What Can Hospitals Learn from The Coca-Cola Company? Health Care Sustainability Reporting

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Summary

The climate crisis and the Covid-19 pandemic are revealing limits to the economic, environmental, and social resources and systems on which society depends. These dual crises are driving increased demand for transparent, equitable, and sustainable enterprise and, consequently, a significant change in business strategy and operations. Corporations of all kinds are undertaking a new form of accounting that not only captures financial performance, but also measures efforts to mitigate the destructive impacts that business operations have on the environment and society. Many corporations, such as The Coca-Cola Company, now publish regular reports using standardized frameworks to communicate progress in sustainability initiatives. In contrast, the U.S. health care delivery system — a financial behemoth that generates substantial adverse environmental and social impacts — has yet to engage in this important practice. In this article, the authors discuss the numerous benefits to the U.S. health care sector from mandated participation in cutting-edge sustainability management and accounting.

Introduction

Coca-Cola is a globally distributed brand with products that contribute to the obesity epidemic, the plastic pollution crisis, and water scarcity in vulnerable communities, all of which harm human health.^1-3 Yet The Coca-Cola Company does something that almost no U.S. hospital or health care system does — it systematically measures, manages, mitigates, and regularly publicly discloses verified data on the negative environmental and societal consequences of its business operations.

The company performed its first assessment of the environmental impact of its products, raw materials, and fuel use in 1969 and since 2005, has regularly published sustainability reports in alignment with the Global Reporting Initiative (GRI), the most commonly used sustainability reporting framework worldwide. The Coca-Cola Company’s 2020 report discloses quantitative progress toward mitigating greenhouse gas (GHG) emissions, plastic waste, the sugar content of its products, and water scarcity⁴ (Figure 1, Figure 2). The company also communicates how their sustainability efforts specifically help to achieve the 17 United Nations Sustainable Development Goals (UNSDGs) released in 2015 to define progress by governments, businesses, civil society, and the general public toward a healthy global community (Figure 3).

The Coca-Cola Company is not unique among large corporations. More than 90% of Standard & Poor’s 500 Companies annually publish sustainability reports, as do many private and nongovernmental entities.⁵ Finding detailed information on sustainability programs for hundreds of companies is as easy as a Google search.

The same cannot be said of U.S. health care organizations, in which there has been little engagement or disclosure utilizing currently accepted best practices in sustainability. This article reviews the current state of sustainability accounting and reporting and explores why the U.S. health care sector must rapidly adopt this common business practice.

Corporate Sustainability Is Well Established

The rapid and widening uptake of corporate sustainability practices and the associated reporting stems from three related factors: (1) global environmental megatrends such as climate change and loss of biodiversity and ecosystems that are forcing companies to address greater disruptions, scarcity, and higher costs; (2) rising interest among investors and lenders increasingly concerned about the potential financial impacts from environmental and social risks; and (3) increasing social pressure from corporate stakeholders such as consumers, investors, employees, regulators, policy-makers, lawmakers, governments, and communities.⁶

Large asset owners and managers (e.g., BlackRock) are increasingly committing to investing in more sustainable companies through initiatives such as the United Nations’ Principles for Responsible Investment. In 2019, the Business Roundtable called for radical change when it released a new Statement on the Purpose of a Corporation. The organization, representing 200 of the largest U.S. corporations, reworked the definition of corporate purpose, which was traditionally understood to be returning profit to shareholders. The new statement declared that “companies must serve not only their shareholders, but also deliver value to their customers, invest in employees, deal fairly with suppliers, and support the communities in which they operate.” In line with this cultural shift, corporations are increasingly committing to science-based climate targets or to net-zero climate emissions and impact.⁷

Science-based targets encompass a set of goals that a business develops to provide itself with a clear route to reducing GHG emissions. The goals are considered “science based” if they are developed in line with the scale of reductions required to keep global warming to less than 2°C above preindustrial levels.

Net zero is a balance between the amount of GHG produced and the amount removed from the atmosphere. Net zero is achieved when the amount added is no more than the amount taken away.

Commitment to sustainable enterprise is not limited to publicly traded companies. Many private companies, nongovernmental organizations (NGOs), and public sector entities now seek to demonstrate good corporate citizenship via environmental and social disclosures. Examples include Cargill, the largest American privately held company; NGOs such as the World Bank and Oxfam; and public sector entities such as the University of Michigan, the City of Chicago, and Amtrak.

These disclosures are commonly termed Corporate Social Responsibility (CSR) or Environment, Social, and Governance (ESG) reporting. Companies create these reports using frameworks promulgated by organizations such as GRI or the Sustainability Accounting Standards Board that provide guidance on how to organize, collect, track, and publish sustainability information. CSR and ESG are based on the Triple Bottom Line — People, Planet, Profit — an accounting concept that seeks to quantitatively measure the environmental and social costs, in addition to the financial costs, of business operations (Figure 4).

CSR is a self-regulating business model that helps a company describe how it is going to be socially accountable — to itself, its stakeholders, and the public — for its impacts on all aspects of society, including economic, social, and environmental. CSR presents the qualitative ideal of aspirations and goals toward a corporate culture of sustainability.

ESG is the quantitative framework to measure and track outcomes that operationalize sustainability. Environmental criteria consider how a company performs as a steward of nature. Social criteria examine how it manages relationships with employees, suppliers, customers, and the communities in which it operates. Governance deals with a company’s leadership, ethics, regulatory compliance, executive pay, audits, internal controls, and shareholder rights.

Some individual health systems have demonstrated exemplary leadership in sustainable operations, though they do not provide consistent disclosures.

ESG accounting provides assurance to stakeholders that negative environmental and social externalities are acknowledged as by-products of business activity; the corporate entity takes responsibility for these negative consequences; and efforts to measure, manage, and mitigate are part of routine business operations and are transparently communicated to all stakeholders. Most companies use third-party accounting firms to verify the accuracy of their ESG data.⁸

Table 1 provides a few general examples of ESG categories, metrics, key performance indicators (KPIs), and links to the UNSDGs potentially relevant for health care organizations.

Table 1.

Selected Examples of ESG Categories Relevant to Health Care Organizations

ESG Categories
Environmental (Planet)	Social (People)	Governance (Profit)
Waste and PollutionEnergy EfficiencyNatural ResourcesClimate Change	Diversity, Equity, InclusionSafety & Well-BeingQuality of CareHuman Rights & Labor StandardsPrivacy & Data Security	Corporate Ethical BehaviorCorporate Governance Accounting/Tax TransparencyCompliance
Example metrics and their mapping to UNSDGs for health care organizations
Total annual GHG emissions, per employee and patient encounter (UNSDG 13: Climate Action)Total annual energy consumed, percentage of grid electricity, percent renewable (UNSDG 7 & 13: Affordable and Clean Energy, Climate Action)Total annual waste by weight, type, and disposition (e.g., on-site incineration, landfill, treatment/storage/disposal facility) (UNSDG 12: Responsible Consumption and Production)Description of climate risk policy/practices (e.g., infrastructure resiliency projects, compliance with CMS Emergency Preparedness Rule) (UNSDG 13: Climate Action)	Number of hours/percentage of employees trained in antiracism (UNSDG 10: Reduced Inequalities)Percentage of employees leaving per total full-time employeesNumber of hours and expenses of safety training per employee (UNSDG 8: Decent Work and Economic Growth)Average Hospital Value-Based Purchasing total performance score, across all facilities (UNSDG 3: Good Health and Well-Being)Excess readmission ratio per hospital and payment adjustments as part of HARPPatient satisfaction score (UNSDG 3: Good Health and Well-Being)Percent total spend on community benefit and local/minority procurement (UNSDG 11: Sustainable Cities and Communities)	Percentage of board diversity, DEI policies (UNSDG 5 & 10: Gender Equality & Reduced Inequalities)Total annual cost of fees/fines associated with Medicare and Medicaid fraud under False Claims Act (UNSDG 16: Peace, Justice and Strong Institutions)Number of ESG KPIs in annual reportExecutive pay: ratio and link to ESG performance

ESG = Environment, Social, and Governance, UNSDG = United Nations Sustainable Development Goals, GHG = greenhouse gas, DEI = diversity, equity, and inclusion, CMS = U.S. Centers for Medicare & Medicaid Services, KPI = key performance indicator, HARP = Health and Recovery Plan. Source: The authors, created with information from: T1. Sepetis A. Sustainable finance in sustainable health care system. Open J Business Manage 2020;8:262-281. T2. Sustainability Accounting Standards Board. Health Care Delivery Sustainability Accounting Standard. 2018. Accessed December 13, 2021. https://www.sasb.org/wp-content/uploads/2018/11/Health_Care_Delivery_Standard_2018.pdf

Moving to Mandated ESG Disclosure

Despite broad participation in sustainability reporting by a wide variety of organizations, it remains a predominantly voluntary construct in the United States. However, the U.S. Securities and Exchange Commission (SEC), which regulates and enforces financial disclosures for listed companies, is considering potential ESG reporting requirements. This step follows recent European Union (EU) rules on financial disclosure of ESG topics.⁹

If the EU model is adopted here, publicly listed companies in the United States would be required to disclose ESG metrics, such as annual production of GHGs, air and water pollutants, and material waste; up-to-date risk assessments related to infrastructure damage from natural disasters; projections of potential climate risks that might affect company financial performance (e.g., stranded assets and supply chain disruptions); and clear corporate policies related to climate change (e.g., governance). SEC rules may also require companies to include data on social progress, such as human rights; workforce health, safety, and well-being; and diversity, equity, and inclusion (DEI).

