The Lancet Commission on obesity calls for a reframed understanding of obesity, undernutrition, and climate change as a global syndemic of interconnected crises with common societal drivers.1Swinburn BA Kraak VI Allender S et al.The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report.Lancet. 2019; 393: 791-846Summary Full Text Full Text PDF PubMed Scopus (1043) Google Scholar Within low-income and middle-income countries (LMICs), research and advocacy on how transnational food and beverage corporations are impacting obesity and undernutrition is growing. These discussions should be expanded to include the industry's impacts on environment. Internal industry documents found in the University of California San Francisco's Food Industry Documents Library, in combination with publicly available ones, show that Coca-Cola is almost as concerned about its role in water scarcity as it is about obesity in LMICs, especially Colombia. Although keeping these two issues separate is in the company's interests, linking them is in the best interests of public health. As consumer health concerns have driven down soda sales in developed countries, Coca-Cola and its Latin American bottling franchise, Coca-Cola FEMSA, have experienced double-digit growth in the Colombian market. Colombian researchers and health advocates have responded with a vigorous campaign promoting anti-obesity regulations, including soda taxes and front-of-package nutrition labels. However strong industry opposition appears to have blocked these efforts so far.2Jacobs A Richtel M She took on Colombia's soda industry. Then she was silenced.https://www.nytimes.com/2017/11/13/health/colombia-soda-tax-obesity.htmlDate: Nov 13, 2017Date accessed: June 22, 2020Google Scholar Although obesity has been the focus for Colombian public health advocacy, climate change and water scarcity are looming concerns for Coca-Cola. During a 2016 visit to Colombia, Coca-Cola's president and chief operating officer, James Quincey, emphasized that heat, water scarcity, and a possible soda tax were key barriers to completing the company's planned investments in the country.3Goltzman M Fwd: JQ Interview El Tiempo Colombia 013016. Industry Documents Library.https://www.industrydocuments.ucsf.edu/docs/#id=mycl0226Date: 2016Date accessed: June 22, 2020Google Scholar Quincey's visit coincided with the worst drought on record with water rationing in some parts of the country, and with the launch of a new bottling plant in the town of Tocancipa that reportedly saved “between 20 and 30% in the use of water” and could “decrease the carbon footprint and encourage the use of sustainable packaging.”4HsbnoticiasCoca-Cola FEMSA inauguró en Tocancipá su nueva planta embotelladora.https://hsbnoticias.com/noticias/nacional/coca-cola-femsa-inauguro-en-tocancipa-su-nueva-planta-embote-141655Date: 2015Date accessed: June 22, 2020Google Scholar Critics observed that the new Tocancipa plant's consumption comprised 68·5% of the municipality's entire water use.5Witness for PeaceCoca-Cola's new bottling plant threatens workers' rights in Colombia.https://www.solidaritycollective.org/post/coca-cola-s-new-bottling-plant-threatens-workers-rights-in-colombiaDate: July 2, 2015Date accessed: June 24, 2020Google Scholar In 2016, Coca-Cola was monitoring government debates in some parts of Latin American over declaring water access a universal right, noting concerns that this could lead governments to tax the company's water use.6Goltzman M FW: INFORM: Global Government Relations Dashboard. Food Industry Documents.https://www.industrydocuments.ucsf.edu/food/docs/#id=grcl0226Date: 2016Date accessed: June 24, 2020Google Scholar Meanwhile Coca-Cola and Coca-Cola FEMSA were actively pursuing public–private partnerships with water protection groups in Colombia to promote a positive public image. Water for Education was one such partnership seeking to place water treatment facilities in Colombian schools while training children in the value of this resource.7Coca-Cola FEMSA Nuestra gente. Sustainability Colombia.https://www.coca-colafemsa.com/presencia/colombia/nuestra-gente-colombia.htmlDate: 2020Date accessed: June 22, 2020Google Scholar Coca-Cola was helping to sponsor the Global Shapers program which brought benefits to the company's reputation by targeting millennial leaders, only 17% of whom were found to trust multinational corporations.8Goltzman M Cherry K FW: INFORM: Coca-Cola Shaping a Better Future grant challenge for global shapers - 2015 winners. Food Industry Documents.https://www.industrydocuments.ucsf.edu/food/docs/#id=xzcl0226Date: 2015Date accessed: June 22, 2020Google Scholar The Global Shapers hub in Cartegena, Colombia was a grand prize winner in 2015 for its Water for Life initiative promoting water access in rural communities. Water for the Future remains a Coca-Cola-funded partnership with governmental and nongovernmental groups in Colombia that seeks to recover water in the basins of Bogotá and Medellín to compensate for the company's water extraction. Coca-Cola and Coca-Cola FEMSA argue that this programme has allowed them to achieve water neutrality by returning 100% of the water used to make their beverages back into the environment.9Coca-Cola CompanyEmail to Mike Jacobson regarding millennials fostering peace in Bogota, Colombia awarded grant from the Coca-Cola company. Food Industry Documents.https://www.industrydocuments.ucsf.edu/docs/#id=tkcm0229Date: 2017Date accessed: June 22, 2020Google Scholar Independent studies note that the company's definition of water neutrality fails to account for the water used to produce bottles, packaging, sugar, and other ingredients. Sugar production constitutes approximately two-thirds of the total water footprint for soda; depending on the sweetener, it takes an estimated 442–618 litres of fresh water to produce one litre of soda.10Srivastava A The privatization of water in India: how Coca-Cola destroys the Aquifer.https://www.globalresearch.ca/the-privatization-of-water-in-india-how-cocacola-destroys-the-aquifer/5472625Date: Dec 31, 2015Date accessed: June 22, 2020Google Scholar Coca-Cola views water scarcity as a top concern for corporate sustainability only second to the obesity crisis, and seeks to deflect criticism and fend off regulation in LMICs. Fragmenting public health opposition by keeping these issues separate is in the interests of transnational food and beverage corporations, including Coca-Cola. Researchers and advocates should follow recommendations by the Lancet Commission on obesity to address this common threat to human nutrition and planetary health as interconnected issues. In India, strong civil society opposition to Coca-Cola's water use led to government interventions that protect communities facing water scarcity. This action preceded passage of a national anti-obesity soda tax promoted by a coalition that included water rights advocates.11Doshi V Indian traders boycott Coca-Cola for ‘straining water resources’.https://www.globalresearch.ca/the-privatization-of-water-in-india-how-cocacola-destroys-the-aquifer/5472625Date: March 1, 2017Date accessed: June 22, 2020Google Scholar Other LMICs should follow India's lead for overcoming dominant industry pressure through the unification of anti-obesity and environmental protection advocacy. At the global level, human and planetary health leaders should define water access as a basic human right, and develop independent systems for monitoring and benchmarking transnational corporations on their combined nutritional and environmental impacts. LS reports personal fees from 3650 Olympic, outside the submitted work. MM reports grants from FAPESP, during the conduct of the study. LS, CK, and EC report support from the Global Health Advocacy Incubator, and funding from Bloomberg Philanthropies, during the conduct of the study. Download .pdf (.22 MB) Help with pdf files Spanish translation of the full text