Coca-Cola Has Been Shaping China's Health and Obesity Guidelines for Years

"The efforts of these companies have been global in scope, and they've been this way since the beginning."

There’s one golden rule for preventing obesity: “eat well and exercise.” But what if someone told you the second half of that golden rule is actually the result of decades of corporate lobbying of public health and exercise science by the Coca-Cola Company? It might seem like a wild conspiracy theory, but a pair of papers released Wednesday in The BMJ and Public Health Reports reveal there’s an alarming amount of truth to that statement.

This isn’t to say that exercise is unimportant when it comes to maintaining health and preventing obesity. However, it’s not more important than cutting out unnecessary calories or dietary sugar. But the Coca-Cola Company, working tirelessly through a series of non-profit organizations, has pushed this message in the United States and beyond, as the new papers show.Harvard Professor of Chinese Society Susan Greenhalgh, Ph.D., shows evidence in her paper that Coke has managed to shape the scientific discourse around obesity in China. The company did this, she explains, by providing funding through a global non-profit, The International Life Sciences Institute (ILSI), which was founded in 1978 by Coke’s then-Senior Vice President Alex Malaspina and maintains connections with the company to this day.

“Almost all the work done on obesity in China, it turns out, was sponsored or co-sponsored and run by ILSI-China,” Greenhalgh tells Inverse. “That was quite a dramatic finding.”

coke china
Coke has provided significant funding for obesity research in China that emphasizes activity over nutrition

Greenhalgh’s Findings

ILSI-China provides funding for a variety of research projects, including research on obesity. Through the course of her work, Greenhalgh found that ILSI-China specifically takes annual payments from food and beverage industry partners, including Coke, PepsiCo, McDonald’s and Nestlé. Her BMJ paper indicates that ILSI-China, from 1999 through 2015, was behind the majority of obesity research in China. Greenhalgh adds that this effort served two purposes: It created an avenue for Chinese research into under-studied chronic diseases like obesity, but it also allowed Coke and other industry partners to shape the research to benefit their own interests — similar to how tobacco companies have historically shaped the research surrounding nicotine and addiction. In this case, Coke worked to downplay diet and emphasize exercise.

“Chronic disease in china is a very low priority, they have so many more urgent health issues to deal with,” says Greenhalgh. “So what happened was in 1999, ILSI global wanted to get obesity on the agendas of the ILSI branches around the world. The reason it was so important was that the Senior Vice President of Coke, Malaspina, wanted to design the public health approach to obesity.”

When Greenhalgh interviewed Chen Chunming (now deceased), a former president of ILSI-China who had previously founded the Chinese Academy of Preventative Medicine, Chen doubled down on the organization’s independence from its corporate funders. “Companies know there won’t be any commercial benefit,” she told Greenhalgh. Though Chunming also added that companies do have a forum by which they can influence ILSI-China’s activities:

Every year they support [us] with money, and then have the right to come to our meetings and give many recommendations about our future activities. We contact them twice a year, asking them their ideas about future activities. Then ILSI decides what kind of meeting to hold next.

Greenhalgh’s analysis of ILSI’s sponsored activities suggests that there is indeed a connection between the interests of ILSI’s sustaining members and the scientific activities of the organization. Between 1999 and 2003, she found that 41 percent of ILSI-China’s “activities” — including conferences, training sessions, and media forums — emphasized nutrition, while zero percent emphasized exercise. By 2004, when Coke launched its Take 10! “corporate responsibility” exercise campaign in the United States, ILSI-China’s activities promoting physical activity increased from zero to 36 percent. By 2010, that proportion had increased to 60 percent of all of ILSI-China’s activities.

These activities, Greenhalgh writes, were reflected somewhat in the Chinese government’s official anti-obesity policies, which emphasized the role of activity over diet and showcased ILSI’s industry-sponsored programs like the “Happy 10 Minutes Campaign,” a school exercise program that was developed by the Chinese CDC after it received funding from ILSI’s Center for Health Promotion.

obesity Coca Cola
Greenhalgh tracked ILSI's activities from 1999 through 2015 to show that there was a shift in the types of obesity-related research it emphasized.

ILSI’s Response

In response to the BMJ paper, ILSI’s American branch provided Inverse with a statement emphasizing that ILSI-China, like all other global branches, must conduct research with a minimum of three companies per project to ensure that “no one company dominates the research agenda.” The company also adds that it has “not been perfect in [its] 40-year history,” and adds that it doesn’t attempt to influence policy. ILSI, as of publishing, has not responded to the Public Health Reports paper.

Because of its unique public-private structure, ILSI fills knowledge gaps and serves society in ways that any one entity on its own cannot. ILSI does not lobby, conduct lobbying activities, or make policy recommendations.

Greenhalgh’s analysis indicates that even though this effect might not be part of ILSI’s agenda, there are clear indications of ILSI influencing the science that informs that policy.

“We need to look carefully at what the role is of these corporate responsibility programs,” she says. “It shows that the efforts of these companies have been global in scope, and they’ve been this way since the beginning.”