While several hurdles exist to full accounting of ESG issues in financial statements — primarily related to the creation of accounting protocols, standards, and metrics that are uniform and widely accepted — the overall intent is to protect shareholders from these areas of growing financial risk and to create more comparable information to evaluate company performance and risk mitigation.

Action by the SEC would signal to all businesses, publicly held, private, and nonprofit, that economic enterprise must account for environmental and social impacts and demonstrate good governance. Lack of ESG action by nonprofits and public sector entities could limit access to capital markets, philanthropy, insurance coverage, affect business partnerships and influence bond ratings. (See Value Drivers for ESG: The Financial Benefits of Sustainability Management and Reporting for Health Care Organizations for further discussion.)

Current Sustainability Efforts in the U.S. Health Care Delivery Sector: Alone Together

Health care delivery is the largest source of U.S. jobs, represents 17.7% of gross domestic product, and results in $3.8 trillion in annual expenditures.¹⁰ The U.S. health care sector also generates substantial waste and pollution, including 8.5% of total U.S. GHG emissions and similar fractions of toxic air emissions, and is associated with health damages resulting in 388,000 disability-adjusted life years annually.¹¹ But as Wall Street moves quickly ahead with ESG, the U.S. health care delivery sector lags far behind in terms of sustainability management and disclosure.¹² Despite the sector’s inherent commitment to improving health, there are large gaps in information and little consistency or comparability in environmental sustainability management and disclosure, and there is almost no accounting or reporting of social and governance performance.

Unmeasured and unmanaged, climate risks to health care operations are substantial and, for some locations, perhaps existential.

At the leading edge, a few large U.S. health systems have published CSR reports consistent with current best practices using established frameworks (e.g., GRI) and disclosure platforms that include ESG reporting. Reports from Cleveland Clinic (see Appendix) and Dignity Health, now part of CommonSpirit Health, are excellent examples that communicate quantitative information about corporate efforts to meet environmental (Figure 5) and social goals (see full discussion in Social Capital: ESG to Enhance the Health Care Workforce) and ensure ethical governance, (see Dignity Health Sustainability Report, pages 15-17).

Some hospitals and health systems have joined fee-based membership organizations that offer proprietary guidance on environmental sustainability operations, collect some facility-level environmental data, and provide green awards. The criteria for such awards are often unclear, unverified or undisclosed. For example, in 2018, Becker’s Hospital Review named the 68 greenest hospitals in America, although GHG emission information, the most basic measure of sustainable operations, was available for only seven of the awardees.¹³

Other hospitals have sustainability committees or employ a sustainability director or manager; however, according to the American Hospital Association, none have a Chief Sustainability Officer with direct access to the C-suite.¹⁴ Many hospitals have bottom-up recycling or waste-reduction programs driven by “champions” or “green teams” that rely heavily on passionate individuals to rally coworkers, as noted in the American Hospital Association’s Sustainability Roadmap.¹⁵ Despite uncertainty regarding the environmental footprint of health care products, health systems may select “sustainable,” “green,” or “environmentally preferable/friendly” purchasing options from vendors and group purchasing organizations. The lack of standards and oversight can foster greenwashing, the process of conveying a false or misleading impression about environmentally preferable characteristics of products or performance to gain a marketing advantage.

Some hospitals, at state or local urging, participate in voluntary emission-reduction programs. In New York City, for example, several health systems participate to some degree in the Mayor’s Carbon Challenge, which aims to significantly reduce carbon emissions from buildings. Many hospitals participate in the Environmental Protection Agency Energy Star Portfolio Manager benchmarking program and the American Society for Health Care Engineering Energy to Care program, which provide guidance on energy-saving measures and help energy managers track reductions in consumption, although few share these data publicly. Numerous case studies and analyses have demonstrated significant cost savings from improved environmental management in health care facilities.^16-18

Some individual health systems have demonstrated exemplary leadership in sustainable operations, although they do not provide consistent disclosures. Among them is Kaiser Permanente, which eliminated its 800,000-ton carbon footprint through energy efficiency and purchased carbon offsets, reaching carbon neutrality in 2020, the first U.S. health system to do so.¹⁹

Spaulding Rehabilitation Hospital in Boston, MA, was built to withstand sea level rise, with a first floor above the flood zone and critical infrastructure placed on higher floors. This facility can remain fully operational during extreme storms and floods.²⁰

While most hospitals do not provide quantitative information regarding sustainable operations, some declare commitments, goals, and/or achievements in marketing materials and/or sporadically and informally (e.g., press release or website) disclose progress toward a wide variety of environmental sustainability initiatives (Table 2).

Table 2.

Selected Sustainability Initiatives Undertaken by U.S. Health Care Delivery Organizations

Energy use efficiencyWater use efficiencyWaste reduction and recycling programsReduced red bag wasteCleaner energy purchasesHVAC setbacksLED lighting retrofitBuilding retrofitting or recommissioningReduced purchase of single-use productsReprocessing medical devicesEnvironmentally preferable product purchasingLocal and organic food sourcingReduced meat and dairy procurement

Greenspace creationSustainable grounds managementFacility-grown produceReduced consumption of inhaled anesthetic gases, and elimination of desfluraneClean-fuel fleet vehiclesEncouragement of rideshares, public, and active transportationProvision of charging stations for electric vehiclesLEED constructionClimate-resilient constructionReduced use of harmful cleaning chemicalsFossil fuel divestment commitmentsCarbon reduction commitments

HVAC = heating, ventilating, and air conditioning, LED = light-emitting diode, LEED = Leadership in Energy and Environmental Design. Source: The authors

Working groups and academics have explored pathways and roadmaps for decarbonizing the U.S. health care sector and moving it toward sustainable operations.²¹^,²² Some call for action linked to the U.S. Centers for Medicare and Medicaid Services (CMS) reimbursement.¹¹^,²³ Recently, as part of broader efforts to address climate-related health impacts, the Department of Health and Human Services (HHS) announced that new regulations to reduce health care emissions are likely²⁴^,²⁵ and that it is working with the National Academy of Medicine Action Collaborative on Decarbonizing the U.S. Health Sector to identify pathways to operationalize sector-wide reductions. These efforts could be modeled on the existing Federal Government Sustainability Program, which has tracked and reduced emissions and waste in federal buildings, including Veterans Administration Medical Facilities, since 2007.

VBC, SDOH programs, and ESG share a similar ethos and can be envisioned as concentric circles centered around the patient.

Nonetheless, there is no sector-wide push from academic or industry leaders, government, financial backers, regulators, lawmakers, or payors for mandated ESG participation by health care organizations that mirrors the sustainability revolution underway on Wall Street. A lack of clear guidance results in fragmented activity with scattered examples of environmental performance, mostly without verified supporting data. Practically speaking, this means that pollution, emissions, and waste are most likely unaccounted for and unmanaged by U.S. health care organizations.

Reasons for lack of engagement in ESG by the U.S. health care delivery sector have not been systematically explored, but barriers to participation may include: (1) the misperception that sustainability programs are costly or burdensome, especially for hospitals with slim operating margins; this bias persists, even though sustainability programs can provide substantial cost savings/avoidance and improve a wide variety of measures of corporate performance (see full discussion in Value Drivers for ESG: The Financial Benefits of Sustainability Management and Reporting for Health Care Organizations); (2) the rapid pace of health system mergers and acquisitions can complicate efforts to undertake ESG accounting; (3) hospital executives tend to be recruited from within the health care industry and may be unfamiliar with or lack exposure to cutting-edge business practices emerging in other economic sectors; and (4) the sentiment that the enormous societal benefit of providing care exempts health care organizations from the perceived burden of reducing pollution, enhancing social infrastructure, or demonstrating good governance.

Operational Drivers for ESG in Health Care: Keeping the Doors Open

As critical as it is to reduce emissions, health care organizations also face the need to adapt all operations and systems to ensure doors remain safely open as the climate crisis worsens. The most recent Intergovernmental Panel on Climate Change report confirms that climate-related disasters are certain to escalate near term, leading to more hurricanes, floods, extreme precipitation events, wildfires, droughts, extreme heat and cold, infectious disease spread, political conflict, and forced migration.²⁶ Hospitals provide life-supporting services in times of need and often are anchor institutions within their communities. When hospitals are damaged or unable to safeguard health care workers, their capacity to deliver care diminishes, compounding harms beyond employees to patients and their families and the communities they serve.²⁷

Extreme weather events and the Covid-19 pandemic have stretched U.S. health systems beyond capacity and brought the industry to an inflection point — how can care delivery systems operate safely and reliably in the face of converging and escalating threats, a portion of which is caused by their own activities?²⁸ This is the exact challenge large corporations such as The Coca-Cola Company are confronting and a primary impetus for the rapid rise of ESG.

In 2015, the Financial Stability Board, an international body that monitors global financial systems, created the Task Force on Climate-Related Financial Disclosures (TCFD) to determine ESG metrics that best capture the financial, social, and physical infrastructure risks from growing climate instability. These metrics, in addition to current disaster-planning requirements (e.g., local/state regulations, CMS disaster-preparedness rules, and HHS Health Care Readiness Programs), would help hospitals recognize the totality of the risks they face as the climate crisis worsens.

