The hard word on soft drinks
Drinking up to 10 litres of CocaCola a day contributed to the death of an Invercargill mother a decade ago. So has anything changed in the soft drink and health industries since then? Brittney Deguara reports.
In 2010, a New Zealand woman’s love of CocaCola made news all around the world. Natasha Harris, a mother of eight, drank up to 10 litres of the ‘Classic’ soft drink a day – a habit that ultimately contributed to her death. An inquest into the ‘‘unusual circumstances’’ surrounding her death was launched in 2012.
The case raised many questions about soft drinks, such as whether there should be warnings on the labels, or whether caffeine restrictions should be introduced.
Harris died in February 2010 and it has been seven years since the inquest concluded, so were any of the coroner’s questions answered by the beverage and health industries?
Before she died, the 32-year-old predicted she wouldn’t live long, telling her sister-in-law that she felt ill all the time. She was drinking large amounts of soft drinks, eating sporadically, and smoking a lot.
A year later she died of cardiac arrhythmia, a heart attack likely caused by hypokalemia (low potassium levels in her blood, potentially related to the large quantities of Coke she drank).
Coroner David Crerar, in consultation with various medical experts, came to the conclusion that Harris’ Coke consumption wasn’t the sole cause of her death, but a contributor. He said it was ‘‘unlikely that she would have died when she died and how she died’’ were it not for the mass amounts of soft drink she consumed on a daily basis.
Harris’ partner of 15 years Chris Hodgkinson told the inquest that she would drink up to 10 litres a day, which amounted to about a kilogram of sugar. The World Health Organisation’s (WHO) recommended sugar intake for adults was six teaspoons a day, which was 25 grams, 40 times less than the quantity Harris consumed daily.
Following the inquest, Crerar recommended the Ministry of Health consider adding warning labels to carbonated beverages.
‘‘The hazards of the health of the consumers of excessive quantities of sugar and caffeine contained in carbonated beverages could be more clearly emphasised,’’ he wrote in his findings.
Finding out whether these recommendations were acted on was difficult. The Ministry of Health wasn’t aware of any changes made in the wake of the incident.
A New Zealand Food Safety spokesperson confirmed the inquest did not result in any changes to the labelling of caffeine.
‘‘At the time of the inquest, there was a transTasman working group reviewing the overarching policy guidelines for the addition of caffeine in food, but there were no requests or direction to change the Food Standards Code with regards to the labelling of caffeine as there were other factors that may have contributed to the death.’’
In recent years changes were considered, but there had been little action.
In terms of sugar intake, there were no limitations on how much products could contain, nor were food and drink labels required to warn of the impact of excessive consumption.
Food Standards Australia and New Zealand (FSANZ) was currently considering reviewing labelling for added sugars in food and drinks.
There was no recognised acceptable daily intake for caffeine in New Zealand, but there were restrictions in place for cola-type soft drinks (145 milligrams per kilogram of body mass) and energy drinks (320mg per litre), according to the FSANZ website.
Harris’ 10L consumption amounted to 970mg of caffeine.
The coroner made similar recommendations to Coca-Cola. The company was asked to consider adding warnings about the dangers of consuming large amounts, and the quantity of caffeine in the product.
A Coca-Cola Oceania spokesperson told the Sunday Star-Times the presence of caffeine was clearly labelled on Coca-Cola packs and added that the caffeine levels were less than other popular beverages, such as coffee. They failed to answer specific questions over considerations or changes made following Harris’ death and the inquest.
‘‘We adhere to food regulations in every country we operate, including Australian and NZ Food Standards Code. We also take guidance from the large body of science based evidence on the safety of ingredients.
‘‘We have always tried to be as respectful as possible and limit our comments on her passing in 2010.’’
Although soft drink addiction wasn’t a formally recognised addiction, Hodgkinson claimed his partner was hooked on the drink. He told the inquest she drank ‘‘at least 10 litres [of Coke] a day’’, would barely eat, and smoked approximately 30 cigarettes a day.
‘‘She would get moody and get headaches if she didn’t have any Coke and also feel low in energy.’’
Hodgkinson’s mother, Vivienne, supported this claim and said Harris would ‘‘get the shakes, withdrawal symptoms; be angry, on edge and snappy’’ if she ran out.
