This is the latest in a series of Q & A’s written by Kerry Trueman.   It appeared on Civil Eats, August 12, 2015.  And please note references added at the end.

Civil Eats: Your next book, Soda Politics: Taking on Big Soda (and Winning), documents the history of how this sugary beverage gave rise to some of our most powerful corporations and has lately become Public Enemy Number One in the war on obesity.

With sales on the decline, the New York Times recently reported that Coca-Cola is pouring millions of dollars into a 'science-based' campaign to convince the public that the secret to achieving and maintaining a healthy weight is not avoiding excess calories, but getting more exercise. What's the science on more exercise versus fewer calories?

Marion Nestle: When it comes to studies about the health effects of sugary drinks, the science, alas, depends on who pays for it. Studies paid for by government or private health foundations show that if you want to prevent obesity, [a combination of] eating less and moving more works every time.

You can lose weight by eating less on its own. But you will have a much harder time doing that by increasing physical activity. This is because it takes lots of effort to compensate for excess calories. Eat two little Oreo cookies—100 calories—and you have to walk a mile to work them off. Drink a 20-ounce soda and you need to cover nearly three miles. This was the point of the New York City health department's subway current poster campaign, which shows that you need to walk from Union Square in Manhattan to downtown Brooklyn to burn off 275 calories.

The soda industry would love you to believe that the principal cause of obesity is lack of physical activity, and they put tons of money into research to discourage other ideas. They much prefer you to believe that all of their products can be part of an active, healthy lifestyle that includes balanced diets, proper hydration, and regular physical activity. I call the idea the "physical activity diversion." It deflects attention from what really counts in obesity prevention: not eating huge amounts of junk foods, snack foods, and sodas.

Mind you, I'm greatly in favor of physical activity for its many benefits: physiological, social, psychological, and health. But there is a good reason for the outraged reaction to Coca-Cola's video seemingly suggesting that all you have to do to burn off the 140 "happy calories" in a 12-ounce soft drink is to laugh out loud for 75 seconds. This is so far from the reality of calorie balance that several countries actually banned the commercial [in 2013].

Soda companies promote the primacy of physical activity in other clever ways. The Coca-Cola Foundation says that about one-third of its philanthropic contributions go to organizations working to counter obesity, especially through promotion of physical activity.

Both Coca-Cola and PepsiCo invest heavily in sponsorship of international sports teams. They put fortunes into recruiting sports celebrities as spokespersons. These investments accomplish two purposes: they influence fans to buy the products and shift the focus to physical activity. Obesity, these imply, is about what you do, not what you eat or drink. Public health advocates complain about how frequently young people—especially those of color or in low-income families—are exposed to advertising by professional athletes. The sponsored programs and celebrities never suggest that drinking less soda might be a useful health-promotion strategy.

As a nutritionist and co-author of a book titled Why Calories Count, I thoroughly agree that balance, variety, and moderation are fundamental principles of healthful diets, and that weight gain is a result of calorie imbalance.

But soda companies distort these principles to distract from their marketing of sugary drinks and how overconsumption of these drinks overrides normal physiological controls of hunger and satiety. Independently funded research makes it abundantly clear that avoiding sodas is one of the best things you can do for your health.

Sponsorship of research or research investigators by Coca-Cola or the American Beverage Association is reason alone for skepticism.

References: I am grateful to Richard Cooper for forwarding his paper on the relative contributions to obesity of diet and exercise.  From his review of the literature, you must reduce calories to lose weight.

He also pointed me to rebuttals by  Blair and Hill, the investigators featured in the New York Times article cited above.

The rebuttal by Steven Blair and colleagues.

• Funding: Drs. Blair, Archer, and Hand are funded via unrestricted research grants from The Coca-Cola Company for analyses of dietary trends and for an energy balance study.
• Conflict of interest: None declared [Evidently, these investigators do not perceive funding by Coca-Cola as a conflict]

The rebuttal from James Hill and John Peters:

• Conflict of interest: J.H. receives research grants from the American Beverage Association and serves on advisory boards for McDonalds, General Mills and McCormicks. J.P. receives research funding from the American Beverage Association.