Unmeasured and unmanaged, climate risks to health care operations are substantial and, for some locations, perhaps existential. Adapting physical and social health care infrastructure to climate change will require hyperlocal climate risk assessment (e.g., emergency management mapping inclusive of sea level rise) and a deep knowledge of the unique needs related to care delivery. ESG and TCFD climate-risk disclosures provide a framework around which health care organizations can strategically anticipate and manage threats from a rapidly destabilizing climate.

Mission Drivers for ESG: Getting to “Triple Aim” via the “Triple Bottom Line”

The mission of health care, the “why” — improve health — is nearly identical to the “what” — deliver care. Few economic endeavors can claim such a close alignment between product and purpose. The health care mission encompasses a triple aim: improving health outcomes and quality through improved patient experience, advancing population health, and reducing costs.²⁹ A number of industry drivers for meeting the triple aim are shifting the care delivery landscape. Chief among these is value-based care (VBC), which seeks savings from improved health outcomes.

The current predominant payment model, fee-for-service, leads to overconsumption of health care and increased waste, costs, and pollution without necessarily improving health outcomes.³⁰ Health care overuse and lack of preventive care resulting in poor health outcomes leads not only to higher direct health care costs, but also to indirect costs related to environmental and social damage,³¹ costs not captured in traditional accounting. ESG would provide the tools to expose the hidden or “true” costs associated with overuse, waste, pollution, and poor health outcomes, better aligning with VBC.

The Covid-19 pandemic sheds new light on the importance of enhancing social infrastructure and investing in health care workforce safety and well-being.

Parallel to and intertwined with the VBC trend is an increased emphasis on the social determinants of health (SDOH). Up to 80% of health outcomes are determined by social, behavioral, and environmental factors.³² This recognition has prompted health care spending totaling more than $2.5 billion in recent years toward addressing these factors: community programs related to housing, food insecurity, transportation, employment, local purchasing, and education.³² Such programs cement the broader role of health care organizations in society, help them meet their mission, and further the creation of healthy, sustainable communities.

VBC, SDOH programs, and ESG share a similar ethos and can be envisioned as concentric circles centered around the patient. ESG actions make up the outermost loop to close in meeting the health care mission and are consistent with the emergent concept of planetary health care that acknowledges the crucial links among ecological change, human health, and our ability to thrive.³¹

Health care organizations have a duty to do no harm, or at least less harm, to the ecosystems on which we depend. ESG gives a more complete accounting of costs and benefits that can inform a wider range of strategic actions and accountability to avert harms and enhance population well-being, consistent with the planetary care framework (Figure 6).

Social Capital: ESG to Enhance the Health Care Workforce

Over time, the definition of sustainable enterprise has evolved from a primary focus on the environment to a broader consideration that also encompasses impacts on social systems and human capital, particularly workforces. The Covid-19 pandemic sheds new light on the importance of enhancing social infrastructure and investing in health care workforce safety and well-being. Covid-19 death rates in health care workers have been significantly higher among lower-paid workers of color who provided hands-on front-line care and critical support services.³³ Safe worksites and DEI are core features of the “S” in the ESG framework. The Coca-Cola Company, like many large companies, discloses progress toward creating equitable, safe, and healthy workplaces and communities (Figure 7). Dignity Health has done the same (Figure 8).

ESG normalizes the concept that health care workers are human capital to be strengthened rather than cost centers to be driven down.

Workforce safety is more than just ensuring adequate personal protective equipment during a pandemic. Health systems must systematically analyze, account for, and fully disclose benchmarked actions that enhance the safety and well-being of workers, especially given the racial disparities in the health care workforce. The industry must make long-term investments that foster well-being and holistic resiliency. Newer ESG frameworks emphasize action and accounting on leading indicators of workforce well-being, such as preventive and health promotion programs, rather than on lagging indicators, such as simple accounting of injuries and death. In addition to direct and indirect cost savings (Table 3), health care workforce engagement and well-being are linked to better patient outcomes.³⁴

Table 3.

ESG Value to Health Care Organizations

Value chain	Performance benefit
Direct/stewardship^T1	Reduced costs from energy use and emissions intensity; water use; air treatment; and solid waste managementReduced health insurance costsReduced forbearance costs (e.g., payment defaults related to inequality/financial stress)Reduced costs from catastrophic events and recovery (e.g., infrastructure repairs, lost research/academic output, reduced workforce productivity/capacity, lost revenue due to closures/treatment delays, reduced demand for care due to migration)Reduced legal risks/costs
Capital access/cost^T2	Respond to pressure for ESG from wide range of investorsAlpha strategies (outperform the market)Beta strategies (lower risk, diversify)Improved corporate financial performanceMeet demand for good stewardship from donors, funders, municipal bond issuers, capital markets, philanthropy, contractors, business partnerships, local/state/federal governmentsImproved bond ratingsImproved due diligence for mergers/acquisition
Intangible/reputation^T3	Enhanced brand/reputational value (80% stock market value linked to ESG)Enhanced confidence/loyalty from patients, employees (current/potential), academic researchers, students, trainees, regulators, policy makers, communities, business partners and suppliersCompetitive advantage in multihealth system settingReduced risks from lower revenue, higher cost of employment (recruitment/retention), higher cost of goods and services, and reduced access to critical permits and operating constraintsReduced risk to board from activists (e.g., link ESG performance to executive pay)Reduced risk of stigmatization
Regulation^T4	Enhanced regulatory compliance (current/future)Reduced risk of fees/fines related to noncomplianceStronger management of risks/opportunities (e.g., routine stakeholder feedback)SEC ESG regulation and disclosure could apply to both profit and nonprofit health care organizations

ESG = Environment, Social, and Governance, SEC = U.S. Securities and Exchange Commission. Source: The authors, with information from: T1. Whelan T, Fink C. The comprehensive business case for sustainability. Harvard Business Review. October 21, 2016. Accessed January 27, 2022. https://hbr.org/2016/10/the-comprehensive-business-case-for-sustainability. T2. El Ghoul S, Guedhami O, Kwok CC, Mishra DR. Does corporate social responsibility affect the cost of capital? J Bank Finance 2011;35:2388-406. T3. Esty D, Cort T. Corporate sustainability metrics: what investors need and don’t get. J Environ Invest 2017;8:11-53. https://www.thejei.com/wp-content/uploads/2017/11/Journal-of-Environmental-Investing-8-No.-1.rev_-1.pdf. T4. Ransome H. Regulation database update: the unstoppable rise of RI policy: United Nations. Accessed October 6, 2021. https://www.unpri.org/pri-blog/regulation-database-update-the-unstoppable-rise-of-ri-policy/7352.article.

ESG normalizes the concept that health care workers are human capital to be strengthened rather than cost centers to be driven down. Millennials — now the largest portion of the U.S. workforce — place greater emphasis on environmental and social values when making financial, educational, and employment decisions.³⁵ They are highly sensitized to authenticity and likely to reject employment or educational opportunities with institutions that do not align with these values. ESG would give health care organizations a wider lens and more formal mechanisms by which to demonstrate strong ESG values that would maximize the recruitment, retention, and overall well-being of medical undergraduate and graduate trainees, high-value researchers, skilled staff, and allied health care workers.

Value Drivers for ESG: The Financial Benefits of Sustainability Management and Reporting for Health Care Organizations

Beyond the idea that addressing environmental and social externalities from health care is the “right thing to do,” growing evidence indicates that these efforts have significant and wide-ranging positive impacts on financial and business performance that can provide substantial cost savings, reduce risks, and improve numerous measures of corporate performance. Climate change–related business risks and costs are increasing. Climate-driven severe weather events disrupt supply chains, physical infrastructure, and workforce and business operations; increase health risks (e.g., heat and infectious disease); and increase the costs associated with recovery management. Extreme events and climate-related disasters that cost at least $1 billion dollars have risen steadily over the past 20 years.³⁶

Hospital financing is complex, and accurate national financial accounting and disclosures are difficult to find. ESG could create greater transparency in hospital financial disclosures. The U.S. Internal Revenue Service requires nonprofit hospitals to demonstrate benefit by assessing community health needs every 3 years to maintain their tax-exempt status. ESG provides a framework for health care organizations to demonstrate their benefit to communities more broadly and holistically. ESG disclosures would appeal to a broad range of health care stakeholders, thereby enhancing community acceptance and facilitating licenses to operate, meeting local and state regulations related to public need and safety, staffing, and operational requirements. In addition to providing a tax advantage, ESG could benefit the health care organization value chain through four broad categories: direct/stewardship (cost savings), capital access/cost, intangible/reputation, and regulation (Table 3).

