As Georgia’s top public health official, Brenda Fitzgerald led the fight against childhood obesity in a state with one of the highest rates in the country. The program there, funded in part by the Coca-Cola Foundation, emphasizes exercise and makes little mention of the problems with sugary soft drinks — putting the effort at odds with research and the positions of many experts.
Now that Fitzgerald is director of the Centers for Disease Control and Prevention — the country’s top public health official — some public health advocates are concerned that she could incorporate Georgia's approach into the national battle against obesity.
“We hope Dr. Fitzgerald, as head of CDC, avoids partnering with Coke on obesity for the same reason she would avoid partnering with the tobacco industry on lung cancer prevention,” said Jim O’Hara, director of health promotion policy at the Center for Science in the Public Interest.
Public health advocates and researchers have characterized Coca-Cola’s strategy as deflecting public attention from the links between sugary drinks and a host of health problems, including obesity, diabetes and heart disease, by focusing on exercise and offering grants “to buy friends and silence potential critics,” O’Hara said.
To be sure, exercise and physical activity are beneficial for a broad range of health conditions.
“I’m totally for physical activity programs,” said Marion Nestle, a nutrition professor at New York University. “Unfortunately, they don’t do much for obesity. It takes a lot of activity to compensate for excess calories.”
Fitzgerald, who is a physician, was named director of the Atlanta-based CDC last Friday. Agency officials said she was not available for interviews this week. Coke’s funding of the Georgia program was first reported in the Intercept.
She began serving on Georgia's newly created advisory council on childhood obesity after becoming commissioner of the state's public health department in 2011. The council is a public-private partnership with members from government, academia, philanthropy and business, and in the past, its members have included two executives from the Coca-Cola company.
The council's program, Georgia SHAPE, launched in 2012. The state ranked second in the nation for childhood obesity that year. It currently ranks 17th, according to the Trust for America's Health's 2016 obesity report.
Since its start, Georgia's special initiative has received more than $57 million to fight childhood obesity through promotion of nutritious foods and physical activity, according to a state public health department spokeswoman.
The spokeswoman said funding sources include federal grants, in-kind services and private grants and sponsorships from Georgia businesses and organizations such as the Coca-Cola Foundation, Royal Foods, Centene/Peach State, and the Arthur M. Blank Family Foundation. A spokesman for Coca-Cola said the foundation has provided $1 million in grants.
The program encourages elementary schools to add 30 additional minutes of daily exercise. In an April 2013 column still featured on Coca-Cola’s website, “Solving Childhood Obesity Requires Movement,” Fitzgerald said youngsters needed to move more. “We’re not talking about trying out for the football team or preparing for the Olympic Games,” she wrote. “We’re talking about walking a mile and touching your toes.”
Her only reference to food or beverages was an exhortation for children to eat five or more fruits and vegetables a day.
On Wednesday, CDC spokeswoman Kathy Harben noted in a statement that the “Georgia Shape partnership work includes promotion of both physical activity and better nutrition.” She continued: “At CDC, as at the Georgia Department of Public Health, Dr. Fitzgerald recognizes that public-private partnerships can be powerful tools that help extend public health’s reach and ability to save lives, solve problems and speed innovation.”
As to whether Georgia's approach, with Coca-Cola's involvement, is one that Fitzgerald might model at the CDC, the statement said: “CDC has a focus on scientific integrity and a deep commitment to ethical, innovative partnerships that advance the agency’s lifesaving mission.”
CDC's website on obesity emphasizes physical activity as well as a healthy diet, including following dietary guidelines to limit eating foods and beverages with added sugars.
Ben Sheidler, a spokesman for Coca-Cola, said the company's position on obesity has shifted in recent years to address sugar consumption specifically. Coke supports the World Health Organization's recommendation that people limit their intake of added sugars to no more than 10 percent of their total daily calorie intake, he said. That's why it now offers smaller-sized drinks and is making more low- and no-sugar drinks available, along with clearer nutritional information, “so people can make more informed choices for themselves and their families without the guesswork,” he said.
Nationally, there has been growing public concern about beverage companies using philanthropy to fend off public health and regulatory policies that aim to limit soda consumption. CDC itself was criticized in 2016 for two officials' connections to Coca Cola.
Yet some public health groups say industry must be part of the solution. Former first lady Michelle Obama’s Let’s Move initiative engaged the food and beverage industry as well as public health advocates. The initiative tried to work with food and beverage companies to promote voluntary limits on marketing of “lower-value nutrition” foods and beverages — with limited results, public health analysts said.
A policy expert for a national advocacy group said state health officials often try to find common ground with industry in the fight against obesity, such as emphasizing exercise and promoting healthy eating in general.
“It’s politically safe to talk about physical activity and eat good stuff. That’s the norm,” according to the expert, who spoke on the condition of anonymity because she said she didn't have enough information about Georgia's program. “I wouldn’t expect many health officers to be out there railing against Coke. It’s what you’d expect from almost any state health officer from a red state.”
More worrisome, others said, are the Trump administration’s proposed cuts to CDC. The fiscal 2018 budget would cut CDC by more than $1 billion, with reduced funding for chronic disease prevention and the elimination of funding for several programs. Those include the division of nutrition, obesity and physical activity and the Million Hearts program, an initiative to prevent heart disease, stroke and other cardiovascular diseases.
Alice Crites contributed to this report.