People of color are dying from Covid-19 in America in shocking numbers, victims to a disease that attacks those in poor health the hardest.
This disparity is part of the systemic racism that has driven many protestors to the streets over the last few weeks, flaming with anger over the injustices of police brutality and social inequities.
Back at home, they returned to the barrage of ads on television and social media designed to entice them to drink sugary beverages, a leading cause of obesity, type 2 diabetes and heart and kidney disease -- the very conditions that put minorities at high risk of dying during the pandemic.
"If Covid-19 teaches us anything, it's that this kind of marketing has to be stopped," said nutrition researcher Marion Nestle, who has authored numerous books on food marketing, including 2015's "Soda Politics: Taking on Big Soda (and Winning)."
Yet the amount of money spent on such advertising exceeded a billion dollars in 2018, according a new report released Tuesday from the Rudd Center for Food Policy & Obesity at the University of Connecticut entitled Sugary Drinks FACTS 2020.
A billion dollars in one year
"Beverage companies spend a tremendous amount of money on marketing for one reason -- it works," said Sara Ribakove, a policy associate at the Center for Science in the Public Interest, which published a scathing analysis of beverage marketing tactics in 2013.
"Targeted marketing, spread across various platforms such as websites, apps, television and others, contributes to and exacerbates health disparities," said Ribakove, who was not involved in the RUDD study.
A 12-ounce cola drink has about 39 grams of sugar -- so just one soda provides more than the recommended limit -- less than 25 grams of sugar a day. While sports drinks have less sugar, about 21 grams, that's still a day's allowance and the drinks have been linked to obesity, type 2 diabetes and cardiovascular disease.
What about the need for sports drinks to replenish electrolytes like sodium and potassium after a workout? That is a myth when it comes to most of us, experts say: Only extreme athletes need that sort of hydration. The rest of us do just fine with water.
Energy drinks, while sporting much less sugar than their rivals, contain potentially dangerous stimulants such as caffeine, guarana, taurine, ginseng, l-carnitine and creatine. They have been linked to anxiety, dehydration and other serious side effects in youth. There have even been deaths among youth with underlying heart conditions.
Targeting the young
Black and Hispanic youth, who have higher rates of sugary drink consumption than non-Hispanic White youth, were often the primary targets of advertising campaigns, the study found, especially for regular non-diet soda, sports and energy drinks.
"Black kids are seeing more than twice as many ads than White kids see," said study author Jennifer Harris, a senior research adviser for the Rudd Center for Food Policy & Obesity at the University of Connecticut.
"Sugary drinks are some of the most frequently advertised products on Black targeted television," Harris said, adding that marketing dollars on Spanish-language television rose to $84 million in 2018, an increase of 80% since 2010.
"This is about profits," said health inequity researcher Lori Dorfman, an associate adjunct professor of health and social behavior at Berkeley Public Health in California, who was not involved with the study.
"Soda companies target kids of color because that's where the growth market is but also because they are cultural trendsetters so they shape the White youth market too," Dorfman said.
"The youth market is important because the brands kids become loyal to as children stay with them through adulthood and become what they bring home to their children," she added.
"We know that sugary drinks contribute to life-shortening chronic diseases like diabetes, heart disease, fatty liver disease, and obesity," said American Academy of Pediatrics spokesperson Dr. Natalie Muth, lead author of the AAP's policy statement on sugary drinks.
"The fact that so much money is spent to get minority teens hooked on these drinks is reprehensible and more needs to be done to stop it," Muth said, adding that AAP recommends an "excise tax should be placed on these drinks and the proceeds committed to efforts to improve health equity and reduce disparities."
Using youth idols
The RUDD report found that sugary drink advertising was primarily driven by Coca-Cola and PepsiCo brands, including Coke, Gatorade, Powerade and Mountain Dew.
PepsiCo increased their sugary drink advertising by 28% from 2013 to 2018; Coca-Cola spending increased by 81% during that time period as the two giants battle for control of the market.
The campaigns often used Black and Hispanic celebrities and sports figures that youth idolize to carry the message, the report said. Many such campaigns continue today.
Mountain Dew, owned by PepsiCo, ranked first in numbers of ads viewed by youth. Most of the campaigns feature sports celebrities such as "The Dew Team," extreme sports and rock concerts, among other teen-oriented appeals, the report said.
Locked in a battle for sport drink supremacy, Coca-Cola focused on the Hispanic youth market with Powerade. The brand also receives endorsements from the US Women's National Soccer Team and promotes young women athletes with their "Power has no Gender" campaign.
The second biggest spender was PepsiCo, spending $134 million in 2018 to market Gatorade, mostly to Hispanic and Black youth, the report found. Gatorade ranked third in ads viewed on Spanish-language television, and Black teens saw 2.8 times as many ads for the brand as White teens.
Gatorade has contracts with such major athletes as Michael Jordan, Mia Hamm, Peyton Manning and Serena Williams The brand also sponsors promotions aimed at high school athletes, including Gatorade's "Player of the Year" awards honoring high school athletes from all sports.
"When we've done focus groups with Black and Hispanic kids, they love those Gatorade ads. They are so inspirational and so they're very effective," Harris said.
None of this is new, of course. It's common for food and beverage companies to leverage the influence of sports figures and other celebrities "to promote unhealthy food and beverage products to young people and communities of color," said Omni Cassidy, a postdoctoral fellow in the department of population health at NYU Langone Health, who has researched the role of music and sports celebrities in childhood obesity.
