We know that sugar-laden soda can cause cavities. So why is the American Academy of Pediatric Dentistry accepting financial support from Coca-Cola?

BY ALLEN D. KANNER AND JOSHUA GOLIN

John Ruby was angry.

So outraged, in fact, that the associate professor of pediatric dentistry from the University of Alabama at Birmingham found himself hanging a provocative poster on the general bulletin board at the American Academy of Pediatric Dentistry’s annual meeting in May 2003. The poster disappeared, and when Ruby put up another, he was told by the executive director of AAPD to take it down or be thrown out of the conference. The poster featured the familiar Coca-Cola logo in a black circle with a thick diagonal line across it, Ghostbusters style. Across the top Ruby had written “Coca-Cola, Nutritional Trash” and had provided information about the high sugar content of the soda and its high acidity, which can rot teeth.¹ Ruby was protesting the $1 million grant from Coca-Cola that AAPD, the nation’s leading pediatric dental association, had accepted in March 2003.²

Along with many other dentists, Ruby was concerned about the spectacular jump in soda intake among children and adolescents that has occurred over the past five decades. Since 1950, per-capita soda consumption in children has increased by a factor of nearly five.³ Many doctors believe this rise in soda consumption is contributing to the rapid increase in obesity and type 2 diabetes that has been observed in American children over the past two decades.⁴ Recent research suggests that soda consumption is also contributing to high blood pressure in adolescents, especially teenagers of color.⁵ Dentists, of course, are concerned about soft drinks and cavities, or caries.⁶

We first met Dr. Ruby when our group, the Campaign for a Commercial-Free Childhood, was collecting signatures from dentists for a letter asking AAPD to return the grant from Coca-Cola. In our letter to AAPD, we noted that it was difficult “to imagine a research funder less appropriate for AAPD than Coca-Cola, the world’s most popular brand of soda.”⁷ We went on to say that the AAPD–Coca-Cola partnership sends a message to the American public that soda drinks are not harmful; if they were, surely pediatric dentists wouldn’t team up with Coke. We wondered if this message did not fly in the face of recent policy statements by the American Dental Association (ADA) and AAPD itself recommending that soda intake be limited, because drinking sugared beverages, as AAPD put it, “contributes to the initiation and progression of dental caries.”⁸, ⁹

In short, we believed AAPD was selling out. Despite its protests to the contrary—AAPD insisted it was not endorsing any of Coca-Cola’s products—the fact remained that Coke could use the grant to counter claims that it did not care about children’s health. AAPD knew Coke was likely to do this when it signed on. But still, we were curious: Did the rest of the dental world share our opinion?

While gathering signatures for our letter, we learned that although many dentists were appalled by the grant, a good number of them were unwilling to challenge AAPD publicly because they feared retaliation. Dr. Oliver Campbell, a 76-year-old dentist in New Jersey who has been in practice since 1959 and who was at the same conference attended by Dr. Ruby, e-mailed us that “I got the feeling that the dentists with university affiliations did not want to speak out. They were afraid that their part-time university teaching or research job would be in jeopardy. . . . How sad.” Dentists in private practice told us they were worried about losing referrals if they publicly criticized the Coke deal.

We also obtained a copy of a letter, dated March 17, 2003, to Dr. David Curtis, then president of AAPD, from Dr. Robert Shaw, then president of the Washington State Dental Association, which said, “Congratulations! In a moment of bad judgment and/or pure greed, you have managed to undermine the efforts of the state [dental] associations to get soft drinks out of schools by legislation or negotiation. . . . The really sad thing about this is that severe damage has been done, and it is permanent. Even if you backed out of the deal today, you have forever undermined the credibility of the dental profession with regard to soft drinks.”¹⁰ 

Dr. Shaw’s letter was referring to Coca-Cola’s and PepsiCo’s practice of signing “pouring contracts” that give beverage companies exclusive rights to sell and market their products in schools. Recently, the Minnesota Dental Association (MDA) vigorously supported a bill to ban soda drinks from schools, only to have the bill killed at the last minute as the result of successful maneuvering by professional lobbyists from Coke and Pepsi.¹¹ As MDA fought Coke, AAPD was taking money from the company.
While AAPD was negotiating the Coke deal, it issued a policy statement on vending machines in schools.¹² We have scrutinized this policy statement, and we’re still not clear if AAPD opposes pouring contracts. In contrast, the ADA takes a clear stand against pouring contracts, and the American Academy of Pediatrics flat-out recommends that “Pediatricians work to eliminate sweetened drinks in school.”¹³, ¹⁴

