages to obesity and diabetes.”
Mark Gottlieb, executive director of the Public Health Advocacy Institute, characterizes this filing as, “the tip of the iceberg when it comes to purveyors of sugar-added products seeking to shift all responsibility for health harms to their consumers. Coke pays dietitians to tell consumers things like drinking coke can be a healthy snack and pays scientists to deny that sugary drinks are linked to obesity and then suggests that the main cause of obesity and related disease is lack of exercise. The hypocrisy of suggesting to consumers that burning calories through laughing can offset the harmful effects of drinking soda is no laughing matter. And, yes, Coke really suggested that.”
PHAI’s partner, the Center for Science in the Public Interest included the following bullet points from the complaint in its press release.
- Coca-Cola’s senior vice president, Katie Bayne, claims that “[t]here is no scientific evidence that connects sugary beverages to obesity.”
- “There is no unique link between soda consumption and obesity,” claims a post on the ABA’s website.
- “Simply put, it is wrong to say beverages cause disease,” the ABA stated in another release.
- Coke’s incoming CEO, James Quincey, equated sugar-sweetened beverages to any other calories, dismissing their unique contribution to the obesity epidemic by asserting such beverages contribute only two percent of calories overall.
- Coke also paid health professionals to promote sugar-sweetened beverages, including one dietitian who suggested that an eight-ounce soda could be a healthy snack, like “packs of almonds.”
The Public Health Advocacy Institute set up its Center for Public Health Litigation in 2014 in order to hold responsible corporate interests that harm public health and defend policies that protect public health.
Thursday, February 11th, 2016
By Cara Wilking, JD, Consulting Attorney, Public Health Advocacy Institute
[PLEASE NOTE: This blog post was prepared prior to unexplained changes to Coca-Cola’s database of its funding of organizations in the United States. The information reflects the dollar amounts initially reported by Coca-Cola in the Fall of 2015.]
For years, the month of February has been the kick-off of the Coca-Cola Company’s sponsorship of the National Heart Lung and Blood Institute’s (NHLBI) Heart Truth campaign. Heart Truth began in 2002, with the goal of raising awareness that heart disease is the number one killer of women. The campaign fits within the general mission of NHLBI to collaborate with a range of stakeholders to promote the prevention and treatment of heart, lung, and blood diseases. As part of the Department of Health and Human Services (HHS), NHLBI provides research funding and conducts outreach with the public to improve the public health. As a federal agency, NHLBI is subject to legal limits on its use of funds and HHS’s ethical guidelines for co-sponsorship of events. These guidelines are meant to guard against conflicts of interest that would undermine the primary mission of NHLBI. Coke’s corporate funding disclosures in the Fall of 2015 indicate that as public pressure on NHLBI built, Coke shifted the bulk of its heart health giving to a tight circle of non-governmental heart health organizations consisting of the American College of Cardiology, the Preventive Cardiovascular Nurses Association, the American Dietetic Association, and Brigham and Women’s Hospital in Boston, MA.
Coke’s Heart Health Campaign
From 2008 to 2014, The Coca-Cola Company, under its Diet Coke brand, was the Heart Truth campaign’s most visible co-sponsor: Despite the fact that HHS’s ethical guidelines place a particular emphasis on avoiding the appearance of product endorsement, Heart Truth logos were printed on billions of Diet Coke cans, heart health-themed Diet Coke ads ran during the Olympic Games, Coke enlisted high-profile celebrities like Heidi Klum to appear at Heart Truth events, and Diet Coke beverages were distributed at community heart health screenings.
NHLBI’s partnership with Coke drew ire from the public health community because it seemed untenable to partner with a company that also sells sugary drinks linked to obesity and heart disease. The fact that the partnership focused on Diet Coke was particularly problematic because it closely followed the release of the NHBLI-funded Framingham Heart Study’s findings that consumption of diet soft drinks appeared to be linked to increased risk factors for heart disease.