Integrating ESG into Health Care Operations

The U.S. health care sector must measure, manage, mitigate, and transparently disclose the negative environmental and social externalities associated with health care delivery and must prepare for rapidly escalating climate-related threats. The National Health Service (NHS) in England provides valuable inspiration — the first national health system to commit to carbon net zero. The NHS has tracked, managed, and reduced health care GHG emissions since a parliamentary mandate with the Climate Act of 2008 (Figure 9).³⁷

To achieve a similar outcome in the United States, all health care organizations must participate, and all relevant ESG data must be nonproprietary and assured by credible accounting firms. All hospitals, nonprofit, profit, and local/state-controlled, should, like The Coca-Cola Company, communicate ESG progress through annual publications. The industry’s current limited engagement in sustainability management and disclosure suggests that voluntary efforts will not meaningfully move the needle.¹² Pathways and mechanisms to ensure participation and to operationalize ESG in the health care sector are outlined in Table 4. To avoid undue financial or administrative burden in operationalizing ESG, federally funded technical support, expert sustainability consulting and accounting services, and financial advising should be uniform and freely available to all health care organizations regardless of tax status.

Table 4.

Key Elements to Operationalize ESG in the U.S. Health Care Sector

Mandate participation for all U.S. health care organizations receiving federal funding through HHS.Link ESG performance to CMS Conditions of Participation and reimbursements.Build off existing reporting frameworks (e.g., GRI, SASB, and TCFD) to create core health care ESG metrics for:Environmental impacts (reconciled with health outcomes), climate risks (e.g., climate modeling to determine hyperlocal risks to supply chains, physical and social infrastructure, and community resilience)Social impacts (e.g., workforce well-being, fair wages, and DEI)Governance (e.g., board diversity, ethics, link ESG performance to executive pay)Require third-party assurance of ESG measures through auditing that evaluates processes, systems, and data.Map ESG actions to the UNSDGs.Require public disclosure in a format consistent with currently available disclosure frameworks.Collaborate with public and private sector ESG and sustainability experts to bring best-practice sustainability science into hospital operations and care delivery.Fund academic research into sustainability science and health services research, including quality and safety. (Funding: Agency for Healthcare Research and Quality).Establish a national health care sustainability task force for oversight of all programs housed at HHS.Create a national data center, funded by and housed at HHS and tasked to:Capture facility- and system-level ESG data through the American Hospital Association/EPA Energy Star program for operations/infrastructure and CMS for clinical operations and outcomes.Develop baselines, benchmarks, KPIs, and best practices in ESG metric creation.Create and publish annually a Sustainability Scorecard for every facility and health system.Build sustainability science into allied health professional education.Encourage incorporation of ESG metrics into national health system rankings (e.g., U.S. News & World Report).

ESG = Environment, Social, and Governance, HHS = Department of Health and Human Services, CMS = U.S. Centers for Medicare & Medicaid Services, GRI = Global Reporting Initiative, SASB = Sustainability Accounting Standards Board, TCFD = Task Force on Climate-Related Financial Disclosures, DEI = diversity, equity, and inclusion, UNSDG = United Nations Sustainable Development Goals, EPA = Environmental Protection Agency, KPI = key performance indicator. Source: The authors

Conclusions

Kaiser Permanente, Cleveland Clinic, and many other hospitals and health systems have demonstrated leadership in environmentally sustainable operations and inspire possibilities on a larger scale. Yet, without standardized metrics, outside assurance, and transparent disclosure, there is no way to verify the true impact or value of efforts, develop best practices to inform sector-wide actions, or ensure accountability. Voluntary efforts will inevitably wane and fall short of well-intentioned promises. A unified, sector-wide “all-in” mandate that incentivizes specific ESG actions and disclosures is the only way to rapidly operationalize and ensure enduring progress.

Organizational systems already exist in most hospitals that can capture ESG measures. For instance, many hospitals routinely convene environment of care committees for which measures of sustainable operations would make a natural fit. Similarly, human resource departments capture data that can illuminate ways to enhance workforce resiliency. Annual reports, already published by many hospitals and health systems, could be expanded to communicate to stakeholders environmental and social progress and policies for good governance. Creating uniformity in these disclosures will help track sustainability progress sector wide and reduce greenwashing.

Some might argue that more regulatory reporting is unfairly burdensome to health care institutions, especially because sustainability measures in general are evolving and greenwashing abounds. Metrics are an area of intense debate, especially when it comes to accounting for carbon embodied in the supply chain and developing measures that facilitate comparability within and among industries. Health care delivery has additional unique, but not insurmountable, sustainability challenges. Reconciling negative externalities to quantum of health delivered will be the most challenging, given that some environmental and social harms are simply unavoidable.

The cost savings and performance improvements associated with ESG accounting should alone compel action.

But the answer is not less engagement, rather more. The cost savings and performance improvements associated with ESG accounting should alone compel action. Engaging the health care sector’s enormous intellectual and financial capital could greatly contribute to sustainability science, particularly as it relates to direct and indirect impacts on ecosystems and human health — arguably the only metrics that matter. Consider the role medical academia could play in the emerging sustainability science that seeks to more fully understand and quantify positive restorative actions — so-called “handprints” — to offset harms from footprints.³⁸ ESG would help move health care action upstream to disease prevention and health promotion, thereby reducing disease burden, improving health outcomes, and lowering health care costs and related environmental emissions and pollution and would realign health care delivery with its mission — the restoration and protection of human health.

Integrating a sustainability program into enterprise operations begins with a thorough analysis of all stakeholders within the sphere of corporate influence. This not only engages stakeholders, but also gives them a voice; consider the positive impact this would have on the health care workforce, which has faced the dual crises of the pandemic and extreme events. Meeting the challenge presented by the growing climate crisis requires accounting for and strengthening both social and physical infrastructure. Stakeholder analysis gives rich insight into operational strengths, weaknesses, risks, opportunities, and emerging trends.

Social and environmental data can inform the creation of strategic priorities; pinpoint areas in need of change; set baselines, benchmarks, and performance goals; and mark progress toward continual improvement. Good governance would ensure commitments are kept.

While many large corporations such as The Coca-Cola Company are working to create a more sustainable enterprise, no sector of society alone can stem the tide of converging threats. The climate crisis is here; the pandemic persists; new threats loom.³⁹ In 2019, the United States spent more on health care than did any other high-income country in the world, up to a third of which is waste⁴⁰ — only to rank last in measures of health outcomes.⁴¹ Compounding this failure, the true costs associated with wasted care (pollution, extreme events, and social instability) are unmeasured and unmanaged. The U.S. health care sector can no longer afford not to act on sustainability. It is time for bold, collective action. Health care organizations must strive to be at least as good as a sugared beverage company when it comes to protecting people and the planet.

This is why you should wash your hair with cola

Posted by zedie

Washing your hair with cola could have great benefits

Do you dream of having a head full beautiful hair but is the reality a little grimmer? If you have limp, dull hair, you might want to keep reading for this trick involving cola. You’re not alone; a lot of women have hair that lacks volume and shine. That’s not that strange if you think about what we collectively do to our hair: the frequent washing, dyeing, straightening and curling we do doesn’t do our hair any favours. Luckily, there’s a simple product that might just make all the difference, and you’re likely to have a bottle of it in your fridge already.

Washing your hair with cola could make a big difference. We’re not sure if you’ll want to drink it after reading this, though…

Cola

Did you know cola is actually useful for a lot of different things? You can use it to descale your tea kettle or to clean the toilet, for example. Apparently, the popular beverage is so chemical that it can clean things. Who knew? You can also use it to remove chewing gum from your (or your children’s) hair. Fill a bowl with coke and put the piece of hair with the chewing gum in it. Let this sit for a while and you’ll see how easy it is to remove the gum.

Go to the next page to read about how you can wash your hair with cola to make it healthier and watch the video!

Wash your hair

We can’t tell you if this truly works as well as some of the claims make it out to, but this trick is definitely worth a try if you want more voluminous hair. The cola is said to cause your hair to be less limp and to create a ‘messy’ structure – but in a good way. The high acidity level of cola causes the hair scales to close and contract. This makes your hair shine. Sounds pretty good, right? Beauty vlogger Ellko gave the trick a try and is very satisfied with the results. All you need is two small bottles of coke and water to rinse it out again!

Take a look at the video for the instructions!

Coca-Cola considering ‘healthy’ cannabis-infused drinks

Posted by zedie

Coca-Cola says it is “closely watching” the use of CBD (Cannabidiol) as an ingredient in “wellness beverages” as a growing number of companies develop cannabis-infused drinks.

CBD is a cannabinoid that can be extracted from both marijuana and hemp varieties of cannabis. CBD doesn’t produce the high associated with marijuana, however, it is believed by many to have calming, anti-inflammatory and pain-relieving properties.

While Coca-Cola said it has “no interest in marijuana or cannabis,” they have stated: “Along with many others in the beverage industry, we are closely watching the growth of non-psychoactive CBD as an ingredient in functional wellness beverages around the world,” the company added. “The space is evolving quickly. No decisions have been made at this time.”

Coca-Cola released their statement after a report from Canada’s BNN Bloomberg reported that they were in “serious talks” with Aurora Cannabis, a medical marijuana producer and distributor, to develop drinks infused with CBD.

Following the BNN report, stocks for Aurora Cannabis spiked 17% and Coca-Cola’s shares rose slightly.

Aurora spokeswoman Heather MacGregor said her company “has expressed specific interest in the infused-beverage space and we intend to enter that market”.

CBD oil has boomed in popularity as a number of states and countries legalize the use of CBD, hemp and marijuana products. The CBD market is forecast to grow $2.1 billion by 2020 according to Hemp Business Journal.

