Whenever Buffett raises a can of 80-cent Coke, he moves a step further from his $118 billion fortune. Coke won't depreciate Buffett's assets, but it might cause the 91-year-old to suffer from osteoporosis, indigestion, tooth decay, kidney stones, and more frequent urination. Even if he were 80 years younger, it would be the same. 01
Are Carbonated Drinks Healthy?
On August 29, 2022, three trending topics appeared on Weibo. "Drinks are one of the reasons for the younger onset of gout," "Brushing teeth after drinking carbonated drinks can worsen tooth damage," and "After listening to experts' advice, beverage companies have reduced production." The three trending topics had different angles but pointed to the same conclusion: carbonated drinks are more harmful to health than people think. This is not the first time carbonated drinks have been flagged for health issues. Over the years, due to their high sugar content, carbonated drinks have been included in the "unhealthy" list by public opinion. As a common sweetener, fructose is widely used in carbonated drinks. The initial controversy was whether excessive sugar intake affects sugar metabolism. Around 2010, the medical community began to suggest that excessive fructose intake could lead to gout. Among studies by multiple research institutions, China Medical University gave the most direct conclusion: carbonated drink consumption increases the risk of gout, and the risk rises with increased frequency of consumption. The spread and exaggeration of public opinion have made consumers pay more attention to sugar issues. According to research by China Commercial Industry Research Institute, under the trend of health consciousness, nearly 80% of Chinese consumers now pay attention to beverage ingredients, especially the sugar content. This has led to a consumption trend. Coca-Cola, Sprite, and Pepsi, all famous carbonated drink brands, have launched sugar-free and sugar-substitute products. Riding this trend, Genki Forest successfully cultivated star products like sparkling water. But sugar intake is only one of the sins of carbonated drinks. The trending topic "Brushing teeth after drinking carbonated drinks harms teeth" has made many people doubtful and anxious. According to research by Fujian Medical University, fruit vinegar drinks rank first in tooth erosion, with carbonated drinks second. Their acidic pH directly erodes tooth surfaces. Subsequently, fermentable sugars in carbonated drinks spread to dental plaque, producing acid through microbial fermentation, causing dental caries and dental erosion. The carbonation effect of carbonated drinks exacerbates both types of damage. Research from Anhui Medical University added another blow: even brushing or rinsing immediately after drinking carbonated cola has little effect on protecting teeth, unless using a straw to minimize contact between the drink and teeth. Two data trends, though not directly linked, show a concerning parallel. One is from the "2020 China Children's Health Status Analysis Report," which shows that from 2010 to 2019, the permanent tooth caries rate among primary and secondary school students increased by 6.4 percentage points. The other is the rapid development of carbonated drinks in China: after reaching a historical sales peak in 2014, they have remained at a similar high level. But the health controversies of carbonated drinks go far beyond sugar intake and tooth decay. Many carbonated drinks add phosphoric acid or phosphates to enhance flavor. Some studies suggest that excessive phosphorus affects calcium absorption in bones, potentially leading to calcium loss and even osteoporosis. Phosphorus is an essential element for the human body. According to the Chinese Nutrition Society, the appropriate daily phosphorus intake for adults is 700 mg, which requires about 10 cans of 330 ml cola to reach. Although Ai Hua, chief physician at Peking University Third Hospital, believes that only extreme cases of drinking five to ten bottles at once would harm bone health, the British Journal of Nutrition soon provided new research findings: What may more easily cause bone density loss is not phosphoric acid but the caffeine in carbonated drinks. Additionally, caffeine, often added to cola-type carbonated drinks, may also lead to diuresis and kidney stones. On September 3, 2022, the Sixth Affiliated Hospital of Sun Yat-sen University relayed a report from Science and Technology Daily, which mentioned that caffeine has a diuretic effect, promoting water excretion, so carbonated drinks make you thirstier. Excessive caffeine intake increases calcium ion levels in urine and accelerates the excretion of magnesium and citrate, both of which help prevent kidney stones. Even carbon dioxide, the core of carbonated drinks, is now considered unhealthy. According to research by Southeast University, because carbon dioxide inhibits bacteria, it also inhibits normal flora in the gastrointestinal tract, ultimately damaging the digestive system. Therefore, frequent consumption of carbonated drinks is not recommended. 02
The "Healthy" History of Carbonated Drinks