In 2010, the Center for Science in the Public Interest (“CSPI”) called on the government agency to sever its ties with Coke, but NHLBI publicly refused to do so. The primary rationale NHLBI gave for keeping Coke as a corporate sponsor was that the company allowed the agency to extend its reach to get out the message that heart disease is an important health concern for women. CSPI’s challenge to the program led to a public debate about the role of Coke in NHLBI’s educational activities.
Coke’s Heart Truth Contracts with NHLBI
In 2010, PHAI requested Coke’s contracts with the NHLBI pursuant to the Freedom of Information Act (FOIA) and received copies of contracts the company entered into with Ogilvy Public Relations Worldwide on behalf of the NHLBI from 2007, 2008, 2009 and 2010:
- Coke Agreement_December-17-2007
- Coke Agreement_Jan-3-2008
- Coke Agreement_Oct-21-2008
- Coke Agreement_Jan-13-2010-2011
At the time, the dollar amounts in these contracts were redacted as proprietary information.
Coke’s recent funding disclosures date back to 2010, and show that in 2010 the company paid NHLBI $440,000 in support of a fashion show to promote heart health awareness. Through its contracts with NHLBI for the 2010 Heart Truth Fashion Show, Coke was granted:
-Exclusivity as the only carbonated beverage category event sponsor
-Full use of the NHLBI Heart Truth logo in any Coke marketing, advertising and or promotional materials or activities
-Assistance from NHLBI’s agent, Ogilvy, in the “development of heart health content and messages” for its use
-“Access to heart health experts and spokespeople to serve on Coca-Cola’s behalf including at Coca-Cola luncheons, ambassador program, opinion shaper and other customer/VIP events”
-Highlighted attention to Coca-Cola’s partnership activities on the Heart Truth webpage
-Soundbites from NHLBI representatives at Heart Truth events for use by Coca-Cola
-The right to provide free samples of Coca-Cola products at the fashion show
-The right to feature Coca-Cola advertising in essentially all aspects of the event
-Pre-approval of “all [NHLBI] creative materials, press releases, collateral materials, signage and other items using” Coca-Cola’s trademarks
The breadth of the rights granted to Coca-Cola is in keeping with a typical private arrangement for event sponsorship, but seems startling in the context of a government run educational campaign. Ogilvy Public Relations Worldwide was awarded multi-year government contracts from the NHLBI totaling $11.9 million to execute the Heart Truth campaign on its behalf. Organizers of complex, national educational campaigns must work with sponsors to ensure events run smoothly. The contracts Ogilvy entered into on NHLBI’s behalf with Coke, however, reveal a situation where it appears that NHLBI was granting Coke rights to advance the company’s commercial agenda.
Coke Abruptly Shifts Its Heart Health Spending
In March of 2010, PHAI wrote a detailed letter to the Associate General Counsel for Health and Human Services (HHS), asking that it review NHLBI’s relationship with Coke pursuant to the agency’s written ethical guidelines for co-sponsorships of events. In its reply, HHS cited a general provision of the Public Health Service Act granting NHLBI the authority to conduct health promotion campaigns and deferred decision-making about the appropriateness of Coke’s co-sponsorship of the Heart Truth campaign to NHBLI. Despite NHLBI’s public defense of Coke in response to CSPI’s letter and apparent agency inaction after PHAI’s request to review the relationship, after 2011 Coca-Cola shifted its support for Heart Truth and other heart health activities sharply away from the NHLBI.
According to Coke’s initial funding disclosures in the Fall of 2015, between 2010 and 2015, Coke’s total funding of heart health-related organizations and educational activities was approximately $8 million (click here for a detailed description). $7.8 million of these funds went to just five organizations: NHLBI (via Ogilvy and the Foundation for the National Institutes of Health), the American College of Cardiology, the Preventive Cardiovascular Nurses Association, the American Dietetic Association, and Brigham and Women’s Hospital in Boston, MA. NHLBI-related funding of the Heart Truth totaled $1.9 million with Coke’s contributions peaking at $1 mil in 2011. Starting in 2012, Coke sharply reduced its direct NHLBI support and shifted its gifts to private organizations not subject to FOIA requests.