I wrote this piece for The Guardian in response to the New York Times article earlier this week about Coca-Cola’s funding of scientists who think obesity is more about exercise than drinking sodas:

These days, you almost have to feel sorry for soda companies. Sales of sugar-sweetened and diet drinks have been falling for a decade in the United States, and a new Gallup Poll says 60% of Americans are trying to avoid drinking soda. In attempts to reverse these trends and deflect concerns about the health effects of sugary drinks, the soda industry invokes elements of the tobacco industry's classic playbook: cast doubt on the science, discredit critics, invoke nanny statism and attribute obesity to personal irresponsibility.

Casting doubt on the science is especially important to soda makers. Overwhelming evidence links habitual consumption of sugary drinks to poor health. So many studies have identified sodas as key contributors to chronic health conditions – most notably obesity, type-2 diabetes and coronary artery disease – that the first thing anyone trying to stay healthy should do is to stop drinking them.

Soda companies know this. For at least the last 10 years, Coca-Cola's annual reports to the US Securities and Exchange Commission have listed obesity and its health consequences as the single greatest threat to the company profits. The industry counters this threat with intensive marketing, lobbying and millions of dollars poured into fighting campaigns to tax or cap the size of sugary drinks.

But it is also pours millions into convincing researchers and health professionals to view sodas as benign.

Just last month, the Mayo Clinic Proceedings published a study arguing that the results of national dietary surveys, such as those that link sugary drinks to type-2 diabetes, are so flawed that they constitute a major misuse of public funds. The authors report honoraria, speaking and consulting fees from Coca-Cola.

This week's revelation of Coca-Cola's funding of the Global Energy Balance Network is only the latest example of this strategy in action. The Network promotes the idea that to prevent obesity you don't need to bother about eating less or drinking less soda. You just have to be more active. Never mind that most people can't lose weight without also reducing their intake.

A reporter who looked into this group discovered that Coca-Cola had funded the research of the scientists behind it, and generously. The network's website was registered to Coca-Cola. None of this, however, had been made explicit.

Most nutrition professional journals now require researchers to declare who funds their studies, making it possible to compare study outcomes with funding sources. Studies sponsored by Coca-Cola almost invariably report no association of sugary drinks with diabetes, they question the validity of studies that do find such associations or, as in the case of Global Energy Balance Network investigators, they find activity to be the most important determinant of body weight.

Analyses of studies funded by Coca-Cola or its trade association demonstrate that they have an 83% probability of producing results suggesting no harm from soda consumption. In contrast, the same percentage of studies funded by government agencies or independent foundations find clear linkages between sugary beverages and such conditions. Coincidence? I don't think so.

Since March, I've been posting industry-funded studies with results that favor the sponsor's interests every time I find five of them. They are easy to find. Despite pleas to readers to send me industry-funded studies that do not favor the sponsor, I hardly ever get them. Whenever I come across a study that shows no harm from sodas, I immediately look to see who paid for it.

Soda companies spend generously to convince researchers and health professionals not to worry about sodas' health effects. But why do researchers take the money? It is too simplistic to say that they are "bought." Industry-funded investigators say they believe the funding has no effect on the design, conduct or interpretation of their research. But research involves choices of questions, assumptions and methods. It is not difficult to carry out a study that appears to meet high scientific standards yet fails to include critical controls that might lead to alternative conclusions.

Researchers funded by Coca-Cola need to take special care to control for unconscious biases but can only do this if they recognize the possibility. Many do not. Neither do many peer reviewers or editors of scientific journals. Although food-company financial support should not necessarily bias results, it appears to do so in practice.

Industry-funded scientists resent questioning of the influence of sponsorship on the quality of their science. They charge that investigators who find adverse effects of sodas on health are equally biased by career goals, righteous zeal or anti-corporate morality. Yes, independent scientists may have biases of their own, but their overarching research goal is to improve public health. In contrast, the goal of soda companies is to use research as a marketing tool.

Disclosure is essential. If a study is funded by Coca-Cola, caveat emptor.

I’ve had a busy week dealing with the aftermath of Anahad O’Connor’s New York Times story about how Coca-Cola pays scientists who argue that obesity is more about activity than what you eat—drinking sodas, for example (I’m quoted).   It’s gotten 1180 comments.