Interestingly, carbonated drinks, now mired in "unhealthy" controversy, originally debuted with a health pitch. In 1888, American tycoon Asa Candler's headache recurred. After drinking a cup of "ancient version" Coca-Cola brought by a servant, he felt energetic again. Asa Candler saw a business opportunity. Coincidentally, the inventor of Coca-Cola, John Pemberton, had passed away, so Candler acquired the rights to Coca-Cola and founded the Coca-Cola Company in 1892. At that time, Coca-Cola, as its name suggests, was made from coca leaves (containing cocaine) and kola nuts (containing caffeine). Back then, Coca-Cola's promotional posters were filled with claims like "cures headaches, relieves fatigue, treats morphine addiction," and with its good taste, Coca-Cola became popular across the United States. Pepsi, Coca-Cola's rival, also started with a "health" angle. In 1893, pharmacist Caleb Bradham developed a new medicine to treat stomach ailments and, following Coca-Cola's success, added kola nuts to make a carbonated drink. Originally called "Brad's Drink," it initially sold poorly. To highlight its stomach-healing properties, Bradham combined the root "pepsi" (from dyspepsia) with "kola" to create the name Pepsi-Cola. With the "stomach ailment" concept, Pepsi gained the capital to compete with Coca-Cola. In 1929, Charles created the first bottle of 7 Up. Based on the knowledge of the time, the lithium citrate in the formula could regulate mood and treat manic depression. In its early years, 7 Up also used "lithium citrate" as a selling point, even naming it "Lithiated Lemon-Lime Soda." With scientific progress, people discovered that early carbonated drink formulas were not beneficial to health. In 1903, due to the addictive nature of cocaine, Coca-Cola removed it from the formula; in 1931, Pepsi removed pepsin due to "stomach treatment controversies"; in 1948, 7 Up removed lithium due to various side effects. After removing those ingredients that once shaped the "healthy" image, the main components of various carbonated drinks were reduced to caffeine, sugar, and carbonic acid, but only because they were at the boundaries of scientific understanding. Once academia began studying the relationship between sugar and health, doubts quickly spread to carbonated drinks. In 1964, Pepsi launched a sugar-free Diet Pepsi; in 1982, Coca-Cola also launched a sugar-free product, the famous Diet Coke. In fact, the Chinese naming of Diet Coke still shows the strategy: continuing to play the "health" card. However, at that time, consumers had not fully realized the harm of high sugar intake, so the sugar-free products of Pepsi and Coca-Cola did not make much of a splash. Entering the 21st century, as science advanced and understanding deepened, controversies began to spread anew. The United States was the first to be affected. With rising obesity rates, carbonated drink sales in the U.S. began to decline year by year from 2005. After 2014, China's carbonated drink market also became sluggish. According to data from Qianzhan Industry Research Institute, from 2012 to 2018, the growth rate of traditional carbonated drink sales experienced a cliff-like decline, with negative growth in 2015, 2016, and 2018. In 2017, Coca-Cola and Pepsi's net profits fell by 81% and 23% respectively compared to 2016, hitting their lowest points since 2013. ▲Top: Pepsi Bottom: Coca-Cola Meanwhile, governments began regulating sugary drinks. "I ask them to reduce the sugar content of Milo to 5%, otherwise we will legislate to control sugar in all drinks," said Sri Lankan President Maithripala Sirisena in a public speech in November 2017, suddenly pulling out a bag of instant Milo and attacking its sugar content, declaring "war" on beverage companies. Following this, countries began taxing high-sugar content. ▲Source: Caijing Magazine With consumers questioning the health of carbonated drinks and governments taxing sugar content, carbonated drink companies seem to face a dilemma: change the formula and face public opposition, or keep it and face public opposition. Historically, Coca-Cola once "made a big mistake." In 1985, under pressure from Pepsi, then-CEO Roberto Goizueta decided to stop producing traditional Coca-Cola and replace it with a new formula, named "New Coke." Given the era, most Chinese people never tasted this new product and can only describe it based on legend: it was "smoother, rounder, and more harmonious." But New Coke turned into a fiasco: old Coke was hoarded, and protesters gathered at Coca-Cola headquarters. Two months after launch, the consumer hotline was overwhelmed with 1,500 complaint calls daily. Finally, in August 1985, traditional Coke returned to shelves. New Coke lasted over a decade before being discontinued in July 2002. With that precedent, even the boldest CEO would hesitate to overhaul the formula drastically. 03
The "Healthy" Path of Involution