Canadians can legally buy and consume cannabis starting October 17th. South Africa’s highest court has recently legalized the use of cannabis by adults in private places, although it remains illegal to sell, supply and use in public. The statement has been seen as a prelude to further legalization in the united states.

Coca-Cola has been diversifying their product portfolio with recent investments in sparkling water and coffee beverages. Demand for sugary sodas has declined each year over the last decade as consumers become more health conscious.

Beer giant Molson Coors announced on August 1st that they were teaming up with The Hydropothecary Corporation, a Canadian medical marijuana grower, to develop cannabis-infused non-alcoholic beverages. Although it likely that these beverages will not only contain CBD, but also THC, the cannabinoid that causes the high or buzz effect of marijuana.

Two weeks later, spirits company Constellation Brands announced a new $4 billion in investment in Canada’s Canopy Growth, a Canadian medical marijuana producer, in exchange for a 38% stake in the company.

Diet Coke’s Moment of Panic

Posted by zedie

The problem with the soda is right there in the name: It’s neither healthy-seeming enough to thrive as a diet drink nor tasty enough to thrive as a cola.

With sales of Diet Coke in a prolonged rut, Coca-Cola announced last Wednesday that it is tweaking the design of its most famous zero-calorie soft-drink can to be more slender and colorful. It is also launching several new flavors of Diet Coke, including “Feisty Cherry,” “Twisted Mango,” and “Zesty Blood Orange.”

“You don’t mess with a good thing,” Coca-Cola said in its statement. But, quite to the contrary, Coca-Cola is in a near-permanent state of messing with its things. The first version of Diet Coke debuted in 1982. The very next year, the company released a caffeine-free Diet Coke, and a cherry-flavored variety followed in 1986. This century, several more flavors have joined the family, including lemon, vanilla, lime, black cherry, and raspberry.

These changes—in addition, of course, to the old standards—amounted to a winning formula. At the peak of soft-drink consumption in the mid-2000s, America consumed 53 gallons of soda per person each year—more than half a liter, per person, per day.

But soda’s prospects have since fizzled. Diet Coke may still be the second-most popular soda in the country, but soft-drink consumption has declined every year this decade, according to an analysis shared with The Atlantic by the research group IBISWorld. In its last annual report, Coca-Cola said that the volume of Diet Coke sold in North America declined by 5 percent—more than any other Coca-Cola beverage brand identified in the report.

Per Capita Soft-Drink Consumption

It’s not hard to understand Diet Coke’s imploding popularity: The diet beverage is suffering both as a diet product and as a beverage.

A growing consumer focus on health has clearly dented soda’s dominion. Beyond widespread concerns of the dangers of artificial sweeteners, government research has found that daily drinkers of diet soda are at higher risk for strokes and other “vascular events.” While Diet Coke’s new can designs are tall and slender—a possible reference to the body type a diet-beverage drinker seeks—more of them simply don’t trust any kind of soda to be a part of a healthy diet. Between 2000 and 2015, switching from sodas to other beverages saved the country an estimated 64 trillion calories in total—that works out to 71 fewer calories per day, per drinker.

At the same time that academics have questioned the health effects of soda, the U.S. has undergone a profound change in its taste for liquids, in three major ways.

The new line of slender Diet Coke cans (Coca-Cola)

First, bottled water has transformed from an ecologically dubious ordinary consumer product to an ecologically dubious economic juggernaut. Since 2000, bottled-water consumption has tripled. In 2016, the volume of it consumed surpassed that of soda in the United States for the first time ever, according to data from the Beverage Marketing Corporation (BMC). Meanwhile, related categories such as flavored water and flavored seltzer water have grown even faster, albeit from a much smaller base. Sales of so-called “value-added” water, like Coca-Cola’s vitaminwater, have grown by nearly 3,000 percent since the turn of the century, according to BMC. The flavored-seltzer market is growing by more than 10 percent annually, with the top five brands—Sparkling Ice, LaCroix, Perrier, San Pellegrino, and Polar—now accounting for $1.2 billion in yearly sales.

Second, whereas many Americans once turned to Diet Coke to power their afternoons, these days the market for energy-giving beverages is crowded. At the peak of Diet Coke craze, in the early 2000s, soft drinks outsold coffee by a three-to-one margin in the U.S. But thanks to rising coffee consumption (and coffee’s high price, relative to soda), the U.S. coffee industry is on track to surpass domestic soda sales sometime in the early 2020s. Meanwhile, sales of energy drinks in the U.S. have grown by more than 5,000 percent this century, according to analysis from the BMC.

Finally, while Diet Coke is still one of the most popular sodas in the country, it’s losing market share to more-flavorful beverages. Many drinkers prefer the richer taste of classic Coca-Cola, which is still growing worldwide. Sales of Sprite and Fanta are also rising in the U.S., according to Coca-Cola’s financial reports. Research has shown that black cans and avoiding the word diet in beverage titles lures male consumers; indeed, the black-bottled Coca-Cola Zero Sugar is growing at Diet Coke’s expense.

But slender bottles with streaks of color probably won’t arrest Diet Coke’s demise. As the Harvard business professor and author Clayton Christensen has written, products and customers have certain “jobs” that need to be done. One could argue that, in the last decade, all of the jobs of Diet Coke are being outsourced to superior beverages. The role of hydration has been outsourced to bottled water and sports drinks, like Gatorade. Getting a jolt of energy has been outsourced to coffee and energy drinks, like 5-Hour Energy. And the satisfaction of a cold liquid fizzing on one’s tongue? That’s been outsourced to the trendy crop of flavored seltzers, like LaCroix. In the end, it probably doesn’t matter what the Diet Coke can looks like. Young people know what’s inside the can. Perhaps that’s precisely why they’re drinking so much less of it.

Coca-Cola’s secret influence on medical and science journalists.

Posted by zedie

A series of journalism conferences on obesity received covert funding from Coca-Cola.

Paul Thacker investigates

Industry money was used to covertly influence journalists with the message that exercise is a bigger problem than sugar consumption in the obesity epidemic, documents obtained under freedom of information laws show. The documents detail how Coca-Cola funded journalism conferences at a US university in an attempt to create favourable press coverage of sugar sweetened drinks. When challenged about funding of the series of conferences, the academics involved weren’t forthcoming about industry involvement.

For drinks manufacturers such as Coca-Cola the idea that consuming their products is fine as long as you exercise—reinforced with expensive advertising campaigns associated with sport—has been an important one. As Yoni Freedhoff, assistant professor of medicine at the University of Ottawa, told The BMJ, “For Coca-Cola the ‘energy balance’ message has been a crucial one to cultivate, as its underlying inference is that, even for soda drinkers, obesity is more a consequence of inactivity than it is of regularly drinking liquid candy.”

The six figure bill for funding these journalism conferences was more than repaid in favourable press coverage, say critics. Documented evidence of the industry’s covert influence on the media is rare. In 2004, researchers examined secret documents made public during tobacco litigation. Attempting to derail the effect of the US Environmental Protection Agency’s 1993 report on secondhand smoke, the tobacco industry successfully placed stories in major print publications about the report’s “scientific weakness” to help “build considerable reasonable doubt . . . particularly among consumers,” the researchers wrote.1 They concluded that even journalists can fall victim to well orchestrated public relations efforts, regardless of the quality of the science used in these PR exercises.

Source:bmj.com

63% of Americans Actively Avoid Drinking Soda

Posted by zedie

Story at-a-glance

Sixty-three percent of Americans actively try to avoid soda, compared to 41 percent in 2002
Rates of soda consumption have been dropping for decades, and Americans now consume about the same amount they did back in 1986
Coca-Cola is engaging in an intensive marketing ploy to “reintroduce” Coke, using smaller serving sizes and personalized cans to target teens
While carbonated soda sales fell 2 percent in 2013, Diet Coke sales dropped 7 percent amidst fears of aspartame’s health risks
Adolescent rats fed sugary drinks for one month had both impaired memory and trouble learning

Americans are finally starting to realize the dangers of soda, with nearly two-thirds (63 percent) saying they actively try to avoid soda in their diet, a new Gallup poll revealed.¹

This is a significant increase from 2002, when only 41 percent were trying to avoid soda, and a clear sign that, as TIME reported, “the soda craze is going flat.”²

Soda Consumption Falls to Lowest Level in Decades

The soda industry is a $75-billion market,³ an industry that reached its greatest heights in the US during the 1980s and 1990s, when Coca-Cola began pushing larger drink sizes and “upsizing.” Fountain drink sizes grew more than 50 percent by 1990, and in 1994, the 20-ounce plastic bottle was introduced in the US.

As people drank more and more soda, rates of obesity and diabetes soared, and while the soda industry still denies to this day any connection, research suggests otherwise. The “supersized” mentality seems to have backfired for Coca-Cola and other beverage companies, because as the health risks become clear, sales have been on a steady downward spiral.

As Businessweek reported:⁴

“For decades, soft-drink companies saw consumption rise. During the 1970s, the average person doubled the amount of soda they drank; by the 1980s it had overtaken tap water. In 1998, Americans were downing 56 gallons of the stuff every year—that’s 1.3 oil barrels’ worth of soda for every person in the country.

And then we weren’t as thirsty for soda anymore, and there were so many new drink options that we could easily swap it out for something else. Soft-drink sales stabilized for a few years…

In 2005 they started dropping, and they haven’t stopped. Americans are now drinking about 450 cans of soda a year, according to Beverage Digest, roughly the same amount they did in 1986.”