Here’s Dan Wasserman’s from the Boston Globe:

In all fairness, let’s see what Coca-Cola’s Chief Technical Officer, Dr. Ed Hays, says in response (straight out of the tobacco industry’s playbook):

I was dismayed to read the recent New York Times' inaccurate portrayal of our company and our support of the Global Energy Balance Network (GEBN). The story claimed Coke is funding scientific research to convince people that diets don't matter – only exercise. In fact, that is the complete opposite of our approach to business and well-being and nothing could be further from the truth.

Yes, we fund scientific research through GEBN and we are proud to support the work that scientists such as Dr. Jim Hill and Dr. Steve Blair do – because their type of research is critical to finding solutions to the global obesity crisis.

At Coke, we believe that a balanced diet and regular exercise are two key ingredients for a healthy lifestyle and that is reflected in both our long-term and short-term business actions.

The article even got the attention of Congress.  Here’s the statement from Rosa de Lauro (Dem-CT), sponsor of The SWEET Act to tax sugars:

This research is reminiscent of the research conducted by the tobacco companies to mislead the public about the health risks of smoking.  The American public will not be fooled. There is a wealth of sound scientific research that demonstrates the link between sugar-sweetened beverage consumption and a host of health conditions, including diabetes, heart disease, and obesity.  This new group and their research are a sham," DeLauro said.  "People want to be healthy and they want their kids to be healthy and realize that drinks full of empty calories are not good for them. That is why more and more Americans are opting to drink less soda every year.

I wrote a piece for The Guardian, which I will post today.

I don’t keep track of my interviews or media appearances unless people send me links (I post them under Media), but Rachel Harrison at NYU kept score yesterday.  As I said, a busy couple of days.

ASK MANX: How many carbs and protein should I be eating post-workout? You like waixy maize? –BORN

When I first started training, there was nothing I looked forward to more than my post-workout meal. It was the time when my muscles were starved for food. But more importantly, I thought it was a time when my body needed a massive insulin surge to take carbs and transform them into hard earned muscle.

What you eat after a workout is less important than meeting your overall calorie and macronutrient guidelines for the day.

In my mind, insulin meant sugar, and sugar meant Frosted Flakes. (And lots of Frosted Flakes, as in several very large bowls.) After all, I was convinced my body was like a sponge after a workout and would soak up all the carbs.

Turns out, my mindset regarding the need for significant carbs after a workout was misguided. Of all the ingredients involved in building the body you want, there's a certain mystique about the role and importance of the meal you enjoy after your workout.

There's no shortage of information and opinions on what you should eat, how much you should eat, the importance of the timing, and the dangers of what you risk by not emphasizing this meal. And while timing is not insignificant, the latest research indicates that most what we thought was true about the post-workout meal no longer holds as much accuracy.

One of the most common suggestions revolves around the consumption of carbs after your exercise session. While consuming carbs after a workout is perfectly fine—and carbs are necessary for muscle growth—our bodies don't need as many carbs as we think. More importantly, we don't need to load up on simple carbs (think sugar) in order to refuel and see changes.

The New Rules of Post-Workout Meals

The biggest problem with focusing on what to eat after your workout is that we tend to view this meal in isolation. Instead, it's best to be aware of what you had before your workout, or if you train in the morning, what you had for your last meal before you sleep.

Your body doesn't run on a short-term fuel supply. Your glycogen (muscle energy, if you will) is filled up anywhere between 350 to 500 grams of carbohydrates. If those numbers don't mean much to you, that's more than enough fuel to get you through your weigh workout; and plenty for most endurance sessions, too.

Your goal is to promote muscle protein synthesis (muscle growth and repair), and for that to happen, you don't need a massive insulin spike. In fact, research has shown that a moderate amount of protein and carbs (or even protein alone, more on that soon) can max out the muscle protein response after exercise.

In this study, scientists found that insulin is "permissive rather than stimulatory.” Instead, it's to make sure you activate insulin and allow it to do its job.

Translation: the goal isn't to jack up insulin to see a greater response.  More carbs and insulin is not better and does not accomplish more.

Pre-Workout v.s. Post-Workout: A Team Approach

This certainly differs significantly from the general ideology passed down from some supplement companies. The commonly held belief is that if you don't use fast-acting carbs immediately after a workout, then you won't elevate your insulin levels, you won't recover, your body will shrink, and all potential gains will be lost.

