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Home » Cardiac Health, EU Health, Health

Public policy interventions are urgently needed to tackle cardiovascular disease

Submitted by on 12 Apr 2018 – 15:10

Despite the abundance of scientific evidence on the damaging effects of unhealthy food, inadequate diets have continually remained the main risk factor for cardiovascular disease (CVD), the number one killer in the EU accounting for over three deaths per minute. Ahead of a meeting in the European Parliament dedicated to discussing “Transforming European food and drink policies for cardiovascular health” Karin Kadenbach MEP, Co-Chair of the MEP Heart Group, explains why.

In a world where obese and overweight people have outnumbered underweight individuals, and where diabetes, hypertension and hypercholesterolemia are on the rise, it appears logical that healthy eating should be a collective responsibility incorporating also a full spectrum of public policy interventions to address the very context within which individual choices are made.

Despite the fall in death rates observed over the past three decades, CVD (including heart disease and stroke) remains the leading cause of death in Europe, causing over 1.8 million deaths annually in the EU alone, with higher rates in Central and Eastern Europe than in the rest of Europe. The past 25 years also saw an increase in the absolute number of CVD cases, with 49 million people (9.6 percent of the total EU population) living with CVD today. This means that people are living longer but not better.

Disease patterns have also changed significantly in the EU. Although smoking remains a leading risk factor for individuals, unhealthy diets are by now the biggest risk factor for CVD at a population level – responsible for 49 percent of the CVD burden, and generating an estimated annual cost of €102 billion – with growing trends of obesity (20 percent in my home country, Austria), and a steady increase in diabetes rates (in some countries by more than 50 percent) across Europe.

We may have reduced death from CVD, but we are still far from restraining its social and economic burden, or tackling its causes successfully. This gloomy picture calls for a collective effort addressing multiple levels from patient care, education and engagement (through healthcare professionals and patient organisations) to food systems ‘interaction’ (through dialogue with all actors along the food chain).

Importantly, an overarching EU supported framework should complement these actions with targeted upstream initiatives aimed at creating supportive environments through public policy and regulatory measures. There is a positive track record in many fields (the most prominent being tobacco control), and there is no reason why upstream prevention should not be extended to all other risk factors, particularly nutrition.

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Indeed, there is an abundance of scientific evidence proving that dietary habits influence CVD risk. There is also broad consensus on what a cardiovascular health-promoting diet means, ie,a shift from an animal-based diet to a plant-based diet that includes vegetables, fruit and berries in abundance.

Wholegrain products, nuts and seeds, fish, pulses and low-fat dairy products are important, as are non-tropical vegetable oils in modest amounts. Foods or drinks that are low in vitamins, minerals and dietary fibre and high in free sugars, saturated fat, trans fats or salt fibre should be avoided. Limited consumption of red and processed meat products would also contribute to better heart health in Europe.

In an ideal world, individuals would request to have access to healthy food only. However, consumer demand interacts with other ‘forces’ on the market, which is why governmental interventions are needed to balance consumer, marketing, trade and other interests so that the healthy choices become the default choice: attractive, affordable and available. Concretely, EU policymakers can:

- legislate on the composition of foods aimed at reducing energy density, intake of salt, saturated fat, trans fatty acids (TFAs) and sugars in foods and beverages;

- take measures to increase especially consumption of fresh fruit and vegetables;

- take action towards restricting advertising and marketing of unhealthy foods and drinks to children on TV, internet, social media and food packages;

- set mandatory and harmonised simplified front-of-pack nutrition labelling;

- help reshape the Common Agriculture Policy (CAP) to align it with policies to promote public health, and take healthy nutrition into account in trade negotiations.

Some of these measures which are supported both by healthcare professionals and patient organisations have already been attempted at the EU level and/or by individual member states with positive outcomes. For instance, six European countries have adopted a legislation to restrict industrially produced TFAs in the food chain. At the EU level, the European Parliament resolution on transfatty acids is now awaiting the outcome of the European Commission’s impact assessment.

Encouragingly, recent EU presidencies have also been focusing on aspects closely related to healthy eating. In 2016, the Dutch EU Presidency paved the way for the adoption of Council Conclusions on Food Products Improvement, and in 2017, the Maltese EU Presidency proactively engaged towards halting the rise of childhood obesity in the EU by 2020. Preliminary plans of the upcoming 2018 Austrian Presidency of the EU are also aligned with these endeavours.

I trust that by joining hands with all stakeholders along the food chain – including patients and healthcare professionals – policymakers can make a difference. The first step is to ensure an open dialogue and identify joint actions which support win-win outcomes. This will be the aim of the MEP Heart Group meeting that I will be chairing this month in the European Parliament.

Supporters of a heart healthy Europe – stay tuned!