Brigham and Women’s Hospital Cardiologists Associated with Millions in Coke Money
Coke’s Heart Truth partnership with NHLBI was created under the leadership of then NHLBI Director Elizabeth (Betsy) Nabel, MD. Dr. Nabel is a cardiologist who left public service in 2010 to become President of Brigham and Women’s Hospital (BWH) in Boston, MA. Dr. Nabel traveled to Canada to be an official 2010 Olympic Games Torchbearer for Coke and spoke glowingly about her relationship with Coke.
It turned out that Dr. Nabel was not the only Coke heart health partner at BWH. She was joined by Dr. JoAnne Foody, MD, the Medical Director of BWH’s Pollin Cardiovascular Wellness Center. Dr. Foody is featured as a heart health expert in continuing education presentations produced by Coca-Cola’s Beverage Institute for Health, and in 2011 was selected to serve as the Editor-In-Chief of the American College of Cardiology’s (ACC) CardioSmart initiative. ACC received $2.6 million in Coke funding for CardioSmart and community screenings between 2010 and 2015. CardioSmart is described as “a patient education site committed to providing accurate, un-biased heart health information in an advertising-free environment.”
Coke clearly valued its relationship with Dr. Foody. As was reported in 2012, she was included in an email sent from Coca-Cola executive Helen Tarleton to a list of “partners” in various health organizations sharing the company’s position on a proposed New York City ordinance to limit soda portions. The email asked Dr. Foody to disseminate a Coke infographic downplaying the role of sugary drinks in the obesity epidemic. Coke’s direct request to advance a policy position potentially at odds with CardioSmart’s mission to educate heart health patients is a striking example of the depth of the relationships it formed with its public health “partners.”
In 2013 and 2014, Dr. Nabel and Dr. Foody leveraged their relationship with Coke into $1.2 million dollars of funding for a BWH cardiovascular health initiative called ClimbCorps to promote stair climbing for heart health and provide heart health education. Dr. Foody served as the ClimbCorps’ Medical Director. In 2013, Coca-Cola executive Helen Tarleton personally attended a ClimbCorps event with Dr. Nabel and Dr. Foody. The program no longer has an active website and all links to ClimbCorps redirect to the BWH general website. The program’s emphasis on physical activity fit well within Coke’s overall obesity strategy to focus on physical activity as opposed to diet.
Coke Exits the Heart Health Picture
Coke’s funding disclosures paint a more complete picture of how it operated and who it turned to when it needed to shift its giving from a highly scrutinized government agency to private organizations. In response to public pressure, Coke has since bowed out of the heart health initiatives it funded over the past five years:
- Coke ended its role as a corporate sponsor of NHLBI’s Heart Truth Campaign in 2014
- After being called out by the New York Times for funding junk science promoted by Coke and researchers it funded that focused on what it calls “energy balance science” (which claims that there is no established link between soda consumption and obesity and promotes exercise as the most effective way of compensating for the extra calories derived from soda consumption), Coke announced in September 2015 that it would no longer fund the American College of Cardiology including the CardioSmart program
- ClimbCorps is no longer an active program of BWH
In the process, millions of dollars were spent in ways that Coke itself now admits were not adequately transparent, and were inappropriate given the company’s overwhelming commercial interests in the health issues addressed.
There is no question that funds are desperately needed for programs to address crucial diet-related public health issues like cardiovascular disease in women. Coke spent $8 million on heart health education in five years (not including the in-kind contributions it made via specially printed product packages, Heart Truth dedicated websites and television commercials), while the federal government spent just $17 million on the Heart Truth campaign over ten years. The problem with Coke’s heart health spending is that its primary goal has been to downplay the role of sugary drinks in the obesity epidemic and to position diet beverages as healthy alternatives. Neither of these positions is fully supported by actual evidence and, as such, are in conflict with the mission of truly unbiased cardiovascular health initiatives.