Your body isn't carb-dependent because post-workout because you ate before your workout can have a big impact.

In fact, a pre-exercise meal can help ensure that your insulin levels remain elevated up until your workout is over. If you eat protein and carbs before you train, insulin can remain elevated for several hours. And if you don't like solid foods, combining 6 grams of essential amino acids with about 35 grams of carbohydrates can keep insulin levels about four times higher than fasting levels for about two hours.

This isn't to tell you must eat before you train (it's completely goal dependent and also a matter of how well you digest food before you exercise).

Instead, it's to emphasize how easy it is to create an insulin response that will help your body before, during, and after training. And more importantly, it allows you to know the flexibility involved in choosing what you eat before or after a workout without having to worry that you must follow a specific plan that might not feel right for you. (This is something I’ve tested with clients and have found to be much more beneficial than rigid plans.)

Insulin's ability to prevent muscle protein breakdown and maximize muscle protein synthesis isn't dependent on massive amounts of carbs (because you're not completely depleting your glycogen stores), and doesn't require a special carb blend.

This is another instance of people majoring in the minor. The, "I need magical fast-acting carbs from waixy maize within 30 minutes of training" is not as important as focusing on the bigger picture. In this case, making sure you have some protein and carbohydrates after a meal, and focusing on a good overall diet.

Whereas many people believe that the 5 percent is where winners are made, it's really where the most stress occurs, arguments erupt, and progress can be stalled.

Master the big picture details first, and you're likely to see more results, have better compliance, and achieve much better clarity. Then you can tackle the most specific details.

What You Should Eat Post-Workout

The urgency of a post-workout meal is significantly exaggerated. Moreover, most research with glycogen depletion and repletion focuses on endurance athletes. If you're a runner putting in serious mileage, for instance, your need for glycogen-replenishing carbs is greater but still not urgent—and it's on both ends of the spectrum.

Most people who have exercised are familiar with the concept of carb-loading. And yet, research published in the Journal of Applied Physiology found that bumping up carbohydrates to more than 50 percent of their diet (and maxing out at 75 percent) didn't improve muscle glycogen and only led to a minor 5 percent improvement in their performance. In other words, all those extra carbs are not worth it. (Although the meals might be enjoyable.)

When it comes to weight training, your body is in even less of a need for the instant carb surge. That's because most weight workouts—even the more aggressive approaches in the 45 to 60 minute range—won't come close to depleting your glycogen stores.

And if you do eat a preworkout meal, that need is even less as the food you ate beforehand is most likely still being absorbed by your body even after you've finished. What's more, even if you don't eat carbs before a workout and skip them in the time period immediately after you train, as long as you eat carbs several hours later your body will still recover and glycogen resynthesis will occur within about 24 hours. (Yes, the body is an amazing machine.) Consider this good news as the benefits of the post-workout meal period are experienced for a longer period of time.

The majority of the most recent research emphasizes that timing is less important than the total amount of food you eat, and the macronutrient ratios (of proteins, carbs, and fats) you consume.

That’s not to say eating after a workout isn’t important; rather, “after a workout” is just a much longer period of time than originally thought. In fact, the idea of the "small anabolic window" is minimized with each passing year (this is not a bad thing).

It now appears that your post-workout window is really open for about 24 hours rather than 30 to 60 minutes, with the first 4 hours being when you want to make sure you eat or have a shake.

That means more flexibility with your meals and not feeling forced to slog down a shake if you're not hungry.

Just as valuable is the research that suggests the increasing importance of protein after your workout. A study published in 2010 found that adding carbs (about 50 grams) to 25 grams of whey protein did not increase post-exercise protein balance compared to the protein without carbs.

As for carbs? Unfortunately the research just isn't as clear. This excerpt is from a research review in the Journal of the International Society of Sports Nutrition on nutrient timing published by Alan Aragon and Brad Schoenfeld.

It is tempting to recommend pre- and post-exercise carbohydrate doses that at least match or exceed the amounts of protein consumed in these meals. However, carbohydrate availability during and after exercise is of greater concern for endurance as opposed to strength or hypertrophy goals.

