Chicago: University of Chicago Press, 2024. US$25.00, paper. ISBN 9780226834733.
Soda Science is Susan Greenhalgh’s well-researched and riveting account of how the Coca-Cola Company (in this context, Coca-Cola), operating through ostensibly independent scientific groups, convinced Chinese health officials to focus on physical activity (“move more”) rather than dietary intake (“eat less” or “eat better”) as policy strategies to prevent obesity. Greenhalgh, as a social anthropologist specializing in China, is uniquely equipped to tell this hitherto unrevealed story. By “soda science,” Greenhalgh refers to Coca-Cola’s deliberate sponsorship of researchers, nutrition scientists, and nutritionists to convince them to exonerate sugar-sweetened beverages from blame for contributing to weight gain, obesity, and obesity-related chronic diseases—and to cast doubt on any research suggesting otherwise.
In this book, Greenhalgh presents the evidence for these contentions in two parts. Part 1 deals with Coca-Cola’s financial relationships with two organizations in the United States, the now-defunct Global Energy Balance Network (GEBN), and the International Life Sciences Institute (ILSI, since renamed the Institute for the Advancement of Food and Nutrition Sciences). GEBN was an organization formed by several well-established nutrition scientists and exercise physiologists for the express purpose of promoting physical activity as the best means to lose weight, despite overwhelming evidence to the contrary. Yes, physical activity is essential for good health, but the amount of exercise performed by all but the most elite athletes does not expend nearly enough calories to affect weight; reducing calorie intake works far better. In 2015, a front-page investigation by the New York Times revealed that GEBN was funded entirely by Coca-Cola, causing the group to disband, and forcing Coca-Cola to revise its policies for supporting research.
ILSI, however, is far more important to this story. It is a quintessential industry front group, although it hides that fact better than most. It was originally created by Coca-Cola in the late 1970s to ensure that nutrition science promoted the interests of food corporations, and has always been funded by “Big Food” corporations. In the United States, ILSI has tended to keep a relatively low profile but has never missed an opportunity to promote the interests of its food-industry sponsors, most notably Coca-Cola. Nevertheless, ILSI positions itself as an independent scientific think-tank prizing scientific integrity above all other values. Hence, front group.
ILSI’s self-proclaimed integrity has attracted many nutrition scientists to its committees, position papers, research studies, and research journal. When ILSI first began paying attention to obesity, its efforts focused on diet as well as physical activity. But as Coca-Cola became increasingly involved in the direction of such efforts, ILSI shifted its focus to physical activity.
In recent years, much of ILSI’s work has been global, and the group has long been suspected of nefarious influence on the food and nutrition policies of international governments. Because such influence generally occurs in private and behind the scenes, it has been difficult to document, let alone prove. Thus, an outstanding contribution of this book is the evidence it provides about precisely how ILSI was able to exert policy influence in one country, China.
The second part of Soda Science relates how ILSI, working through personal connections (guanxi) at the highest levels of the Chinese Ministry of Health, convinced the Chinese government to ignore diet as a cause of obesity and instead target physical activity as the preferred obesity-prevention measure. Greenhalgh presents an intimate, first-hand account of how ILSI managed this, and at the same time offers much broader points about how corporations are able to influence government science and health policies.
Greenhalgh was able to do this by using the basic methods of social science: interviews with Chinese officials and other key informants, qualitative analysis of the content of these interviews, and further analysis of diligently searched published materials from ILSI-China and other relevant documents. If this book does nothing else, it illustrates the superb power of qualitative research methods to obtain information impossible to discover in any other way.
Soda Science demonstrates beyond question that China’s anti-obesity policies were influenced by Coca-Cola, working through its Chinese ILSI front group. The documents show how Chinese members of ILSI were able to convince high-level health officials to ignore public health measures to improve dietary intake, and to exclude from consideration anything like taxing sugary beverages, removing them from schools, or putting warning labels on them and restricting their marketing to children, as some countries in Latin America have done. For China, the lack of attention to these and other anti-obesity policies is a lost opportunity.
For those of us who have long followed ILSI’s efforts in the United States, the findings of this book are revelatory about how this organization operates on the ground. It is hard enough to get information about ILSI’s actions in the United States, but even less is known about its actions in low- and middle-income countries. Because of Soda Science, we now know more about ILSI in China than we do about how this group operates anywhere else. This book is a compelling account of how Coca-Cola used ILSI to keep China from considering policies that might affect its profits. As an in-depth qualitative study, it makes an invaluable contribution to our understanding of how food companies use front groups to achieve policy objectives.
Marion Nestle
New York University, New York City