Why is there a red dress on diet Coke cans?

I have a question for the NHLBI: why is there a red dress on diet Coke cans? But before raising the question, let’s step back for a moment. Last Tuesday at the ACC Bob Harrington and Steve Nissen debated each other (and, occasionally, the audience) over the subject of conflicts of interest in medicine. The debate was widely covered by the Associated PressForbes, the Wall Street Journal Health Blog, and MedPage Today (where you can also find a link to listen to the initial presentations of the debaters).

The debate was combative but thoughtful and even nuanced– among other things, Harrington conceded that there have been many egregious cases of conflict of interest and Nissen acknowledged that academics need to work with industry. But after the debate almost the only thing reporters and others who were in the audience focused on was a Nissen blooper, which happened when Nissen criticized the AHA for issuing a statement some time ago that pointed out the limitations of a study linking soda consumption to metabolic syndrome. Nissen said the AHA had compromised itself by accepting money from Coca-Cola. To illustrate his point he showed images of Diet Coke cans with red dresses and hearts.

Turns out Nissen made a mistake. The AHA does not have a deal with Coke. But here’s where it gets weird: the NHLBI has its own Women’s Heart Health red dress program, and it does have some kind of deal with Coke. Who knew there were two such programs? And who would ever have thought Coke could buy a partnership with the NHLBI?

The NHLBI told MedPage Today that “Diet Coke does not pay any money for use of the red dress logo on the can… NHLBI does not receive any money directly from Diet Coke,” though they acknowledged that “Diet Coke has provided donations to the Foundation for the National Institutes of Health.”

Maybe I’m missing something here but this seems really bizarre. Go to the Corporate Partners page of the NHLBI’s The Heart Truth website and you can see that Diet Coke is first in a long list of corporate partners. Here’s how the text reads:

“Diet Coke continues to help spread The Heart Truth®through visibility on 6.7 billion packages of Diet Coke featuring The Heart Truth and Red Dress symbol. In 2010, Diet Coke designed limited edition “heart graphic” packages that will greatly increase visibility and awareness of the campaign.”

If I read this correctly, the NHLBI is claiming that Diet Coke is doing a favor to the NHLBI by putting these graphics on soda cans and thereby spreading the word about their program. My own simple interpretation is that Coke is paying to use the graphic.

Are we really expected to believe that there is no connection between the appearance of these graphics on the Diet Coke can and the hundreds of thousands of dollars that Coca-Cola gives to the Foundation for the NIH? Just take a look at the Foundation’s annual reports. In 2008 the Foundation reported that Coca-Cola donated between $250,000-$499,000. No word what they spent last year or are spending this year on the expanded campaign.

And does Diet Coke really expect us to believe that the company is somehow heart healthy? The NHLBI should have absolutely no involvement in any high concept PR campaign like this in which the lofty goals of promoting cardiovascular health are debased by an association with the largest seller of sugared sodas in the entire world. Let there be no doubt: soda companies are part of the problem, not the solution, and Coca-Cola can’t make up for the damage it has caused by throwing some money at the NIH.

On Diet Coke’s website the NHLBI is listed as one of “our partners” and that “together, we’ve raised awareness for important issues and delivered refreshing ideas for you to enjoy.” Refreshing. Hmmm. Where have I heard that before? Oh, right, Coke ads.

The Diet Coke website contains a host of tips and suggestions for heart healthy living. One tip they don’t include: cut out sugared soda. (I guess Diet Coke’s commitment to heart health doesn’t go so far as to upset the corporate parent.) But a number of recommendations on the Diet Coke website, including the very first tip, focus on eliminating junk food like potato chips. Could it be a coincidence that Coke’s big rival, Pepsi, owns Frito Lay?

Or, perhaps, cutting out soda just wasn’t important enough. After all, they only had room for about 70 tips, and clearly it was more important to include such important advice like this:

Don’t Forget Accessories. Sunglasses aren’t just for looking great (but they do, don’t they?) You’ll want them if you’re walking outside. And don’t forget an umbrella if it’s sprinkling.

I suppose it’s possible the NHLBI doesn’t see a problem here. After all, it’s hard to see the details when you’re wearing sunglasses.


  1. Jan Weber MD, FACC says:

    Res Ipsa Loquitur.

    — Nerozumim

  2. Thanks for pointing this out….I thought this new ad campaign seemed oxymoronic.

  3. Having attended the session at the ACC in question, I wish that Dr. Yancy had driven home the egregious error as it would have probably opened the door for others to challenge some of Nissan’s other arguments — some were legitimate, but the majority merely reflected the same type of fear mongering that Nissan, himself, criticized of the media and their coverage of healthcare stories.

    In terms of the red dress on Diet Coke cans…hell, any kind of awareness is better than no awareness at all. As we all know, the business of medicine is precisely that — a business and it is that business which drives innovation and enables access to care. No doubt that there was some sort of corporate interactions between Coke and the NHLBI. However, it likely only represents a little evil, as the end goal is to increase awareness; marketing the red dress campaign (even if on a source of part of the epidemic) is precisely in line with such goals.

    On an aside, I remain curious as to why the AHA issued comments cautioning over-extending the applicability of the results of studies showing a correlation between soda consumption and the metabolic syndrome. Perhaps that would have been a good question for Dr. Yancy to have addressed.

  4. Allene said, “In terms of the red dress on Diet Coke cans…hell, any kind of awareness is better than no awareness at all”.

    Awareness of what, that the NHLBI will do anything for money!
    Its called advertising and endorsing.

    Or were the ,”Most doctors smoke Lucky Strikes” from the 1960’s also meant to serve up awareness, and of what, that doctors bend over if the price is right.

    Wilbur Larch MD, FACC


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