Furthermore, the importance of co-ingesting post-exercise protein and carbohydrate has recently been challenged by studies examining the early recovery period, particularly when sufficient protein is provided. Koopman et al 52 found that after full-body resistance training, adding carbohydrate (0.15, or 0.6 g/kg/hr) to amply dosed casein hydrolysate (0.3 g/kg/hr) did not increase whole body protein balance during a 6-hour post-exercise recovery period compared to the protein-only treatment….

For the goal of maximizing rates of muscle gain, these findings support the broader objective of meeting total daily carbohydrate need instead of specifically timing its constituent doses. Collectively, these data indicate an increased potential for dietary flexibility while maintaining the pursuit of optimal timing.

Lab to the Kitchen: Designing Post-Workout Meals

What does it all mean? There is no "perfect meal" for after your workout. While the post-workout time period is still important and valuable, when it comes to achieving your goals, what you eat after (or even before) a workout is less important than meeting your overall calorie and macronutrient guidelines for the day.

If you are someone who tracks calories or macros, your daily goals should be focus 1A and 1B. In general, days where you train you should eat more carbs, and days when you don't train you'll most likely have less.

From there, determining what to eat post-workout depends on your preference. If eating pre-workout leaves you feel groggy or sick to your stomach, some branched-chain amino acids or potentially fasting (research has shown that protein breakdown is elevated after fasting and eating after training while fasted can have a positive effect; or if you don't fast not eating 3 to 4 hours before your workout can be beneficial because a meal of protein and carbs can keep amino acid levels elevated for up to 6 hours) might be best for you.

But if you still need more direction for your post-workout meal, your top priority is probably protein. That's because research shows that if you eat protein any time around your workout (before, during, after) then you have a similar increase in muscle protein synthesis.

Anywhere between 20 and 40 grams of protein before or after (or both) should do the trick, and based on Aragon's research, a similar amount of carbs should work—although the science is not as definitive.

If you're worried about eating fat in your post-workout meal, well, don't. The idea that post-workout fat will slow down an "anabolic effect" of protein is unsubstantiated in any research. While protein and carbs are still the preferred nutrients, having some fat (think eating eggs) is not going to slow your process.

What you eat during the course of the day matters more than what you eat before or after your workout. In the post-workout meal prioritize protein over carbs, and when adding carbs understand there's no need for massive amounts to raise insulin. This is not an anti-carb approach. Instead, it’s a matter of realizing the lack of urgency for carbohydrates post-workout, and understanding that you don’t need to consume excess amounts of carbs to recover properly.

Coca-Cola, in case you missed the furor over last week’s New York Times article, has a huge public relations problem.

The damage control begins today with Coke’s CEO’s op-ed in the Wall Street Journal:

Our company has been accused of shifting the debate to suggest that physical activity is the only solution to the obesity crisis. There also have been reports accusing us of deceiving the public about our support of scientific research…I am disappointed that some actions we have taken to fund scientific research and health and well-being programs have served only to create more confusion and mistrust. I know our company can do a better job engaging both the public-health and scientific communities—and we will.

By supporting research and nonprofit organizations, we seek to foster more science-based knowledge to better inform the debate about how best to deal with the obesity epidemic. We have never attempted to hide that. However, in the future we will act with even more transparency as we refocus our investments and our efforts on well-being.

He promises that the company will:

• Publish on our website a list of our efforts to reduce calories and market responsibly, along with a list of health and well-being partnerships and research activities we have funded in the past five years, which we will continue to update every six months.

• Charter and recruit an oversight committee of independent experts to advise and provide governance on company investments in academic research.

• Engage leading experts to explore future opportunities for our academic research investment and health and well-being initiatives.

Personally, I can’t wait to see the list of Coke-funded research activities.  Want to bet how many of those studies came out with results that Coca-Cola can use to claim that sugary drinks have no effect on obesity or type 2 diabetes?  I’d also like a count of the number of studies Coca-Cola has funded to cast doubt on the National Health and Nutrition Examination Survey, the country’s major dietary monitoring program, which has the annoying habit of linking sugary drinks to those conditions.

Mr. Kent ends his piece with this plea:

As we continue to learn, it is my hope that our critics will receive us with an open mind.

Unless Coca-Cola stops pouring millions of dollars into fighting soda caps and taxes, stops targeting its marketing to minorities, and stops lobbying against public health measures to help people eat more healthfully, keeping Mr. Kent’s version of an open mind will be difficult. 

