A red dress has become the latest symbol in the ongoing debate about pharmaceutical company support of research or continuing medical education... but whose dress is it that is jauntily displayed on cans of Diet Coke?
The American Heart Association says it's "not our red dress," even as leading pharma critic Dr. Steven Nissen claims that it is.
Nissen, head of cardiovascular medicine at the Cleveland Clinic Foundation and a past president of the American College of Cardiology, debated the hot topic of industry influence with Dr. Robert Harrington, who is director of the Duke Cardiovascular Research Institute.
In his presentation, he said the red dress on the Coke can was a clear sign that the American Heart Association had crossed an ethical line by endorsing a soft drink, even as observational studies have suggested that soft drinks -- including diet drinks -- are major drivers of obesity.
Harrington, who was listed as the "pro" speaker in the debate, challenged Nissen about the soda can logo, saying that he did not believe the can had an AHA-approved logo on it. "I think that's NHLBI," Harrington said, referring to the National Heart, Lung and Blood Institute.
AHA president Dr. Clyde Yancy said Nissen had it all wrong. The red dress on the Diet Coke, indeed came from the closet of the NHLBI, he said. "And no money has changed hands between Coke and the American Heart Association," Yancy said.
Nissen made a fairly strong circumstantial case against the AHA. For example, after Circulation, the AHA's leading journal published research from Framingham investigators linking soft drink consumption to obesity, the AHA issued a statement that pointed out the limitations of the Framingham study.
The AHA also released a statement that raised questions about a proposal to tax soft drinks as a means of underwriting some healthcare costs while also, possibly, discouraging consumption of the beverages. The soft drink tax proposal came from a perspective published in the New England Journal of Medicine.
Nissen connected the dots from those actions and drew a line that pointed straight to a Diet Coke can.
A NHLBI spokesperson told MedPage Today that the dress in question is the logo for an NHLBI education program called "The Heart Truth."
And although Yancy said that Coke made a large donation to The Heart Truth, the NHLBI spokesperson said no money was involved in the branding deal.
"We have a partnership with Diet Coke," she said. NHLBI wanted and got "more exposure about heart disease in women" and that was the purpose of the partnership, she said.
Yancy told MedPage Today that the AHA often issues statements following publication of studies, especially observational studies. The goal of those statements, he said, was to inform the public of the quality of the findings. "It was disingenuous for Dr. Nissen to suggest otherwise," Yancy said.
But Nissen shrugged-off the AHA protestations. He said the AHA and NHLBI have an ongoing partnership to promote public education about heart disease in women.
An AHA spokesperson told, MedPage Today that the AHA-NHLBI agreement is limited to "co-branding of 'Go Red for Women' Day."
A close look at a Diet Coke can reveals a number of differences between the AHA dress and the NHLBI dress. The AHA version is a little more Texas -- swingy, strappy -- while the NHLBI frock is a bit more like a dress for a paper doll. "And their dress is not on a hanger, ours is," explained an AHA spokesperson.