These were common withdrawal symptoms for addicts, according to public health physician and researcher Dr Simon Thornley from the University of Auckland.
‘‘When you stop . . . you feel not quite right . . . people talk about irritability, can’t concentrate, having urges, cravings for a substance. You only discover the withdrawal symptoms when you try and cut down, so if you keep eating and eating, you sort of stay on the sugar train.’’
He said the combination of caffeine and sugar in these types of drinks made it possible for adults and children alike to get addicted.
Data from the Ministry of Health’s New Zealand Health Survey found 31.8 per cent of children aged 2 to 14 had a fizzy drink one or more times a week, while 10.2 per cent had it three or more times a week.
Dr Harriette Carr, the ministry’s deputy Director of Public Health, said data from the ministry’s 2008/2009 adult nutrition survey found 30.5 per cent of adults aged over 15 years drank soft drink or energy drink three or more times a week, while 8.8 per cent consumed it seven or more times a week.
Harris’ addiction was recognised by her family. Her half-sister, Raelene Finlayson, told the inquest: ‘‘As people use marijuana or drink, she used it as a comfort and obviously got addicted.’’
Considering Harris smoked more than a packet of cigarettes a day while knowing of the potential health hazards, would warning labels on Coke bottles have helped curb the habit?
Thornley believed it was necessary to have sugar and caffeine warnings on soft drinks and thought displaying the number of teaspoons in each product would resonate with consumers better. But he knew more needed to be done to stop excessive consumption.
‘‘People know that it’s unhealthy, but the addiction is so strong that they continue to do it . . . I think probably the number one policy which would help us break our sugar addiction is the
sugar tax,’’ Thornley said.
Sugar taxes have been introduced in Mexico, the United Kingdom, South Africa and part of the United States in recent years. They were only being discussed in New Zealand. Despite various studies supporting the introduction of a sugary drinks tax, the Food Industry Taskforce found there was weak evidence for these taxes to improve health outcomes. It instead recommended limiting advertising, marketing and sponsorship related to energy-dense, nutrient poor food and beverages. These recommendations were yet to be acted on.
Anna Sloan, a registered dietician from Nutrition Connection, said anyone who consumed this much soft drink needed to be educated on the matter.
‘‘[They are] in need of education around the high risk for adverse health outcomes, but mostly non-judgemental help to understand why they might be drinking so much and how to move themselves towards better choices.’’
Crerar found the soft-drinks company wasn’t responsible for the health of its consumers who drank unhealthy quantities.
‘‘[Harris] knew, or ought to have known and recognised the health hazard of her chosen diet and lifestyle,’’ he wrote.
Harris’ half-sister agreed, saying at the inquest, ‘‘nobody forced Tasha to drink all that’’.
Her half-brother Brett Duffy didn’t point the finger at the soft-drinks company either, instead highlighting the many health issues that contributed to her death – ‘‘at the end of the day it wasn’t just the Coke that killed her’’.
The Sunday Star-Times was unable to get in contact with any members of Harris’ family. A Coca-Cola Oceania spokesperson told Sunday
Star-Times their thoughts and sympathies remained with Harris’ family, but reiterated that expert medical expert failed to agree on the most likely cause of her fatal heart attack.
Although no changes were made to labelling, the company did release its newest product Coke Life in Argentina in the same year as the inquest made with the sugar-substitute stevia. This product was replaced in 2018 with Coke Stevia No Sugar and made available in New Zealand.
These alternatives to the full-sugar version were a better option, Thornley said, but ultimately removing them from diets and lifestyles altogether was a better move.
‘‘I think the diet version is much less addictive because of the lack of sugar in it.’’
The Ministry of Health’s advice was to eliminate the consumption of these drinks altogether by making plain water the first choice.
After hearing about this incident, Thornley said it really highlighted the problem of sugar and caffeine addiction, and ultimately, soft-drink addiction.
‘‘We know that sugar causes diabetes, we know that sugar causes rotten teeth, why are we not doing more to curb the problem?’’
For advice regarding excessive caffeine exposure, phone the National Poisons Centre free of charge on 0800 764 766.