Sugar Tax: Who is influencing our public health policies?

Post date: 31-May-2016 09:54:29

Here in the UK, the government is working on a sugar tax that could be designed to have a significant impact on the health of our nation. Many people have opinions on this strategy, and while there is evidence to be reviewed from previous attempts around the world, much of it is conjecture as the exact format of any legislation is yet to be decided. Not all opinions are equal though, and the shape and impact of any government legislation is always influenced by a range of stakeholders and this article seeks to examine some of these key stakeholders and how opinions might be influenced.

Earlier this year I was fortunate enough to attend a public lecture on the role of physical activity in public health taken by Professor Greg Whyte. I was impressed by the breadth of his knowledge, his ability to engage and the powerful way in which he advocated for the role of physical activity. I was already aware that he was working with ukactive supporting their stated aim of increasing physical activity levels “to address the nation’s spiraling health costs and personal wellbeing deficit” and it was precisely this passion for the health of the nation that meant I was surprised to hear him say, in what appeared to be an offhand passing comment, that there was no point in the recently announced UK sugar tax. The professor appeared quite adamant in this opinion however no more was said on the topic and I didn't get a chance to ask any more about his views. The development of the UK version of the tax was (and still is) in it’s preliminary stages and most government policies will always have both proponents and detractors, yet I was surprised that his tone seemed quite so dismissive. My interest had been piqued.

Issues such as a sugar tax fall comfortably onto a battlefield of claims and counterclaims. Hard fought skirmishes take place both within and between groups of scientists and marketeers, all vying for attention from politicians, law-makers and the public. It can be hard for a casual observer to discern the truth although one can be pretty sure that both sides of the argument will deploy familiar tactics to further their own case. This battleground has been well documented (Nestle, 2015) and Brownell and Warner (2009) even produced a “playbook” of tactics that the soft drink companies had developed based on the prior experiences of the Big Tobacco companies and their historical battles with public health advocates.

[Brownell & Warner (2009)]

It was with this knowledge that I had a further look at some of the relationships involved in this issue. Ukactive is a representative umbrella organisation, “comprised of members and partners from across the UK active lifestyle sector” and whose “focus is a long-standing and uncompromising vision to get more people, more active, more often.” It has a board of eight directors that includes the CEOs of some large physical activity service providers, Baroness Tanni Grey-Thompson and Dame Carol Black (Prime Minister’s Advisor on Long Term Conditions). There is a more recent second tier of governance that includes the eight members of the ukactive membership council, drawn from education and a further range of physical activity providers. One of the membership posts is identified as being the sector representative for “wider activity providers” and this is currently held by Liz Lowe, (Corporate Responsibility & Sustainability Manager, Programme Director ParkLives, Coca-Cola GB). In addition, and as part of their stated aims, ukactive have set up a scientific advisory board, a team of “renowned academics who will guide the future direction of the institute, provide a sounding board for ideas and ensure the rigour of research and project design” and on 29th April, 2014 a press release announced that Prof Greg Whyte was to be appointed as the chair of this board.

Interested in finding out more about ParkLives, the physical activity scheme that warranted the presence of a senior Coca-Cola employee on the membership council for ukactive, I did some more research. Coke state that their scheme, ParkLives was designed to, “inspire people to get moving [and] will be delivered in partnership with local authorities.” The scheme was set up in 2014 and the helpful foreword in the report for the first year of the programme tells us that, “independent academics on the ParkLives evaluation panel and at ukactive have reviewed [the] data and made recommendations that we and our local authority partners will follow.” Looking back at the press release for the launch of the project it’s reassuring to see that evaluation had been built into the project from the start and that the chair of the ParkLives evaluation committee would be Prof Greg Whyte. This press release is dated 27th May, 2014, just a month to the day after ukactive announced the launch of their new scientific advisory board; a great effort for a new team.

