The US has one of the highest rates of obesity in the world, with soda consumption identified as one of the factors. On average, Americans consumed 46 gallons of soda in 2009, giving the US one of the highest rates of per capita soda consumption of any country. A recent report estimated that soda consumption caused one-fifth of weight gain in the US between 1977 and 2007.

And the nation’s two largest soda companies sponsored at least 96 national health organizations from 2011 to 2015, dampening the health groups’ support of legislation to reduce soda consumption and impeding efforts to combat the obesity epidemic, School of Medicine and Public Health researchers say in a new study. In addition, in the same five-year period, the Coca-Cola Company and PepsiCo lobbied against at least 28 public health bills intended to reduce soda consumption or improve nutrition, according to the study in the American Journal of Preventive Medicine.

The companies “used relationships with health organizations to develop positive associations for their brands,” said lead author Daniel Aaron, a medical student at MED who co-wrote the study with Michael Siegel, professor of community health sciences at SPH.

“The soda companies can neutralize potential legislative opposition by invoking reciprocity and financial dependence from national health organizations,” Aaron said. “Rather than supporting public health, organizations may become unwitting partners in a corporate marketing strategy that undermines public health.”

Aaron and Siegel researched sponsorships and lobbying efforts by the two soda companies to come up with a list of 96 national health organizations that accepted money from the companies. Twelve organizations accepted money from both companies; one accepted money from just PepsiCo; and 83 accepted money from only Coca-Cola. The authors note that the count could be skewed because Coca-Cola publishes a list of its recipient organizations, while PepsiCo doesn’t.

The sponsorship totals include two diabetes organizations—the American Diabetes Association and the Juvenile Diabetes Research Foundation—a finding that the authors called “surprising, given the established link between diabetes and soda consumption.”

The study also identifies 28 bills or proposed regulations, including soda taxes and restrictions on advertising, that were opposed by the soda companies or their lobbying groups. Siegel and Aaron said these efforts demonstrate the companies’ “primary interest of improving profit, at the expense of public health.”

Between 2011 and 2014, the Coca-Cola Company spent more than $6 million annually, on average, on lobbying, while PepsiCo spent more than $3 million a year, and the American Beverage Association spent more than $1 million a year, according to the study.

Aaron and Siegel compared the ties between soda companies and health groups to corporate sponsorships of tobacco and alcohol companies.

“Previous studies of alcohol company sponsorship and tobacco sponsorship suggest that corporate philanthropy is a marketing tool that can be used to silence health organizations that might otherwise lobby and support public health measures against these industries,” Siegel said. For example, Save the Children, a group that supported soda taxes, dropped the effort in 2010 after receiving more than $5 million from the Coca-Cola Company and PepsiCo in 2009, the study says.

The study recommends that health organizations reject sponsorship offers from soda companies and find alternative sources of funding. It notes that Academy of Nutrition and Dietetics, the American Academy of Pediatrics, and other organizations did not renew contracts with Coca-Cola at the end of 2015.