The millions of dollars offered by these companies is difficult for anyone to turn down, especially athletes of color who want to give back to their communities with their earnings, "even if consuming the food and beverage does not align with sports figures' own values and lifestyle," said Cassidy, who was not involved in the RUDD study.
"We want celebrities to be visible role models for kids — especially for youth of color — but celebrities' influence can become problematic when they promote products that put youth at risk of diabetes and heart disease," Cassidy added.
Experts say soda companies have also taken a page out of the tobacco industry's marketing playbook, by providing funding for many Black communities and endeavors "in ways that don't look like advertising, like funding playgrounds in minority neighborhoods, minority community groups, and sponsorship of Black and Hispanic sports figures," said Marion Nestle, who also authored "Eat, Drink, Vote: An Illustrated Guide to Food Politics."
"These work," Nestle said. "Minority kids identify soda brands with sports figures, and minority community groups find it hard to oppose soda company marketing when the companies have been so generous."
A public commitment
Major beverage companies say they are committed to reducing the impact of their products on the health of the nation. Coca-Cola, PepsiCo and Keurig Dr Pepper belong to the Balance Calories Initiative. Organized in 2014, BCI is a pledge to reduce the amount of calories Americans consume from sugary beverages by 20% by 2025.
In a press release, Coca-Cola calls it "the single-largest voluntary effort by an industry to help fight obesity." The company points to smaller "mini-cans" and 8 oz bottles and an "expanding portfolio of low- and no-calorie beverages -- from Unsweetened Gold Peak Tea to Powerade ZERO to Diet Coke" as examples of success in reducing sugar in drinks.
Coca-Cola spokesperson Ann Moore told CNN via email that, "At the Coca-Cola Company, we agree that too much sugar isn't good for anyone, and we are taking steps throughout the world to help people reduce the amount of sugar they consume from our products.
"In recent years, we have been aggressively changing recipes to reduce added sugar and promoting low- and no-calorie beverage options. In fact, in 2019, we removed 350,000 tons of added sugar globally, on an annualized basis, through product reformulations."
Then why the need for a billion dollars in advertising, study author Harris counters.
"Regular soda advertising has gone up by 41% over the past five years while beverage companies are talking about all the diet and lower calorie products they're introducing," she said.
"I find it outrageous they can spend that amount of money and at the same time say they're trying to encourage people to make better choices. Our report shows they're not putting their money where their mouth is," Harris said.
Last week, PepsiCo CEO Ramon Laguarta published an op-ed in Fortune Magazine in response to the protests surrounding the deaths of George Floyd, Breonna Taylor, Eric Garner, Philando Castile, Alton Sterling, Delrawn Small and so many more.
"Black Lives Matter, to our company and to me," Laguarta wrote. "We have been thinking hard about how PepsiCo can help dismantle the systemic racial barriers that for generations have blocked social and economic progress for Black people in this country."
Laguarta went on to pledge more than $400 million over five years to "lift up Black communities and increase Black representation at PepsiCo."
"The great irony of Ramon Laguarta's promises to counter PepsiCo's conscious or unconscious racist practices in the company, its business, and communities is that none of them addresses targeted marketing," said Nestle.
"The best thing Pepsi could do to improve the health of its customers would be to stop advertising and marketing to children and teenagers, especially those of color," Nestle added.
Public health experts of color CNN spoke to agree.
"For sugary beverage executives to assert that 'Black Lives Matter' at the same time as their companies are aggressively targeting Black kids and teens with ads for their nutrient-free, high sugar beverages is at best, hypocritical and at worst, a diversion from real harm," said Dr. Rhea Boyd, a California pediatrician who teaches nationally on the relationship between structural racism, inequity and health.
"If beverage companies want to seriously assert that Black Lives Matter, they would stop bombarding Black and Latinx kids and youth with ads for their unhealthy products," Boyd added.
Instead, companies should "promote more images of these communities consuming foods and beverages that are more in line with good health and wellness," said NYU Langone Health's Cassidy.
"The world is opening its eyes to structural racism, and everyone is watching how companies respond," Cassidy said.
"Will they think it's sufficient to publish op-eds and press releases about diversifying their workforce and stop there? Or will they take it a critical step further and stop making Black and brown communities sick by promoting unhealthy products to youth of color?"
PepsiCo provided the following statement to CNN: " PepsiCo has strong global commitments on responsible advertising to children of all races, in all communities. We were one of the first companies to articulate a policy on marketing to children and we are constantly auditing our efforts to ensure we are upholding our rigorous marketing standards while also showcasing the full range of our products."
What should be done?
Music, movie and sports figures of color need to play a role as well, Cassidy said. "It would be great if celebrities could use their star power to push for healthier product promotions when negotiating endorsement contracts," she said.
If stars of all races and ethnicities would promise to not promote unhealthy products to kids, then companies could be forced to change, Cassidy added. "We saw this stance happen with tobacco, where almost no athlete would touch a tobacco endorsement."
The RUDD report calls for immediate action across the board: Media companies that produce teen programming should reduce sugary drink advertising; states and cities should tax sugary drinks and use the money to reduce health and social inequities; sales of energy drinks should be banned to children under 18; advocacy and health organizations should push for more consumer education, to name a few.
These initiatives are made more urgent due to the disproportionate effects of Covid-19 on Black and Latino communities, the report said.
"As our country strives to make changes to improve health equity, it should become clear that targeted marketing to get Black and Hispanic children and adolescents hooked on sugary drinks is unacceptable and must stop," said the AAP's Muth.
Dorfman is more blunt: "If the companies were serious about protecting Black lives — instead of profiting off of them — they could revamp their products and stop intensively marketing sugary drinks. It's as simple as that."