COCA COLA? THE NEW TOBACCO

Aim: To highlight volumes of sales of Coca‐Cola in remote Aboriginal communities.

Background: Aboriginal people in remote areas are impoverished, poorly educated, poorly nourished, have limited choices and pay high prices for every commodity. Early life malnutrition enhances susceptibility to chronic disease, which is amplified by a diet of highly processed micronutrient‐deficient calorie‐dense foods. The WHO recommends that sugars constitute <10% (soon potentially <5%) of energy intake. Brimblecombe recently estimated, in three remote communities, that sugars constituted about 30% of energy intake.

Our observations: In a 2011 store audit in a separate study community, with the highest CV death and renal failure rates in Australia, soft drinks, sweets and ice‐creams accounted for 46% of spending on consumables, exclusive of alcohol and cigarettes. Specifically, 108,000 litres of Coca‐Cola Amatil (CCA) softdrink were sold in six months, or >16 litres per month for everyone age 15+ years. On enquiry, CCA's Board Chairman cited corporate resolve to provide a full range of choices to even the most disadvantaged Australians. In 2007, CCA's website nominated the NT as the global leader in per capita Coke consumption. CCA‐led interventions also recently thwarted the NT's container deposit scheme, although this has now been circumvented by alternate NT parliamentary legislation.

Conclusions: Pollution of community and seaways are serious considerations. So are diversion of funds otherwise available for healthy food alternatives, excess empty calories, obesity, diabetes, metabolic syndrome, cardiovascular risk and tooth decay. Furthermore, dehydration and sugar excess probably facilitate the growing multicentric global epidemic of CKD of unknown etiology, and might well be renal toxic per se. An exacerbating role in Aboriginal renal disease cannot be excluded. It is time to act.