Sodas, sports drinks and other sugary beverages are an unhealthy choice for kids, according to the nation's leading pediatricians' group, which strictly opposes the sale and advertising of the products in schools.
Yet Coca-Cola's Live Positively slogan and the soda-maker's familiar red-and-white logo pop up on the American Academy of Pediatrics' consumer education website, healthychildren.org, in a corporate sponsorship that some health experts denounce as a serious conflict of interest.
In response to criticism that their products are fueling the obesity epidemic, Coca-Cola, PepsiCo and other major players in the food and beverage industry have pledged to be part of the solution. In addition to promoting balance, moderation and physical activity, the companies are forming controversial partnerships with the public health sector, including advocacy organizations and professional medical associations such as the pediatricians' group and the American Academy of Family Physicians.
Coca-Cola's Sprite Zero is a national sponsor of the American Cancer Society's Choose You campaign, which encourages women to make healthy lifestyle choices. For five years, Diet Coke has been a corporate partner in a heart disease awareness campaign, Heart Truth, run by the federal National Heart, Lung and Blood Institute. Coca-Cola, PepsiCo and the Hershey Center for Health and Nutrition are official sponsors of the Academy of Nutrition and Dietetics, the nation's largest organization of food and nutrition professionals.
Proponents of such collaboration say addressing the complex problem of obesity requires the type of public-private partnership advocated by first lady Michelle Obama in her Let's Move initiative. Rather than working separately, the argument goes, it's better to use the food industry's resources, such as its dramatic reach and persuasive marketing skills.
"We believe in healthy people; when they're healthy and happy, that's the best thing to do for the long-term health of the business and the right thing to do," said Celeste Bottorff, vice president of Living Well, Coca-Cola North America. Partnerships with the medical community help present a balanced picture of what the science says about diet and exercise, Bottorff added.
But the alliances can threaten the credibility and mission of groups working to improve health. The associations buy for corporations legitimacy, consumer loyalty and positive branding, which benefit a company's top priority: making money for shareholders, according to an editorial published last year in the Canadian Medical Association Journal.
"An organization is not doing its job if it doesn't look at public perception and public trust," Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston, said in an interview. "Trust is a delicate matter that often depends as much on appearance as on reality."
Cash-strapped nonprofits and medical organizations often partner with industry because they need the money, Brody said.
Groups that do so can avoid conflicts of interest if appropriate firewalls are in place, said Dr. Jatinder Bhatia, chairman of the American Academy of Pediatrics' Committee on Nutrition, adding that working together allows the public sector to help influence the private sector.
"Coke is so popular that if we can, over time, get them to create healthier products or healthier messages, then we have won," said Bhatia, chief of neonatology at Georgia Health Sciences University. "Coke's Live Positively initiative aligns with healthychildren.org: to improve the health of children through educational resources. It doesn't say, 'Drink Coke.'"
Critics disagree. They say Coca-Cola's presence on a medical website subliminally reinforces the notion that Coke is good, which is what the company wants.
"It's totally inappropriate for the AAP to have a Coke logo on its website," said Corinna Hawkes, a food policy and public health specialist. "Coca-Cola's leading brand remains full-calorie Coke."
And while the partnership may enable the organization to maintain its website without raising members' dues, the implied endorsement "obscures the broader message that children and families should reduce their intake of full-calorie soft drinks," said Hawkes, a fellow at the Center for Food Policy at City University in London.
In the fight against obesity, the food industry has a mixed record, public health watchdogs say. Some food manufacturers recently persuaded Congress to declare tomato sauce on school lunch pizza to be a vegetable, which appalled those fighting to improve childhood nutrition. Industry-funded groups lobby against obesity-related health campaigns and against legislation banning junk-food marketing to children. The industry also fights soda taxes that could raise revenue for municipal health initiatives.
At the same time, after losing battles at the local and state levels, manufacturers supported federal action to remove sugary drinks from schools. Coca-Cola and PepsiCo are aggressively funding physical activity programs and reformulating certain products to reduce the salt, fat and sugar content. PepsiCo scientists are working on ways to reduce sodium content in products; Coca-Cola was a leader in new calorie labeling.
"From the outside, it often seems that progress isn't fast enough," said Derek Yach, PepsiCo's senior vice president of global health. Yach, who went to PepsiCo from the public health sector, works with international policy, research and scientific groups. "From the inside, every step represents commitment and time.
"Consumer behavior in the food area takes a long time to change. It's not like you can wave a magic wand and shift from high-calorie to low-calorie beverages. Consumer preferences are built up over decades."
Michele Simon, a public health attorney and advocate, said the companies' health initiatives only shift the focus away from "democratic and scientific public policy solutions."
"Food companies are masters at turning criticism into marketing opportunities and at getting us to give them credit for addressing problems they created in the first place," Simon wrote in her book "Appetite for Profit." "They work by co-opting the conversation."
One of the most heated discussions involves whether the food and beverage industry should financially support research and education. PepsiCo has funded a nutritional science fellowship at the Yale School of Medicine; Coca-Cola has sponsored a number of public health programs at the University of North Carolina's Gillings School of Global Public Health.
Shortly after a soda tax was proposed in Philadelphia, the American Beverage Association donated $10 million to Children's Hospital of Philadelphia to fund childhood obesity research. The beverage association was instrumental in lobbying against the 2-cent tax, which was designed to raise about $20 million for obesity-prevention programs plus money for the city's general fund.
In 2010, the American Academy of Family Physicians angered some of its members when it partnered with Coca-Cola to help develop educational content on beverages and sweeteners for familydoctor.org, the group's consumer health and wellness resource.
The Coca-Cola Beverage Institute for Health and Wellness sponsors continuing professional education for registered dietitians, nurses and other professionals. For the nutrition-related Web seminars, Coca-Cola selects the relevant health topics, which range from hydration and bone health to active lifestyles and the safety of non-nutritive sweeteners. Coca-Cola then invites top experts to create and present the content, Bottorff said.
"Large corporations are here to stay. If we partner with industry to educate health care professionals, we're expanding our reach to fight the obesity epidemic, which to me is a good thing," said Lynne Braun, a professor of nursing at Rush University Medical Center who co-presented a Coca-Cola-sponsored Web seminar on women's heart health.
Last fall, Vive en Forma (Get Fit for Life), a Kildeer-based grass-roots organization serving Latino communities, took an interactive education booth to festivals, health fairs and grocery store parking lots in the Chicago area. The wellness events, which featured family fitness and nutrition activities and measurements of body mass index, were made possible by a $75,000 grant from the Coca-Cola Foundation.
Teresa Farias Latter, president of Vive en Forma's board of directors, acknowledged that Coca-Cola and other companies sell products that could contribute to the high rates of diabetes and obesity in the Latino community. On its Facebook page, "fruit drinks and other sugar sweetened beverages" are listed as "worst foods to eat."
But like many caught in the middle between funding and health education, Latter sidestepped the issue.
"At the same time, they have products that can help," she said, citing water.
"We don't tell people to avoid soft drinks," she added. "Our philosophy is, 'Here are the better things to be doing in life: Be careful about fat, be careful about sugar and be active.' It's a combination of eating right and activity."
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