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Coca-Cola and obesity: study shows efforts to influence US Centers for Disease Control

BMJ 2019; 364 doi: (Published 30 January 2019) Cite this as: BMJ 2019;364:l471
  1. Gareth Iacobucci
  1. The BMJ

Correspondence between the Coca-Cola Company and the US Centers for Disease Control and Prevention (CDC) has revealed Coke’s efforts to influence the agency’s approach to tackling obesity, a new study has found.

Published in the Milbank Quarterly,1 the paper said that emails reveal Coke’s interest in “gaining access to CDC employees, to lobby policymakers, and to frame the obesity debate by shifting attention and blame away from sugar-sweetened beverages.”

The emails also demonstrate Coke’s efforts to “advance corporate objectives, rather than health, including to influence the World Health Organization,” says the study.

FOI requests

The paper follows an investigation published by The BMJ last month,2 which showed how Coke had shaped obesity science and steered public health policy towards its own interests in China.

The latest study was based on emails and documents obtained through the US Freedom of Information Act by the campaign group US Right to Know, which lobbies for transparency in the food industry.3 It was jointly conducted by researchers from the London School of Hygiene and Tropical Medicine in the UK, Bocconi University in Italy, and US Right to Know.

The team sent 10 freedom of information requests in 2016-17 for communications sent between employees at the CDC and Coca-Cola. It then carried out a thematic content analysis of the documents provided. Of the 10 requests, three are still pending, five were rejected for being too broad or because no records were found, and three returned 295 pages from 86 emails. The CDC withheld 102 pages to “protect commercial or financial information which is privileged or confidential.”

US Right to Know sued the CDC last year over its failure to release further correspondence between agency officials and current or former Coke employees,4 and the legal action is ongoing. The CDC has faced criticism in recent years for its links to manufacturers of unhealthy products including sugar sweetened drinks.5

Gary Ruskin, co-director of US Right to Know and coauthor of the paper, said, “It is not the proper role of the CDC to abet companies that manufacture harmful products. Congress should investigate whether Coca-Cola and other companies that harm public health are unethically influencing the CDC and subverting its efforts to protect the health of all Americans.”

“Clear conflict of interest”

Martin McKee, coauthor and professor of European public health at the London School of Hygiene and Tropical Medicine, said, “Once again we see the grave risks that arise when public health organisations partner with manufacturers of products that pose a threat to health. Sadly, as this example and more recent ones in the United Kingdom show, these risks are not always appreciated by those who should know better.”

The paper concludes, “It is unacceptable for public health organizations to engage in partnerships with companies that have such a clear conflict of interest. The obvious parallel would be to consider the CDC working with cigarette companies and the dangers that such a partnership would pose. Our analysis has highlighted the need for organizations like the CDC to ensure that they refrain from engaging in partnerships with harmful product manufacturers lest they undermine the health of the public they serve.”

A CDC spokesperson said, “CDC believes that public health and scientific advancement are best served when information is shared among other public health agencies, academic researchers, and private researchers in an open, timely, and appropriate way. CDC professionals have numerous opportunities and extensive ethical and science-integrity checkpoints internally and externally that work to balance its guidelines and recommendations.”

A spokesperson for the Coca-Cola company said, “Over the past four years, the Coca-Cola Company has been on a journey to be a more helpful and effective partner in efforts to address the issue of obesity. We’ve listened closely to those in the public health community and other stakeholders to better understand the most appropriate role we can play to support the fight against obesity in a way that is credible, transparent, and beneficial for everyone, and we have evolved our approach.”


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