AAPD has also adamantly reassured its members and the public that the Coke grant will not scientifically or professionally compromise the association. Yet just after the announcement of the grant, Dr. John Rutkauskas, executive director of AAPD, was quoted as saying the role of soft drinks in the development of caries is “certainly not clear.”¹⁵ In October 2003, Dr. Joel Berg, president of the AAPD Foundation—which officially accepted the Coke grant for AAPD—noted on the National Public Radio program Marketplace that “all foods can cause decay. To blame a product for the problem is somewhat inappropriate, given that it’s how the product is used that can cause the problem.”¹⁶ These statements sound more like public-relations spin from a beverage company than the words of highly visible dentists whose priority is children’s oral health.

It seems clear to us that Coca-Cola’s funding of AAPD has already negatively influenced the organization, from silencing dentists who oppose the deal to lessening dentists’ credibility with the public (according to state dental organizations) to spokespeople for AAPD spinning scientific evidence so as to cast doubt on whether soda causes cavities. All of this occurred before AAPD distributed any of the research funds. Further, we have been told by dentists who wish to remain anonymous that millions more in grants might be forthcoming from Coca-Cola in the years ahead. Even the rumor of such pending funding could subtly steer researchers away from studying the role of soda consumption in the development of caries, and toward other topics more likely to be funded with Coca-Cola’s money.

It was painful for us to watch the turmoil that the Coke deal had set off within AAPD, an organization that typically is on the side of children. It was also difficult to witness the convoluted rationalizations and self-serving excuses that AAPD leaders put forward to justify their position, when basically they just wanted the money. We have seen the same process at work when cash-strapped school administrators and teachers deny the harm of selling soda in schools.
AAPD leaders and school administrators are not bad people; rather, we believe, they are well-intentioned individuals trying to support organizations that are strapped for funds. Moreover, Coca-Cola is fully aware of the financial struggles of such organizations. As we have discovered, Coke is continually hunting for opportunities to sink its financial talons into any organization that might even indirectly influence its ability to sell soda at schools. It has successfully pounced on a number of occasions.

COKE ON THE HUNT
Last fall, Coke announced its voluntary “Model Guidelines for School Beverage Partnerships,” a collection of woefully inadequate suggestions that on the surface make it appear as if Coke is limiting its access to children at school, but in reality do nothing to restrict soda sales to middle and high school students, and permit sugar-laden “sports drinks” to be sold to younger students.¹⁷ Coke can also use these voluntary guidelines to forestall the implementation of tough, legally binding guidelines that would in fact reduce or eliminate Coke’s presence in schools.

Consider, for example, that the first recommendation found in the guidelines is that schools continue to sell soda—or, as they state it, that schools “retain the ability to generate needed revenues through partnerships with beverage providers.” Coca-Cola then offers a list of venues it deems appropriate for company logos in schools: “scoreboards, menu boards, coolers, student publications, and materials to promote educational activities, health, wellness and nutritional education, extracurricular activities, physical activity, and athletic events.” In other words, Coke is suggesting that its logo belongs on materials about nutrition given to children.

We should not be surprised that Coca-Cola would produce such self-serving and ineffective guidelines. It is surprising, however, that the guidelines carry the endorsement of several prominent educational organizations, including the American Association of School Administrators, the National Association of State Boards of Education, the National Association of Secondary School Principals, and the National Alliance of Black School Educators.¹⁸ Surprising, that is, until one realizes that over the past several years, Coke has sponsored, contributed to, or funded programs for each of these organizations.

Coke has also used its considerable financial clout to enlist prestigious children’s organizations as allies. It not only routinely contributes to the National PTA, but until recently also had one of its senior vice presidents on the NPTA’s board of directors. Coca-Cola also collaborated with the Boys and Girls Clubs of America (BGCA) to produce a videotape in which Coca-Cola is prominently featured. This is a curious collaboration, in light of BGCA’s “Cavity-Free Zone” program of oral-health education.¹⁹

Coke’s affiliation with national children’s groups gives its products a veneer of respectability far beyond what most of its other marketing efforts could accomplish. It also defangs possible opponents: If dentists, educators, the PTA, and national children’s groups are neutralized, who’s left?
 

