Table 1 Corporate political activity [104]: how Industry Seeks to Influence Public Regulation, Public Evidence and Public Opinion

• Direct lobbying of decision-makers: Days before the publication of the 2003 WHO guidelines on healthy eating, which recommended that sugar should account for no more than 10% of a healthy diet, the Sugar Association wrote to the then WHO Director General, stating that it will “exercise every avenue available to expose the dubious nature” of the WHO’s report on diet and nutrition. The Association challenged WHO’s $406 m funding from the US and enlisted two US Senators to block the report [105].

• Using ostensibly independent front organizations, e.g. research institutes, trade associations: The American Dietetic Association (ADA), “devoted to improving the nation’s health” produces a series of Nutrition Fact Sheets – which industry sources pay for and take part in their writing [106]. ADA industry partners are provided access to key influencers and decision-makers, and outlets for research findings including professional meetings and scientific publications. In 2015, Coca-Cola was exposed as having provided significant technical and financial support to the nonprofit organization Global Energy Balance. The organization was criticized as little more than a front group – employing scientists to legitimize its message that obesity results from lack of exercise rather than poor diet [107].

• Strategic use of research, funding academics and public health bodies: An investigation by the British Medical Journal uncovered a “tangled web” of connections between the sugar industry and public health experts – through “research grants, consultancy fees and other forms of funding” [108]. A meta-analysis of available research showed clear relationships among the consumption of soft-drinks, poor nutrition and negative health outcomes. The meta-analysis demonstrated that studies funded by industry were more likely to find results favorable to industry [109] than studies funded from other sources. A review of corporate philanthropy by Coca-Cola and PepsiCo between 2011 and 2015 found they sponsored 95 public health organisations in the USA, including those dedicated to fighting diabetes, child health, and heart disease. During the same period, the two companies “lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition” [110].

• Framing the debate: Industry consistently frames personal responsibility or lifestyle as the cause of unhealthy diet, and emphasizes physical activity and education as the most effective solutions. A variety of related messages are also typical of industry framing, including that companies offer choices and pleasure, emphasize moderation and do not encourage consumers to overuse their products [30].

• Discrediting opponents: The food industry often vilifies critics characterizing them as “food police”, leaders of a “nanny state”, and accuses them of desiring to strip people of their civil liberties [111].

• Using legal instruments to protect interests: the tobacco industry has regularly used the mechanism of bilateral investment treaties to “challenge states’ policymaking authority” [112] in controlling tobacco markets. For example, Philip Morris used legal channels to bring claims against the Governments of Australia and Uruguay, opposing their policies on tobacco labelling and plain packaging [78].