#32: Candy Crush
Coca-Cola, the Olympics, and an excess sugar crisis.
Trouble in Paris
In just a few days, the 2024 Summer Olympics will come to a close. So far, some of my favorite moments from Paris include:
Simone Biles capturing 4 medals (3 gold, 1 silver) in gymnastics, returning to dominance after pulling out of the Tokyo Olympics to prioritize her mental health—no twisties this time around.
Novak Djokovic finally winning a gold medal on his fifth time of asking, adding the final accomplishment to his now completely unblemished tennis resume—the GOAT, don’t @ me.
Kristen Faulkner besting the rest of the field in cycling, a sport she picked up just six years ago as an outdoor hobby between her venture capital job—whaaaaaat.
Over the past few weeks, we’ve seen the fittest humans on earth compete against one another, showing why they are, well, superhuman.
But yesterday, the Olympics made headlines, not for Katie Ledecky winning the 800m freestyle again, or Noah Lyles’ 100m photo finish, but for pushback over the Games’ main corporate sponsor: Coca-Cola.
An editorial published in a leading global health journal accused Coca-Cola of sports washing the known consequences of consuming sugar-sweetened beverages (SSBs) and called for the Olympics to end the century-long partnership. The authors correctly scrutinize Coca-Cola’s aggressive marketing strategies that “undermine” the national effort to reduce excess sugar consumption.
Olympians have a huge influence over consumers' health behaviors around the globe; therefore, it makes ZERO sense for the healthiest people on the planet to partner with a beverage that directly contributes to our chronic disease crisis.
Coke is the longest-standing sponsor of the Olympic Games, paying $93m annually to the International Olympic Committee and another $20m every four years to associate themselves with the 10,000+ athletes participating. With the money, Coke not only gets to be the Olymics’ exclusive non-alcoholic beverage partner but also reaches the billions of spectators streaming the event.
Sweetness Overload
Coca-Cola’s core product has changed since it first sponsored the Olympics back in 1928. It replaced its original health hazard—cocaine—with a new one—53g of sugar.
The verdict is still out on whether excess sugar consumption alone causes chronic disease—it may just be a risk factor for obesity, which is much more strongly associated with virtually all chronic conditions.
A 2023 review effectively puts the current evidence into perspective:
Diabetes: Some studies show a positive association between excess sugar consumption and type-2 diabetes, though effects are often intertwined with weight gain and obesity.
Cardiovascular Disease: The relationship between sugar and heart health is complex, so the direct link to sugar alone is not as strong. Still, excess sugar contributes to risk factors for cardiovascular disease.
Cognition and Memory: High sugar intake has been linked to poorer memory and cognitive function, especially in older adults.
Microbiome and Gut Health: Diets high in sugar cause dysbiosis and inflammation, but the exact mechanisms and long-term impacts on human health are still being investigated.
Sugar Tax
Without overcomplicating the literature, excess sugar is bad for you. And with Americans each consuming nearly 100 lbs of sugar per year—with 60 of those pounds coming from added sugars—we have to find a way to reduce consumption.
Countries like Thailand, the UAE, and Canada all have sugar taxes on products with lots of sugar. In 2014, Mexico was among the first countries to introduce such a tax and created a warning label on products that exceed a certain sugar content.
We don’t have a similar mandate in the US, but some cities like Seattle, WA, Boulder, CO, and Washington, D.C. have implemented a soda tax—a sugar-sweetened beverage (SSB) excise tax on soft drinks, juices, and teas—and report cost savings, improved health outcomes, and changes in consumer behavior.
A one-cent-per-ounce tax in Oakland added 94 quality-adjusted life years and yielded over $100,000 in healthcare savings per 10,000 residents.
In a population of over five million pregnant individuals, a soda tax reduced the risk of type-2 diabetes and unhealthy weight gain while also preventing a low birth weight of their newborns.
From 2012 to 2019, sales of sugary drinks fell by 33% in cities implementing an SSB tax.
Lawmakers might be more willing to impose a soda tax than a total sugar tax considering most of the added sugar in the American diet comes from sugar-sweetened beverages.
Within SSBs, soft drinks like Coca-Cola are most consumed.
Though sugar taxes have been effective at reducing sugar consumption in the rest of the world, the US is usually (and unfortunately) an outlier when it comes to chronic disease. I previously wrote a separate piece on nutrition policy, a version of an Op-Ed I published for Emory University’s Human Health blog. As part of my research, I asked (via email) Marion Nestle, NYU Professor of Nutrition, Food Studies, and Public Health, if she thought a sugar tax could work in the US.
“Sugar is already twice as expensive in the US as it is anywhere else. A tax might help reduce consumption but chronic disease rates will only fall if people reduce calorie intake relative to expenditure.”