The relationship between academia and industry is complex and both parties increasingly need each other. Academics need to publish research, generate income and demonstrate the broader impact of their work while businesses should quite rightly partner with Universities to support the development of new products and staff. There are, however, darker arts employed by the big corporations and Marion Nestle (2015) cites the support of worthy causes and development of sponsorship and community partnerships as two of the four clear strategies that Big Soda companies have used under the rather euphemistic title of Corporate Social Responsibility. The generous philanthropy of the Big Food companies presents a dilemma for those interested in promoting good public health but has been suggested as a tactic designed to recruit allies and co-opt critics (Nestle, 2015; Hastings & de Andrade, 2016) and create a “health halo” around their brand (Peloza et al, 2015). For some time, and as a pertinent example, Coca Cola had been a partner in the work of the Global Energy Balance Network (GEBN) in the US, an issue which came to a head last year when the GEBN disbanded under pressure from public health advocates.

Part of the fallout from the GEBN collapse last year helped to raise the profile of this issue and Baroness Tanni Grey-Thompson was prompted to respond on behalf of ukactive. Despite events such as the collapse of the GEBN, ukactive still remain in a relationship with Coca-Cola GB where Coke are one of the twenty-two members of the strategic partner group, one of the eight membership councillors and have close ties between themselves and the scientific advisory board of one the largest physical activity advocates in the UK. Looking through the ukactive response signed by the Baroness, Fred Turok is quoted as saying we shouldn’t conflate the issues of fitness and fatness. This was once the mantra of the GEBN and one of its leading lights, Steven Blair, and the coincidence has not been lost on this observer. I’ve spent more than 20 years being an advocate for the health benefits of physical activity so the thought of undermining anyone else’s work in this area is problematic for me. It is however, my own sense of advocacy that frustrates me when I see concerted efforts to promote physical activity being piggy-backed by big corporations to detract from their own negative influence on the health of the public, and in particular sections of the public that are disproportionately from lower socioeconomic backgrounds.

Having close ties with industry does not automatically mean that the research is compromised, however there are well documented biases in funded studies and there are good reasons that the methods, results, interpretation and dissemination methods of funded research all need additional scrutiny. In order to remain a respected advocate for physical activity, ukactive and its scientific advisory board should sever ties with Coca-Cola GB to avoid the inevitable accusations of bias that may in time detract from its very important and worthy public health message. It would also mean that we could have more confidence in the information and opinions that exist around such an important health issue, all of which will have some degree of influence on the shape of the eventual government policy.

This is a personal blog and does not reflect the opinions of my employer. I have no conflicts of interest to state, apart from being interested in the health and wellbeing of my fellow UK citizens. As always on my blog, there has been no peer-review process, however I would like to thank PW for editorial help on this article.

References and further reading

Bellatti, A. (2015) Conflicts of Interest: Real, Important, and Undeniable. Available at

Bes-Rastrollo, M., Schulze, M. B., Ruiz-Canela, M., & Martinez-Gonzalez, M. A. (2013). Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med, 10(12), e1001578.

Brownell, K. D., & Warner, K. E. (2009). The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food?. Milbank Quarterly, 87(1), 259-294.

Hastings, G., & de Andrade, M. (2016). Stakeholder marketing and the subversion of public health. In Spotswood, F. (Ed.) Beyond Behaviour Change: Key Issues, Interdisciplinary Approaches and Future Directions, Bristol: Policy Press. 181-198.

Karnani, A. (2010) The case against Corporate Social Responsibility Wall Street Journal

Ludwig, D. S., & Nestle, M. (2008). Can the food industry play a constructive role in the obesity epidemic?. JAMA, 300(15), 1808-1811.

Mialon, M., Swinburn, B., & Sacks, G. (2015). A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information.Obesity Reviews, 16(7), 519-530. [researchgate]

Nestle, M.(2015). Soda Politics: Taking on Big Soda (and Winning). Oxford University Press, USA.

O'Connor, A. (2015) Coca-Cola funds scientists who shift blame for obesity away from bad diets (New York times blog, 9/8/15)

O'Connor, A. (2015) Research group funded by Coca-Cola to disband (New York Times blog, 1/12/15)

Peloza, J., Ye, C., & Montford, W. J. (2015). When companies do good, are their products good for you? How corporate social responsibility creates a health halo. Journal of Public Policy & Marketing, 34(1), 19-31. [abstract]

Triggle, N. (2016) Sugar tax: How it will work? BBC 16th March, 2016 by Marion Nestle by Yoni Freedhoff

“ukactive: We are not influenced by Coca Cola” (9/10/15, Health Club Management”