There remain many unanswered questions about Coke’s heart health “partnerships.” To what extent did Coke’s initial participation with NHBLI’s Heart Truth campaign give the company legitimacy through what appeared to have been the government’s imprimatur and grant it access to the private organizations it subsequently partnered with? What other requests for political support did the company make of the heart health organizations it funded? How did Coke’s funding impact the heart health activities of the organizations it funded in terms of dietary recommendations to the public or support for public health policies at odds with Coke’s agenda? The most important question left in the wake of Coke’s co-optation of the Heart Truth campaign is this: Moving forward, how can the United States create and sustain unbiased funding mechanisms for the crucial public health issues of our time?
Tuesday, August 25th, 2015
By Cara Wilking, JD, Consulting Attorney
The Coca-Cola Company’s pouring of millions of dollars into the Global Energy Balance Network (GEBN), a front group focused on exercise as opposed to diet to combat obesity, has crystallized an issue that the public health community has long been concerned about: the role of industry funding to research and develop solutions to public health threats. A New York Times story exposing this funding arrangement has led to a public relations nightmare that finally culminated in a formal statement from Coke’s Chairman and CEO, Muhtar Kent. Mr. Kent stated that the accusation that the company is deceiving the public about its support for scientific research “does not reflect our intent or our values,” and promised more transparency. He promised to make available a list of the funding it supports, and to convene expert panels to assist with future “investments in academic research.”
Coke’s funding of GEBN is part of a well-articulated company strategy it calls “Balancing the Debate.” Coca-Cola’s chief scientific officer, Rhona S. Applebaum , PhD, laid out the Balancing the Debate strategy at a 2012 conference for the sugar industry. (CLICK HERE FOR THE FULL PRESENTATION) The strategy seeks to discredit what the company calls “detractors” in the scientific community like Kelly Brownell, Dean of the Sanford School of Public Policy at Duke University (formerly of Yale University), and public health organizations like Center for Science in the Public Interest.
At that 2012 industry conference, Ms. Applebaum told participants that she had come with a “plea from Coca-Cola” that “we all have to work together and use science.”
To that end, Ms. Applebaum, shared Coke’s strategy to “Balance the Debate” by using three interdependent steps: “Cultivate Relationships,” “Collaborate Research,” and “Communicate Results.” These steps, if properly taken, will result in a balanced debate that will “Address the Negative” and “Advance the Positive” for the food industry.
Ms. Applebaum, was clear that cultivating relationships and research collaborations comes down to dollars and cents. She outlined how to use research funding for “defensive and offensive science and research” to address the issues faced by the food industry.
The GEBN seems to have been tailor-made for the offensive and defensive research Coke had in mind, and it amplifies and expands the mission and capabilities of Coke’s Beverage Institute for Health and Wellness, which is run by Ms. Applebaum. On a slide entitled “What Experts Tell Us,” Ms. Applebaum gave insight into the company’s research agenda to “Shift energy balance,” “Inspire/Motivate consumer behavior change,” and “Bring opportunities (on energy in/out).”