THE BIGGER PICTURE
How do companies such as Coca-Cola become so ruthless in promoting their products—and what can be done about it? To answer these questions, we will need to take a brief look at the structure of the modern corporation and the surprising history of corporations in the US. We anticipate that the structural problems we will mention will become of great concern in the near future as people come to realize their enormous impact.

Joel Bakan, a professor of law at the University of British Columbia and an internationally recognized legal authority on corporations, notes in his recent book, The Corporation (now an excellent documentary film), that, by law, CEOs are mandated to put increasing the company’s bottom line above all other goals, and that “the corporation can neither recognize nor act upon moral reasons to refrain from harming others. Nothing in its legal make-up limits what it can do to others in pursuit of its selfish ends, and it is compelled to cause harm when the benefits of doing so outweigh the costs.”²⁰

Dr. Bakan is describing a fundamental flaw in the deep structure of modern corporations—that they are legally bound to pursue profit regardless of the damage they perpetrate. Taking this legal mandate into account, we can say that Coca-Cola is simply acting the way it was designed to act.

Movements are growing, in the US and elsewhere, to address the structure of corporations. These movements are building on little-known facts about corporate history. Corporations in the US have always been chartered (created) by state governments, and always with the mandate that they serve the public interest. Fearing the potential abusive power of corporations, in the late 1700s and into the 1800s, legislatures set strict limits on corporate activity, making it illegal for corporations to own stock in other corporations (no mergers or acquisitions) or to contribute to political campaigns. In addition, businesses could incorporate for only limited periods of time, perhaps 20 years, and could not operate outside particular locations or beyond narrowly defined purposes. If a corporation broke these laws or any others, the state could revoke its charter and shut it down.²¹

Over the years, all of these limitations except those regarding state charters were eliminated. In addition, in the late 19th century, a California court determined that corporations were legal “persons,” a bizarre ruling that became the foundation for vastly expanded corporate powers and protections.²²

To correct the deep structural flaws that characterize modern corporations, many of the historical limits described above need to be reinstated and corporate personhood revoked. For example, had corporate political activity been prohibited, the Minnesota Dental Association would probably have succeeded in winning passage of its bill limiting soda sales in schools. And without legal personhood, corporations could no longer claim that when they manipulate children through marketing, they are exercising their First Amendment “right” to free speech.²³ Thus, one of the most effective ways for parents to protect their children from Coca-Cola’s wide-ranging marketing ploys, and from many other forms of corporate abuse, is to work with groups that are addressing these larger structural issues (see “For More Information” for a list of such groups).

Parents can also take local action. As members of the PTA, they can work with their local chapters to pressure the National PTA to reject funding from Coke. They can also organize resistance to pouring contracts at their children’s schools, either through the PTA or simply as concerned parents. Writing letters to AAPD (we’ve included the contact information in “For More Information”) protesting its acceptance of funding from Coca-Cola, and insisting it not accept future funding, is a quick, easy, and valuable action. So is educating one’s dentist about the Coke grant.

Sending children to school with healthy drinks (not sodas or sugar-laden fruit drinks) is also helpful. So is limiting or eliminating soda consumption at home. But as worthwhile as these actions are, the soda industry would like parents to believe that these individual steps are the only proper ones for parents to take, a stance that conveniently relieves the industry of any responsibility for its role in promoting soda consumption. Given what we have just described—the subtle, complex, and ubiquitous assault on our schools engineered by Coca-Cola—we hope it is clear that collective as well as individual action is necessary to counter the far-flung influence of the soda industry.

Our group, the Campaign for a Commercial-Free Childhood, is concerned about the vast amount of marketing to which children are exposed. Even as we write, Coca-Cola and other corporations are intensifying their marketing to children, nationally and internationally. Because of children’s emotional and cognitive immaturity, they are far more vulnerable than adults to the manipulative messages of advertising. They are likely to actually believe that “Things go better with Coke,” or at least not question the slogan, until childhood obesity, diabetes, high blood pressure, cavities, and other soda-related health problems have left their bitter aftertaste.
 