In this dilemma, major carbonated drink companies are forced to find a win-win solution. The simplest idea is to reduce sugar. In 2018 and 2019, Coca-Cola's sales grew by 1.6% and 2.2% respectively; in 2019, PepsiCo's revenue also grew by 3.9%. But before that, they had implemented a series of "sugar reduction operations." In 2016, Coca-Cola launched Fiber Sprite with the selling point of "weight loss," and in 2018 and 2019, reduced the sugar content of Coca-Cola by 1.7% and 4.0% respectively. Pepsi also launched 7 Up with 25% less sugar in 2013 and Mirinda with 30% less sugar in 2015. While reducing sugar content, sugar-free carbonated drinks with sweeteners as a selling point also had their moment. In 2018, Genki Forest launched sugar-free sparkling water and, for three consecutive years during the "Double 11" shopping festival, outsold Coca-Cola and Pepsi, starting China's "healthy" involution in sugar-free drinks. In 2021, among new domestic carbonated drink products, "sugar-free," "low/no/reduced fat," and "low/no/reduced calories" were the top three most mentioned terms. Under this trend, major brands are trying to eliminate ingredients with "health controversies," from food additives, preservatives, surfactants, to thickeners, flavors, colors, and sweeteners... The ultimate direction of beverages seems to be racing towards pure water. Major beverage brands have entered the market. Coca-Cola and Pepsi have introduced their North American sparkling waters to China, using the popular sweetener erythritol to cater to Chinese consumers. Domestic brands like Nongfu Spring and Wahaha have also launched new sparkling waters, and even tea-based brands like Heytea and Naixue have joined in. The other side of removing "controversial" ingredients is adding health-promoting ones. Yili added milk minerals to its new sparkling water; VOSS added collagen peptides and promoted "antioxidant and immunity-boosting" benefits; Danone added vitamins C, B6, and niacinamide to its sparkling water; Wahaha even took a unique approach by launching hyaluronic acid sparkling water, claiming it could be used for "skin beautification." According to Nielsen retail insights, as of November 2021, the carbonated drink market grew 15% year-on-year, but sugar-free carbonated drinks contributed significantly to this growth—with sales surging by 85%. ▲Source: Guan Yan Report Network 04
Wanting Refreshment and Fearing Death
Manufacturers are constantly competing around "health," but consumers overlook two issues: The first is that while sugar-free cola has reduced sugar content, controversial ingredients like "carbon dioxide," "phosphoric acid," and "caffeine" still exist. According to national standards, if a food contains no more than 0.5 grams of sugar per 100 grams or 100 milliliters, it can claim to be "sugar-free." In other words, many sugar-free carbonated drinks claiming to be "sugar-free" may not actually be sugar-free. In 2020, the First Affiliated Hospital of Zhejiang University School of Medicine conducted a test comparing blood glucose levels before and after consumption. The results showed that only Coke Zero could be considered truly sugar-free. According to WHO sugar intake guidelines, the total sugar intake from processed foods for a normal person should ideally be controlled within 25 grams per day. Clearly, almost all drinks claiming to be sugar-free, while having reduced sugar compared to traditional carbonated drinks, still cannot completely eliminate sugar, so their impact on health must still be considered. The second issue consumers overlook is that with deeper research, sweeteners are not entirely without controversy. Although global authoritative institutions currently consider sweeteners safe as food additives, the American Journal of Clinical Nutrition pointed out a problem. A 2013 report in this journal showed that long-term consumption of drinks containing artificial sweeteners can also induce obesity and type II diabetes. A study in the authoritative scientific journal Nature also suggested that sweeteners may interfere with the body's ability to control blood sugar. Aspartame, widely added to Coke Zero, has faced continuous doubts, rumors, and even lawsuits over the years. Since the first carbonated drink—Coca-Cola—was born, with scientific progress, efforts to optimize formulas around health have continued. In the future, they likely won't stop. But do consumers really care? While carbonated drinks are in "health involution," the consumer market shows an interesting phenomenon: new tea drinks represented by Heytea, Naixue, Yidiandian, and CoCo have become the fastest-growing sector in recent years. According to data from iiMedia Research's "2022 H1 China New Tea Drink Industry Development and Consumption Trend Survey Analysis Report," the market size of China's new tea drinks was 279.59 billion yuan in 2021, and with rising consumer demand, it is expected to reach 374.93 billion yuan by 2025. In other words, many consumers, after abandoning "unhealthy" carbonated drinks, turn to embrace "unhealthy" milk tea and other drinks that also contain high sugar. Such a fragmented consumption situation makes it hard to say whether "health" is a consumer demand or a marketing demand of beverage companies. More often than not, although everyone says they want to be healthy, reduce sugar intake, and reduce additives, they actually prefer "sweet" tastes, complex addictive flavors, and stimulating textures. This is the essence of carbonated drinks. Each trending topic or study may temporarily scare off some people, but beverage bosses know well that they will come back soon. Even if a few don't, new people will replace the old.