Steven Blair, one of the scientists involved in Coke-funded research, posted this statement today:

I have asked that my video addressing energy balance be taken down from the GEBN website. I regret that a statement I made in this video has been used by some to brand GEBN as a network focusing only on physical activity. This is not true and never has been true. From the beginning the mission of GEBN has been to study the science of energy balance which involves both diet and physical activity. GEBN has some of the top nutritionist experts in the world who have published research showing the importance of diet and in particular of soda consumption in causing obesity. My dismissal of diet as a cause of obesity did a disservice to their work. I hope many of you can relate to feeling so passionate about an issue that you say some things that you later regret. I believe that both diet and physical activity are important in obesity and that we must address both together to help people achieve healthy weights. I look forward to working with other GEBN researchers to do this.

James Hill, another of the scientists involved in this fiasco, also has issued a statement.  When it becomes public, I will post a link to it.

Louise Fisher, a dietitian and food and nutrition consultant in Australia, writes:

I’ve loved your recent blog posts on Coca Cola’s sponsorship of research that fortuitously concludes that it’s not Coke that’s making us fat, it’s lack of exercise.  It’s no surprise to see that the alcohol industry here in Australia is running the same line. I just received a link to a guide to “get the facts on alcohol” Beer the beautiful truth from Lion, one of our biggest suppliers of beer. And what do you know, beer doesn’t make you fat, you just need to be more active.

Under Myth Busters on page 4:

DOES ALCOHOL CAUSE WEIGHT GAIN? DOES BEER MAKE ME FAT? It's not the alcohol per se that causes weight gain. Eating or drinking more calories/kilojoules (energy) than you burn, from any food or drink, can contribute to weight gain. It is important to balance the calories we eat and drink with those we burn through physical activity and basic functioning like breathing and sleeping.

If you do drink, it's important to know the calories in alcohol mainly come from the alcohol content, as well as the carbohydrate and sugars content. For example, a low strength beer will typically have less calories than a full strength beer. So really, it comes down to how much and what type of alcohol you have and what you eat with it – the chips, the kebab. Plus how active you are.

Hey.  If this strategy works for Coca-Cola….

When the New York Times published an article describing Coca-Cola’s financial sponsorship of university researchers who de-emphasize the role of sugary drinks in raising the risk of obesity and type 2 diabetes, it kicked up a storm.

USA Today’s editorial board said:

It isn't that companies pay scientists to put out false research. It's that companies fund the work of scientists who happen to be doing research that spurs consumers to look away from science that hurts corporate interests.

Soft drinks are far less dangerous than cigarettes, but GEBN’s website, tweets and videos come right out of Big Tobacco’s playbook, brought into the digital era. Its leaders have done research in the past under about $3 million in grants given to their universities.

USA Today also printed a response by a Coca-Cola spokesman:

A recent New York Times article created confusion about our support of research and non-profit organizations, stating we want people to think that only exercise matters and not diet — but nothing could be further from the truth. We have always operated under the fact that a healthy, balanced diet and regular exercise are key ingredients for a healthy lifestyle.

That said, we need to do a better job of being even more transparent about the research we fund, the non-profit organizations we support and the way we publicly share this information. And we will.

Yesterday, Senator Richard Blumenthal sent letters to the University of Colorado, West Virginia University, and the University of South Carolina urging them to  clarify the nature of the University’s relationship with projects funded by Coca-Cola and to review the academic integrity of such grant agreements.

I believe your university must determine whether this research is in effect promoting a predisposed and biased agenda, rather than reflecting the impartiality and objectively (sic) expected from a public academic institution.

Years of litigation with tobacco companies were necessary to fully expose the tragic public health consequences when companies lie about the hazards of the products they sell.  I am deeply concerned that we may force future generations to relive this history if corporate-sponsored studies devoid of scientific integrity are permitted once again to deceptively downplay and conceal the dangers of a product consumed on a mass scale.

Do not underestimate Senator Blumenthal’s ability to deal with food companies.  He, you may recall, was responsible for withdrawal in 2009 of the ill-conceived Smart Choices program during his stint as Connecticut’s attorney general.

I’m still waiting for the Global Calorie Balance Network to issue its promised statement.  Stay tuned.