Coca-Cola Seeks to ‘Reintroduce’ Coke to Teen Market, and in ‘Guilt-Free’ Sizes

Part of Coca-Cola’s plan to bring soda back is, ironically, introducing smaller sizes, a strategy they believe might reposition Coke so “people stop feeling guilty when they drink it, or, ideally come to see a Coke as a treat.”

Smaller, 7.5-ounce minicans and 8-ounce glass bottles have been selling well. Even Sandy Douglas, president of Coca-Cola North America, says he limits himself to one 8-ounce glass bottle of regular Coke in the morning. Any more would be too many calories, he told Businessweek.

Meanwhile, Coca-Cola decided to target the teen market directly this summer. Teens, while notorious for their soft-drink consumption, have been quickly bailing ship and opting for energy drinks instead.

So Coca-Cola printed the 250 most common teen names on Coke bottles, hoping to entice teens with the “personalized” drinks. It worked. Sales increased by 1 percent in North America in the last three months.⁵

Beverage consultant Mike Weinstein, former president of A&W Brands, even noted that he goes right into high schools to find out whether teens can identify soda company slogans.

Yet, there seems to be a growing realization within the industry that, as American attitudes about diet change, and more people seek to reduce added sugar and sugary drinks in their diets, appealing to the “healthier” side of their image is needed.

And, here, too, Coca-Cola is quick to respond. They’ve invested heavily in small “healthy” beverage companies like Fuze tea, Zico coconut water, and organic Honest Tea. Coca-Cola also owns Odwalla and Simply Orange juices, Glaceau Vitaminwater, and Core Power sports drinks.

Coca-Cola Chairman and Chief Executive Officer Muhtar Kent has no intention of letting Coca-Cola’s brands, and its namesake product Coke, fall by the wayside.

A $1-billion two-year marketing blitz’s sole goal is to drive its “sparkling” division back to its former glory. And in case you were wondering… its healthy-sounding “sparkling” division includes soda, which is completely delusional.

Your Brain on Soda

When you drink soda, numerous changes happen in your body, including in your brain. A new animal study, presented at the Annual Meeting of the Society for the Study of Ingestive Behavior, found that sugary beverages may be particularly damaging to the brains of adolescents, one of the key age groups soda companies are trying to “court.”

Both adult and adolescent rats were fed sugary beverages for one month. They then were tested for cognitive function and memory.

While the adult rats did okay, the adolescent rats fed sugary drinks had both impaired memory and trouble learning.⁶ Next, the researchers plan to study whether soda leads to inflammation in the brain’s hippocampus, which is crucial for memory and learning.

Diet Coke Sales Plummet Amidst Aspartame Health Concerns

Diet Coke may not contain sugar, but that certainly doesn’t make it a better choice than regular soda. Here, too, Americans are catching on to the risks involved, especially in regard to the artificial sweetener aspartame. Businessweek, reporting on the decline in Coca-Cola’s sales, noted that while carbonated soda sales fell 2 percent in 2013, Diet Coke sales dropped 7 percent.

This, they said, was “almost entirely the result of the growing unpopularity of aspartame amid persistent rumors that it’s a health risk.”⁷ Rumors? Far from it. Research continues to pour in revealing proven health dangers to aspartame.

Among them, a recent commentary that reviewed the adequacy of the cancer studies submitted by G.D. Searle in the 1970s to the US Food and Drug Administration (FDA) for market approval.⁸

Their review of the data found that the studies did not prove aspartame’s safety, while other recent research suggests aspartame has potential carcinogenic effects. The researchers noted:

“Taken together, the studies performed by G.D. Searle in the 1970s and other chronic bioassays do not provide adequate scientific support for APM safety.

In contrast, recent results of life-span carcinogenicity bioassays on rats and mice published in peer-reviewed journals, and a prospective epidemiological study, provide consistent evidence of APM’s carcinogenic potential.

On the basis of the evidence of the potential carcinogenic effects of APM herein reported, a re-evaluation of the current position of international regulatory agencies must be considered an urgent matter of public health.”

You may also be surprised to learn that research has repeatedly shown that artificially sweetened no- or low-calorie drinks and other “diet” foods actually tend to stimulate your appetite, increase cravings for carbs, and stimulate fat storage and weight gain.

A report published in the journal Trends in Endocrinology & Metabolism highlighted the fact that diet soda drinkers suffer the same exact health problems as those who opt for regular soda, such as excessive weight gain, type 2 diabetes, cardiovascular disease, and stroke.⁹ For the record, Coca-Cola maintains aspartame is a “safe, high-quality alternative to sugar.” Clearly they’ve not reviewed the hundreds of studies on this artificial sweetener demonstrating its harmful effects…

What Happens When You Drink Soda?

Soda is on my list of the absolute worst foods and drinks you can consume. Once ingested, your pancreas rapidly begins to create insulin in response to the sugar. A 20-ounce bottle of cola contains the equivalent of 16 teaspoons of sugar in the form of high fructose corn syrup (HFCS). In addition to contributing to insulin resistance, the rise in blood sugar is quite rapid. Here’s a play-by-play of what happens in your body upon drinking a can of soda:

Within 20 minutes, your blood sugar spikes, and your liver responds to the resulting insulin burst by turning massive amounts of sugar into fat.
Within 40 minutes, caffeine absorption is complete; your pupils dilate, your blood pressure rises, and your liver dumps more sugar into your bloodstream.
Around 45 minutes, your body increases dopamine production, which stimulates the pleasure centers of your brain – a physically identical response to that of heroin, by the way.
After 60 minutes, you’ll start to have a blood sugar crash, and you may be tempted to reach for another sweet snack or beverage.

As I’ve discussed on numerous occasions, chronically elevated insulin levels (which you would definitely have if you regularly drink soda) and the subsequent insulin resistance is a foundational factor of most chronic disease, from diabetes to cancer. Today, while many Americans are cutting back on sugary drinks, soda remains a dietary mainstay for many. Along with energy drinks and sports drinks, soda is among the top 10 sources of calories in the US diet (number four on the list, to be exact),¹⁰ and, in 2012, Gallup found that 48 percent of Americans said they drink at least one glass of soda a day,¹¹ with proven detrimental impacts to their health.

Some Advice for Coca-Cola? Get Ready for a Class-Action Suit

Some advice for Coke, plan your budget to include a class-action lawsuit similar to those filed against the tobacco industry. These products are now well linked to the obesity epidemic and chronic disease. Coca-Cola admits to targeting teens (and has previously targeted children through in-school advertising and product placement). Now, they are making attempts to rebrand Coke with a new, healthier image. Their new “Coke Life,” a low-calorie, low-sugar soda in a green can, no less, was designed to “quiet critics,” as it contains less sugar and no aspartame.¹² Yet this new green-washed soda is just basically a cigarette with a filter.

Then there is Coca-Cola’s even more insidious side. Investigative journalist Michael Blanding revealed in his book, The Coke Machine — The Dirty Truth Behind the World’s Favorite Soft Drink, that Coca-Cola bottling plants in India have dramatically lowered the water supply, drying up wells for local villagers while also dumping cadmium, chromium, and other carcinogens into the local environment. Similar claims have been made in Mexico. In many third-world countries, they already don’t have access to clean water, making soda their only choice for a non-contaminated beverage. As the demand for soda grows, the bottling plants increase, further taxing the water supplies left, in a vicious and dangerous cycle.

Join the Growing Number of People Saying ‘No’ to Soda

In order to break free of your soda habit, first be sure you address the emotional component of your food cravings using tools such as the Emotional Freedom Technique (EFT). More than any traditional or alternative method I have used or researched, EFT works to overcome food cravings and helps you reach dietary success. Be sure to check out Turbo Tapping in particular, which is an extremely effective and simple tool to get rid of your soda addiction in a short amount of time.

If you still have cravings after trying EFT or Turbo Tapping, you may need to make some changes to your diet. My free nutrition plan can help you do this in a step-by-step fashion. Remember, nothing beats pure water when it comes to serving your body’s needs. If you really feel the urge for a carbonated beverage, try sparkling mineral water with a squirt of lime or lemon juice, or sweetened with stevia or Luo Han, both of which are safe natural sweeteners. Remember, if you struggle with high blood pressure, high cholesterol, diabetes, or extra weight, then you have insulin sensitivity issues and would likely benefit from avoiding ALL sweeteners.

Sweetened beverages, whether it’s sweetened with sugar, HFCS, naturally occurring fructose, or artificial sweeteners like aspartame, are among the worst culprits in the fight against obesity and related health problems, including diabetes and heart and liver disease, just to name a few. Ditching ALL of these types of beverages can go a long way toward reducing your risk for chronic health problems and weight gain, not to mention your exposure to potentially cancer-causing additives like caramel coloring and aspartame.