To add a gloss of legitimacy to Coke’s vision for funding science to serve its agenda, its chief scientific officer, Ms. Applebaum, co-authored two papers: one in 2009 with guiding principles for industry funding of food science and nutrition research, and one in 2012 with guiding principles for establishing panels of scientific advisers. With respect to funding food science and nutrition research like that conducted by GEBN, Ms. Applebaum co-wrote the following guiding principles:
In the conduct of public/private research relationships, all relevant parties shall:
1) conduct or sponsor research that is factual, transparent, and designed objectively; according to accepted principles of scientific inquiry, the research design will generate an appropriately phrased hypothesis and the research will answer the appropriate questions, rather than favor a particular outcome;
2) require control of both study design and research itself to remain with scientific investigators;
3) not offer or accept remuneration geared to the outcome of a research project;
4) prior to the commencement of studies, ensure that there is a written agreement that the investigative team has the freedom and obligation to attempt to publish the findings within some specified time frame;
5) require, in publications and conference presentations, fully signed disclosure of all financial interests;
6) not participate in undisclosed paid authorship arrangements in industry-sponsored publications or presentations;
7) guarantee accessibility to all data and control of statistical analysis by investigators and appropriate auditors/reviewers; and
8) require that academic researchers, when they work in contract research organizations or act as contract researchers, make clear statements of their affiliation; require that such researchers publish only under the auspices of the contract research organizations. (emphasis added).
These guiding principles clearly were not adequately followed in the case of Coke’s funding of the GEBN, and it remains to be seen what other research it has been cultivating as part of its effort to “balance the debate.” Moreover, the whole concept of funding “defensive and offensive science and research” is completely at odds with the principles of objective research design contained in the guiding principles.
Coke has had a concerted effort to fund science in its favor pursuant to a specific plan laid out by its chief scientist in 2012, and it failed to adequately follow the ethical guidelines its chief scientist helped to write in 2009. The remedies CEO Kent now promises are to disclose who the company has funded (something, according to their chief scientist, the company should have already been doing), and enlisting more experts to help sort things out. For Coke’s CEO to say that the criticism of actions that were clearly in line with a well-articulated Coca-Cola Company strategic plan and failed to comply with basic ethical principles co-written by its chief scientific officer “does not reflect” the company’s “intent” or “values” is partly right and partly wrong. It clearly reflects Coke’s intent to fund science to serve its interests. It does not, however, reflect the purported values of the company with respect to working with scientific researchers.
Tuesday, August 13th, 2013
by Cara Wilking, J.D., Rebecca Leff and Katelyn Blaney
The Ultimate Fighting Championship (UFC) has its roots in “cage-fighting” and was long considered too wild and violent for mainstream sports fans. Not long ago cage-fighting was shunned by parents, banned by states and rejected by broadcast networks and cable operators for its brutality. While cage-fighting remains outlawed in some states, it has been recast as mixed martial arts (MMA). UFC has successfully migrated from pay-per-view television to the Fox Television broadcast network. Despite the UFC’s efforts to rehabilitate its image, bouts are still held in an eight-sided cage (called the “octagon”) where fighters’ blood is commonly spilled. The UFC has an official energy drink called Xyience Energy. NOS energy drink (a Coca-Cola Company product) sponsors MMA champion Georges St-Pierre and has built an ad campaign around the UFC champion. UFC fighters appear on cans of Xyience, attend promotional events and wear the Xyience logo. According to the president of Xyience, UFC fans, who are two thirds male, between the ages of 21 and 34 are the company’s target demographic.
Energy Drinks Are Associated with Increased Risk-Taking, Including Fighting
Energy drink composition, marketing and consumption are currently under investigation by state and federal regulators. Energy drink consumption has been linked to adverse health events including caffeine intoxication, dehydration and even death. Moreover, a 2008 study found that frequent energy drink consumption by young adults, particularly young white males, was positively associated with risk-taking including fighting. The study concluded that energy drink consumption is closely associated with problem behavior syndrome. The group the study found to be most at risk overlaps with Xyience’s target demographic.
Six States and the Association of Ringside Physicians Ban the Use of Stimulant Drinks During MMA Fights
In order to protect the safety of combatants, Arkansas, Florida, Michigan, Ohio, Oklahoma, and Wisconsin ban the use of energy drinks during professional or amateur mixed martial arts bouts. Click here for a legal summary of these policies. State athletic commissions require that a physician be present ringside during mixed martial arts bouts. The Association of Ringside Physicians, a group created “to develop medical protocols and guidelines to ensure the safety and protection of Professional Boxers and MMA Athletes,” stipulates that “only water or an approved electrolyte drink by the Commission may be consumed during the bout,” and “[c]ontestants should not consume energy drinks on the date of the contest.”