— Marion Nestle, Author of award-winning books including What to Eat and Food Politics: How the Food Industry Influences Nutrition and Health.
Sweeter Alternatives
Whether a sugar tax seems like a good idea or not is becoming less important, since many products have already shifted to using alternative sweeteners. Unfortunately, the public health guidance on these sugar substitutes is even more all over the place than with sugar itself, fueling ongoing consumer skepticism of nutrition science.
Remember aspartame, the artificial sweetener used in Diet Coke and Coke Zero?
Here’s what three different public health agencies have to say about it:
International Agency for Research on Cancer (IARC): Aspartame is possibly carcinogenic, as it could cause liver cancer.
World Health Organization (WHO): Non-nutritive sweeteners like aspartame do not offer long-term benefits in reducing body fat in children or adults, and increase the risk of diabetes, heart disease, and mortality in adults.
Food and Drug Administration (FDA): The FDA does not have safety concerns about aspartame when used under approved conditions—aspartame is one of the most studied food additives in the human food supply.
And aspartame aside, there’s a whole other gamut of artificial and natural sweeteners, each with its own broad spectrum of public health advisory.
Sugar Crash
Despite the confusion, consumers still want to consume less sugar in their diet, creating an opportunity for products touting zero sugar to shine. The zero-sugar food and beverage market is expected to grow from $19.17B (2023) to $23.30B (2028).
The zero-sugar beverage market specifically is set to quadruple from $3.3B to $13.2B over the next decade.
Looking to replace the Gatorade-Zeros, Body-Armor Lytes, and Coke-Zeros of the world, new better-for-you beverage brands are making drinks that taste good—but not at the expense of consumer health.
Olipop sells prebiotic-rich soda alternatives that contain just 2-5g of sugar per can—likely hitting ~$500m in sales by the end of the year.
Liquid Death tapped Ozzy Osbourne in a recent ad featuring “death dust,” the canned water brand’s new electrolyte powder—reaching a $1.4B valuation following their last funding round.
Odyssey Elixir’s mushroom-based energy drinks boast ingredients like adaptogens and nootropics, with minimal sugar content—raising a $6.3m Series A in February.
GLP-1sssssss
The rise of GLP-1s has created the conditions needed for better-for-you CPGs to thrive. People who feel less hungry from taking these pills are increasingly looking for low-sugar and low-calorie options.
GLP-1s also demand a whole new level of nutrition education and support. Consumers must make smarter nutritional decisions to sustain the weight loss effects of GLP-1s long-term.
Startups improving nutrition education and increasing access to dietitians are also poised to become more valuable in the era of weight loss drugs:
Fay’s business-in-a-box model enables registered dietitians to operate as independent practitioners, making five to eight times more money using the platform.
Bitewell’s food “farmacy” personalizes digital grocery shopping based on members’ health conditions through a B2B model.
Culina Health offers insurance-covered one-on-one nutrition counseling, pairing patients with RDs.
Foodsmart just raised $200m to scale its telenutrition services to continue addressing food insecurity.
Final Thoughts
Above, I describe some of the emerging opportunities that come with GLP-1s, another one being the increased demand for strength training solutions—whether digital or in-person—to counter muscle loss side effects.
Still, those urging the Olympics to “cut ties” with Coca-Cola are on to something. Imposing a sugar tax, selling more zero-sugar products, and democratizing access to dietitians can only do so much in curbing diet-related chronic diseases.
To really move the needle, sporting events and athletes need to stop partnering with ultra-processed and sugary food brands. I’m certain Nestle would also agree because when I asked her about policy implementations that would be most effective, she said:
“I would like to see a ban on marketing anything to children—full stop. And this means TV, social media, sports, and music promotions.”
Elsewhere, school lunches are still in desperate need of a nutritional makeover. Considering this alongside blocking food industry marketing to children, it’s clear that reducing sugar overconsumption in kids will likely have a trickle-down effect on health that lasts generations.
When I think about these trickle-down effects, I find the relationship between diet and mental health most compelling. Considering that 90% of serotonin is made in the gut, the gut-brain axis is a substantial mediator of mood and risk of depression and anxiety. Whether the gut is nurtured or neglected through poor or proper nutrition will partially determine if the youth mental health crisis will remain just that, a crisis.
What I’m reading this week:
Who wears wearables?, Rock Health
Lawmakers cast doubt on expert panel studying alcohol for 2025 dietary guidelines, STAT
How the restaurant drama ‘The Bear’ mirrors working in a hospital, STAT
Co-pays block inmates from accessing health care: study, Axios
Wear This AI Friend Around Your Neck, WIRED
Who do you think would be an ideal main sponsor of the Olympics?
Speaking of GLP1s, I thought interesting that Lilly was a sponsor. I see it as a medicine company (disease mitigation), less so a health company.
What health companies are large enough to take this global responsibility?