Source:mercola.com

CDC Executive Resigns After Being Caught Colluding With Coca-Cola to Salvage Soda Market

Posted by zedie

Story at-a-glance –

Email evidence shows a Centers for Disease Control and Prevention (CDC) executive aided a Coca-Cola representative in efforts to influence World Health Organization (WHO) officials to relax sugar limits
Last year, WHO announced soda is a key contributor to child obesity, suggesting restrictions on sugary beverages
Two days after Barbara Bowman, Ph.D., director of the CDC’s Division for Heart Disease and Stroke Prevention (DHDSP), was exposed for offering guidance to leading Coca-Cola advocate, Bowman resigned from her post

I’ve often written about the collusion between industry and our regulatory agencies, and how industry-funded research tends to simply support and promote the industry agenda rather than shed truthful light on the benefits or risks of any given product.

Recent media reports have now revealed devastating evidence showing a Centers for Disease Control and Prevention (CDC) executive aided a Coca-Cola representative in efforts to influence World Health Organization (WHO) officials to relax recommendations on sugar limits.¹

In March 2015, WHO published a new sugar guideline that specifically targeted sugary beverages, calling them out as a primary cause for childhood obesity around the world, especially in developing nations, where the soda industry is now aggressively expanding its reach.

WHO’s recommendation to limit soda consumption was a huge blow to an already beleaguered soda industry, struggling to maintain a declining market share amid mounting evidence identifying sweetened drinks as a primary contributor to the obesity and diabetes epidemics.

The damning email correspondence between Coca-Cola and the CDC was obtained by the nonprofit consumer education group U.S. Right to Know (USRTK).² According to PhillyVoice:³

“The emails were between Barbara Bowman, Ph.D. director of the CDC’s Division for Heart Disease and Stroke Prevention, and Dr. Alex Malaspina, a former Coca-Cola scientific and regulatory affairs leader and the founder of a food industry-funded group, International Life Sciences Institute (ILSI).

They allegedly show Bowman’s multiple attempts to aid Malaspina’s relationship with WHO leaders whose actions (think soda tax) were hurting the beverage industry.

According to the report, Bowman — whose job is to try to help prevent obesity, diabetes and other health problems — ‘appeared happy to help the beverage industry cultivate political sway with the World Health Organization.'”

Soda Politics

This kind of political maneuvering and back scratching is covered at length in Marion Nestle, Ph.D.’s book “Soda Politics.” I interviewed Nestle, a professor of nutrition, food studies and public health at New York University, last year.

In response to the CDC-Coke scandal, she says:⁴

“[T]he fact that a high-level U.S. health official is communicating in this way with a beverage industry leader appears improper,” adding the emails “suggest that ILSI, Coca-Cola and researchers funded by Coca-Cola have an ‘in’ with a prominent CDC official.

The official appears to be interested in helping these groups organize opposition to ‘eat less sugar’ and ‘disclose industry funding’ recommendations.

The invitation to dinner suggests a cozy relationship … This appearance of conflict of interest is precisely why policies for engagement with industry are needed for federal officials.”

Nestle’s book reveals the soda industry is well aware of the connection between soda consumption and obesity and obesity-related diseases.

Soda companies are by law required to inform the Securities and Exchange Commission (SEC) about vulnerabilities, and for the last decade Coca-Cola has been telling the SEC that obesity is the most significant threat to soda industry profits.

In short, Coca-Cola knows that once the truth about soda’s influence on obesity becomes fully recognized, their jig is up.

Exposed CDC Official Steps Down

For many years now, health advocates have warned people about the connection between sugary drinks and obesity, and the message has slowly but surely started to take hold.

U.S. soda sales have dropped 25 percent since 1998,⁵ no doubt due to successful public health advocacy, and this makes the current scandal all the more scandalous, as it’s an attempt by a high-level health official to undo all the work that’s already been done to protect the public health. According to USRTK:⁶

“Alex Malaspina was able to ask for and receive regular input and guidance from a top official at the … CDC on how to address actions by the World Health Organization that were hurting the food and beverage industry.

The emails … reveal that … Bowman … tried to help Malaspina find inroads to influence WHO officials to back off anti-sugar talk. Bowman suggested people and groups for Malaspina to talk to, and solicited his comments on some CDC summaries of reports … ”

Surprisingly, Bowman had the good sense to immediately vacate her post once her betrayal of the public trust was exposed.

According to The Huffington Post,⁷ Bowman “announced her immediate departure from the agency … two days after it came to light that she had been offering guidance to a leading Coca-Cola advocate who was seeking to influence world health authorities on sugar and beverage policy matters.”

Perfect Example of Why Revolving Door to Industry Needs to Be Shut

While Bowman didn’t mention her public disgrace as a factor in her resignation, saying she’d made the decision to retire “late last month,” her boss, Ursula Bauer, Ph.D., confirmed Bowman’s dealings with Coca-Cola in an internal email to CDC staff.

In it, Bauer states the “perception that some readers may take from the article [revealing Bowman’s dealings with Malaspina] is not ideal,” adding that the situation “serves as an important reminder of the old adage that if we don’t want to see it on the front pages of the newspaper then we shouldn’t do it.”⁸

Bowman’s connections to Coca-Cola actually dates back decades,⁹ and it’s anyone’s guess as to how those ties may have slowed down the path to truth and influenced public health policy. She’d been at the CDC since 1992; she was appointed director of the Division for Heart Disease and Stroke Prevention (DHDSP) in February 2013. But earlier in her career, Bowman worked as a senior nutritionist for Coca-Cola.

This just goes to show the power of the corporate and federal regulatory agency revolving door allegiances. Public servants must choose the hard road of doing what is best for the public, not their former bosses and acquaintances.

Few have that kind of integrity, it seems, and this case is a perfect example of why the door between private industry and public health and regulatory agencies needs to be more closely monitored. This is not a new problem and is pervasive in Washington for other industries. Yet the U.S. Congress and Senate continually fail to pass legislation to address this glaring loophole that decimates public health.

Philadelphia Imposes Soda Tax and Other Bad News for Big Soda

This scandal comes on the heels of a number of blows against the soda industry. Aside from WHO Director General Dr. Margaret Chan announcing soda is a key contributor to child obesity and suggesting restrictions on sugary beverages, Philadelphia recently decided to implement a soda tax to cut consumption.

Mexico imposed a soda tax in 2014, and San Francisco requires ads for sugary drinks to include a health warning as of last year. Many cities around the world are also considering similar measures to restrict soda sales. However, the stance against sugar taken by WHO was perhaps considered one of the most serious. In a June 2015 email to Bowman, Malaspina expresses worry about negative publicity related to sugar-rich products and European soda tax plans.

Malaspina says WHO’s actions can have “significant negative consequences on a global basis,” and that “the threat to our business is serious.” He also notes that WHO officials “do not want to work with industry,” adding that, “something must be done.” In response to Malaspina’s request for suggestions on how to get an audience with WHO, Bowman replies that “someone with Gates or ‘Bloomberg people’ may have close connections that could open a door at WHO,” USRTK writes.

“She also suggests he try someone at PEPFAR program, a U.S. government-backed program that makes HIV/AIDS drugs available through the sub-Saharan Africa. She tells him that ‘WHO is key to the network.’ She writes that she ‘will be in touch about getting together.'”

Clearly, the soda industry is struggling to stay alive. But at what cost should they be allowed to promote their business? It’s equally clear that the price for their unrestricted success is disease and death of its consumers, which is why these kinds of backdoor dealings are so unpalatable.

Without Conflicts of Interest, Could Junk Food Industry Survive?

In 2013, I interviewed Michele Simon, who has practiced public health law for nearly 20 years, fighting corporate tactics that deceive and manipulate you about health. Last year, she released a report that revealed disturbing ties between the American Society for Nutrition (ASN) — considered a premier source of nutritional science — and the primary purveyors of obesity and chronic ill health.

ASN is sponsored by 30 different companies, including Coca-Cola, Kellogg’s, Monsanto and the Sugar Association, just to mention a few, each of which pays $10,000 a year in return for “print and online exposure, annual meeting benefits, and first choice to sponsor educational sessions, grants, awards and other opportunities as they arise.” As noted by Simon:

“In other words, food, beverage, supplement, biotech and pharmaceutical industry leaders are able to purchase cozy relationships with the nation’s top nutrition researchers.”

Junk food purveyors gain even more influence by sponsoring educational sessions at various conferences and annual meetings, and featuring speakers that represent the industry. ASN’s ties are particularly problematic since they also publish three academic journals, including the American Journal of Clinical Nutrition (AJCN).

These ties can “taint scientific objectivity, negatively impact the organization’s policy recommendations, and result in industry-friendly research and messaging that is shared with nutrition professionals and the general public alike,” according to Simon.

Obesity researcher David Allison, Ph.D. tops the list of those with the most conflicts. Allison serves on the editorial board of the AJCN, ASN’s flagship publication, even though he has ties to PepsiCo, the Sugar Association, World Sugar Research Organization, Red Bull, Kellogg, Mars, Campbell Soup and Dr. Pepper Snapple Group.

According to Simon, “having Allison in such a critical gatekeeper role demonstrates how industry can potentially influence even the science that gets published.”

‘Just Say No’ to Soda

“Just Say No” was a slogan created by first lady Nancy Reagan. The “Just Say No” advertising campaign against recreational drug use was prevalent through the 1980s. Today, the same slogan would be appropriate to discourage soda consumption, and a whole lot easier to implement as well.

If you struggle with weight or chronic health issues, replacing soda and other sweet drinks, including fruit juices, with pure water could be one of the best things you could possibly do. Granted, other dietary changes are likely needed as well, but for many, ditching soda can go a long way.