The Cross-Promotion of UFC and Energy Drinks Is Unfair and Deceptive to Young Consumers
Marketing energy drinks alongside cage-fighting warrants further investigation as a potentially unfair and deceptive trade practice under state and federal consumer protection law. A deceptive trade practice is a marketing tactic that is likely to mislead a reasonable member of the target audience and is material to the consumer’s decision to purchase the product. A reasonable member of the target audience of UFC fans would be misled into thinking that energy drinks are permissible during bouts. The reasonable consumer likely does not know that energy drinks are actually banned during bouts in six states and by the Association of Ringside Physicians. This omission is not easily discovered by consumers as one has to search state athletic commission regulations to find such information. The cross-promotion of UFC and energy drinks is material to the target demographic because there are a number of energy drinks on the market that do not cross-promote UFC. Placing the UFC logo or pictures of a UFC fighter on a can and sponsoring top UFC fighters is intended to drive UFC fans to select drinks like Xyience and NOS over other energy drinks.
Energy drink cross-promotion of UFC may also be considered an unfair trade practice in jurisdictions that focus on marketing that violates established public policies. As noted above, six states and the Association of Ringside Physicians ban the use of energy drinks during fights. Marketing that associates energy drink consumption with UFC violates these established public policies and presents a potential health harm to the target audience of consumers—a demographic of energy drink users research has shown already is susceptible to engaging in risky behavior like fighting.
Energy Drinks and Fighting Don’t Mix
Xyience and NOS should abandon their association with UFC and MMA. Current marketing campaigns are unfair and deceptive to the target audience of consumers. Consumers deserve the same protections six states and the Association of Ringside Physicians extended to professional and amateur MMA athletes when they banned the use of energy drinks during bouts.
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).
Thursday, February 9th, 2012
The Public Health Advocacy Institute is asking the FDA to investigate and take enforcement action against The Coca-Cola Company’s unlawful use of heart health claims on cans of Diet Coke. In February of 2010, 2011 and 2012, The Coca-Cola Company has released Diet Coke cans labeled with a large red heart symbol, the National Heart Lung and Blood Institute’s “The Heart Truth” Red Dress logo, and references to women’s heart health. Taken together, the large red heart symbol, the Red Dress logo and references to heart health imply a relationship between consuming a specific food, Diet Coke, and reduced risk for heart disease. The cans pictured below represent the cans in circulation in 2012 (left), 2011 (center) and 2010 (right).
The FDA defines health claims to include “any claim made on the label or in labeling of a food…that expressly or by implication, including ‘third party’ references, written statements (e.g., a brand name including a term such as ‘heart’), symbols (e.g., a heart symbol), or vignettes, characterizes the relationship of any substance to a disease or health-related condition.” 21 CFR § 101.14 (a)(1). In its food labeling guidance the FDA states, “ health claims characterize a relationship between a substance (specific food component or a specific food) and a disease (e.g., lung cancer or heart disease) or health-related condition (e.g., high blood pressure), and are supported by scientific evidence (see 21 CFR 101.1472).” FDA, Guidance for Industry: A Food Labeling Guide (April 2008), http://www.fda.gov. The use of the heart symbol, the phrase “The Heart Truth” and the reference to a national health organization implies that Diet Coke consumption is beneficial to heart health. This claim is not supported by scientific evidence and is not otherwise allowed under FDA regulations.
This type of misbranding is especially damaging to the public because it unequivocally links the product to a desired health outcome through multiple uses of the word “heart” and the use of a heart symbol—expressly the type of symbols, third party references and words the FDA references in its regulations and guidance on health claims for the food industry. The FDA should act immediately to investigate The Coca-Cola Company’s unlawful use of this health claim, issue the appropriate warning letter and take enforcement action as necessary.