NOTES
1. John Ruby, phone interview with Allen Kanner (4 June 2004).
2. American Academy of Pediatric Dentists, Partnership to Promote Pediatric Dental Health (3 March 2003): www.aapd.org/hottopics/news.asp?NEWS_ID=210
3. American Dental Association, “ADA Weighs
In on Vending Machines” (February 2002):
www.ada.org/public/media/releases/0202_release02.asp
4. Ibid.
5. Margaret R. Savoca et al., “The Association of Caffeinated Beverages with Blood Pressure in Adolescents,” Archives of Pediatrics and Adolescent Medicine 158, no. 5 (May 2004): 473–477.
6. J. R. Pinkhan, “Soda Pop Controversy/Conspir-acy,” Journal of Dentistry for Children 69, no. 3 (Sep–Dec 2002): 232.
7. www.commercialexploitation.com/saynoto
coke/letter.htm
8. See Note 3.
9. American Academy of Pediatric Dentists, “Policy Statement on Beverage Vending Machines in Schools” (May 2002).
10. Robert Shaw, letter to Allen Kanner (17 March 2003).
11. Healthy Vending Coalition press release, “Broad, Diverse Coalition Formed to Support Legislation Promoting Healthy Choices in Minnesota School Vending Machines” (3 March 2004); www.mmaonline.net/media/04.03.04HealthyVending.cfm
12. See Note 9.
13. See Note 3.
14. “Soft Drinks in Schools,” Pediatrics 113, no. 1 (January 2004): 152–154.
15. Marian Burros, “Dental Group Is Under Fire for Deal,” New York Times (4 March 2003): A-16.
16. “Coke and Dentists,” Marketplace, National Public Radio (22 October 2003).
17. Coca-Cola, “Model Guidelines for School Beverage Partnership” (17 November 2003): www2.coca-cola.com/ourcompany/hal_school_beverage_guidelines.pdf
18. Ben Feller, “Coca-Cola, Education Groups Agree on Guidelines for Drink Sales,” Ledger-Enquirer (14 November 2003): www.ledger-enquirer.com/mld/ledgerenquirer/7264726.htm
19. www.bgca.org/programs/healthlife.asp
20. Joel Bakan, The Corporation: The Pathological Pursuit of Profit and Power (New York: Free Press, 2004): 60.
21. Ibid.
22. Ibid.
23. Thom Hartmann, Unequal Protection: The Rise of Corporate Dominance and the Theft of Human Rights (Emmaus, PA: Rodale Books, 2002).
FOR MORE INFORMATION
American Academy of Pediatric Dentistry
Parents with concerns about AAPD’s partnership with Coke may contact AAPD president Neophytos Savide and executive director John Rutkauskas at American Academy of Pediatric Dentistry, 211 East Chicago Avenue, Suite 700, Chicago, IL 60611-2663; 312.337.2169; www.aapd.org
Coca-Cola’s Business Practices
Corporate Accountability International is leading a campaign to stop Coca-Cola from depleting groundwater supplies in India and thus turning water into an unaffordable luxury for many communities (www.stopcorporateabuse.org).
The Campaign to Stop Killer Coke has organized several successful boycotts of Coke to protest the treatment—including alleged kidnappings and murders—of union organizers at Coca-Cola bottling plants in Colombia (www.corporatecam
paign.org/killer-coke).
Marketing to Children
The Campaign for a Commercial-Free Childhood (formerly Stop Commercial Exploitation of Children) is a national coalition of healthcare professionals, educators, advocacy groups, and concerned parents who counter the harmful effects of marketing to children through action, advocacy, education, research, and collaboration among organizations and individuals who care about children. We support the rights of children to grow up—and the rights of parents to raise them—without being undermined by rampant consumerism (www.commercialexploitation.com).
The Bigger Picture
CorpWatch counters corporate-led globalization through education and activism. It works to foster democratic control over corporations by building grassroots globalization—a diverse movement for human rights, labor rights, and environmental justice (www.corpwatch.org).
The International Forum on Globalization is an alliance of 60 leading activists, scholars, economists, researchers, and writers. The IFG provides analysis, joint activity, and public education in response to economic globalization (www.ifg.org).
POCLAD (Program On Corporations, Law, And Democracy) instigates democratic conversations and actions that contest the authority of corporations to govern (www.poclad.org).
Allen D. Kanner, PhD, is a child,
family, and adult therapist in Berkeley, California, and a cofounder of the Campaign for a Commercial-Free Childhood. He is coeditor of Psychology and Consumer Culture: The Struggle for a Good Life in a Materialistic World and Ecopsychology: Restoring the Earth, Healing the Mind. Along with
his wife, Mary Gomes, PhD, he is raising Cassidy, their newborn daughter.
Joshua Golin, MA, is the action coordinator for the Campaign for a Commercial-Free Childhood and is a graduate student in child development and urban and environmental policy
at Tufts University.