If you crave some flavor, try adding some lime or lemon juice to still or sparkling water. Tea is another option. Just avoid adding sugar, and steer clear of bottled varieties as they’re usually loaded with added sugars. Ditto for so-called “designer water” like Vitamin Water.

If you find it difficult to quit, don’t be discouraged. Many are indeed addicted to soda. To break free, be sure to address the emotional component of your food cravings using tools such as the Emotional Freedom Techniques (EFT). A version referred to as Turbo Tapping tends to be particularly useful for eliminating soda addiction in a short amount of time.

If you still have cravings after trying EFT or Turbo Tapping, you may need to make some changes to your diet. My free nutrition plan can help you do this in a step-by-step fashion.

Remember, sweetened beverages, whether sweetened with sugar, high-fructose corn syrup (HFCS), naturally occurring fructose or artificial sweeteners are among the worst culprits in the fight against obesity and related health problems, including diabetes and heart disease. Ditching ALL of these types of beverages is a significant first step toward reducing your risk for chronic health problems and weight gain.

It’s No Myth, Cocaine Was Once An Important Ingredient In Coca Cola.

Posted by zedie

It’s No Myth, Cocaine Was Once an Important Ingredient in Coca Cola.

https://m.curiosity.com/paths/its-no-myth-cocaine-was-once-an-important-ingredient-in-coca-cola-american-heroes-channel/?utm_source=facebook&utm_medium=social&utm_term=food&utm_content=link&utm_campaign=20160901fbk00CRSTcocaine#

Coca-Cola ‘Pays Scientists to Protect Sugary Drinks, Junk Food’

Posted by zedie

And pays health leaders to say soda is healthy

Coca-Cola ‘Pays Scientists to Protect Sugary Drinks, Junk Food’
Recent news has come out exposing Monsanto for trying to discredit any scientist who paints a less-than-rosy picture for biotech and GMO crops.

To join this play on the consumer conscience is a ploy from the international soda seller, Coca-Cola. Some claim that the company pays scientists who will shift the blame away from junk food diets and sugar-laden sodas for causing a global obesity epidemic, and numerous other serious health concerns.
In fact, Coca-Cola was caught paying ‘health leaders’ to say soda is a ‘healthy snack’ before.

Coca-Cola claims that it wants America to be fit. Really…

Does it seem ironic that one of the major contributors to the growing obesity rate around the world, Coca-Cola, gave $3 million in 2012 to Chicago’s Garfield Park Conservatory Alliance in order to begin a ‘wellness program’? The mega-corp also donates millions to strike down GMO labeling.
Here’s an idea for wellness – stop selling people drinks so full of GM sugar that they don’t get a single nutritional need met, while simply filling up on empty, calories. Not to take the focus off of our own responsibility to educate ourselves and eat better, but Coca-Cola heading a ‘wellness’ campaign is like Charles Manson trying to lead a workshop on how to get in touch with your ‘inner child.’

Yet, similar to the tactics used by Big Tobacco, Coca-Cola and other companies aligned with the Grocery Manufacturer’s Association simply use ‘science’ to persuade a nation to keep up with their sugar addictions.

These addictions are real. Consider Natasha Harris who died in 2013 from a cardiac arrhythmia, according to a 19-page coroner’s report. Harris, a mother of 8 from Invercargill, New Zealand, was known to smoke heavily and skip multiple meals, but coroner David Crerar concluded that the sugar and caffeine she got by drinking more than 2.6 gallons of Coca-Cola Classic per day was ‘the substantial factor’ in her death.”

We are supposed to forget facts like these with Coca-Cola’s new ‘science-based’ marketing campaign attempt to fancy up a ridiculous message which tells America to just move more, and worry less about the calories they consume. We learn from the New York Times articles (linked in the first paragraph) that:

“The beverage giant has teamed up with influential scientists who are advancing this message in medical journals, at conferences and through social media. To help the scientists get the word out, Coke has provided financial and logistical support to a new nonprofit organization called the Global Energy Balance Network, which promotes the argument that weight-conscious Americans are overly fixated on how much they eat and drink while not paying enough attention to exercise.”
That’s odd since a 12-oz can of Coke contains around 138 calories. This means that most people would have to walk almost an hour to burn off the calories in one Coke. This also ignores the fact that the sugar levels in Coke and the fake-sugars in Diet Coke are responsible for a host of other ailments aside from obesity – from insulin resistance to migraines.

Then there’s the dire consideration that found in a Danish study showing that men who drank 32 ounces or more of Coca-Cola daily could reduce their sperm count by nearly 30%, or that those who drink soda’s like Coca-Cola tend to eat less nutrition-filled fruits and vegetables.

Yes, the very same company that is launching a ‘science-based’ campaign for ‘wellness’ makes products which contain:

Phosphoric Acid (in Coca-Cola and Diet Coke) which has been shown to destroy bones by contributing to osteoporosis as well as damaging teeth.
Aspartame, now known as AminoSweet, whichhas been linked to numerous diseases and health problems.
Food dyes and other chemical additives that are known carcinogens.
GM Sugar – Want a reality check for how much sugar (often of the genetically modified variety) is in Coca-Cola?

This doesn’t even cover the questionable ‘wellness’ provided by products like Vitamin Water, which has been the subject of both a lawsuit, and subsequent settlement.

Or how about the California judge who has allowed a suit against the Coca Cola Company to proceed, despite Coke’s claims that the lawsuit is without merit. The plaintiffs are suing Coke, alleging that the following claim is false:

“No artificial flavors.
No preservatives added.
Since 1886.

Why would this claim be false? Take a look at the ingredient list and you can decide:

‘Carbonated water, high fructose corn syrup, caramel color, phosphoric acid, natural flavors, caffeine.’”

So as we drink to our ‘health’ Steven N. Blair, an exercise scientist, says:

“Most of the focus in the popular media and in the scientific press is, ‘Oh they’re eating too much, eating too much, eating too much’ — blaming fast food, blaming sugary drinks and so on . . .and there’s really virtually no compelling evidence that that, in fact, is the cause.”

Sure, eating calorie-filled food with high sugar content, and carcinogenic ingredients – that’s a sure way to wellness – said NO ONE, EVER. Oh, wait, unless of course you work for Coca-Cola.

Many health experts are smart enough to know better. They warn that this message is misleading and irresponsible.

COCA-COLA’S HONEST LOGO SHOWS WHICH ORGANS ARE HARMED WHEN YOU DRINK IT

Posted by zedie

We all like to drink a refreshing coke sometimes, but drinking too much of it, however, can damage your health.

This honest logo createdy by designer from Nicaragua, Fabio Pantoja, has a dark twist: the letters depict the different organs and parts of your body that suffer damage after having too much soda.

“More than a critic to CocaCola, it’s a critic to myself, to see if I can finally stop drinking this poison once and for all!” writes the designer on his Behance page. There, you can check the research and makeover of Pantoja to create his “Uncover the truth,” along with his many other pieces.

	zedie on Your Very Own Consciousness Ca…
	Cosmic Consciousness… on Your Very Own Consciousness Ca…
	zedie on New Research Links Reused Deep…
	The Healthiest Kinds… on The Healthiest Kinds of Salt:…
	zedie on Bobby Caldwell: Death from Flu…
	Diane Hardy on Bobby Caldwell: Death from Flu…
	zedie on So Is Coffee Bad for You in An…
	Americaoncoffee on So Is Coffee Bad for You in An…
	A Star on the Forehe… on How Often Should You Really…
	Get Hitch on Regain Control of Your Data in…

Summary

Introduction

Corporate Sustainability Is Well Established

Table 1.

Selected Examples of ESG Categories Relevant to Health Care Organizations

Moving to Mandated ESG Disclosure

Current Sustainability Efforts in the U.S. Health Care Delivery Sector: Alone Together

Table 2.

Selected Sustainability Initiatives Undertaken by U.S. Health Care Delivery Organizations

Operational Drivers for ESG in Health Care: Keeping the Doors Open

Mission Drivers for ESG: Getting to “Triple Aim” via the “Triple Bottom Line”

Social Capital: ESG to Enhance the Health Care Workforce

Table 3.

ESG Value to Health Care Organizations

Value Drivers for ESG: The Financial Benefits of Sustainability Management and Reporting for Health Care Organizations

Integrating ESG into Health Care Operations

Table 4.

Key Elements to Operationalize ESG in the U.S. Health Care Sector

Conclusions

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Washing your hair with cola could have great benefits

Cola

Wash your hair

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Story at-a-glance

Soda Consumption Falls to Lowest Level in Decades

Coca-Cola Seeks to ‘Reintroduce’ Coke to Teen Market, and in ‘Guilt-Free’ Sizes

Your Brain on Soda

Diet Coke Sales Plummet Amidst Aspartame Health Concerns

What Happens When You Drink Soda?

Some Advice for Coca-Cola? Get Ready for a Class-Action Suit

Join the Growing Number of People Saying ‘No’ to Soda

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Soda Politics

Exposed CDC Official Steps Down

Perfect Example of Why Revolving Door to Industry Needs to Be Shut

Philadelphia Imposes Soda Tax and Other Bad News for Big Soda

Without Conflicts of Interest, Could Junk Food Industry Survive?

‘Just Say No’ to Soda

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