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11th Dec 2023

EU food system 'flawed', heart experts say

  • In 2015, the WHO’s International Agency for Research in Cancer classified red meat as "probably carcinogenic" and processed meat as carcinogenic. (Photo: Pixabay)

In a new report released on World Heart Day (29 September), experts from the European Heart Network (EHN) say unhealthy diets account for around half of the deaths and disability caused by cardiovascular disease (CVD) in Europe.

The report - Transforming European food and drink policies for cardiovascular health - says that the food chain set-up is "flawed and fails to deliver affordable healthy diets to all".

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  • Within the EU countries, where around 49 million people have some form of cardiovascular disease, research showed a total annual cost of €210 billion to the economy in 2015. (Photo: Pixabay)

The study sets out dietary goals for overall populations - including targets for salt, saturated fats and 'free sugars' consumption - and urges governments to translate them into guidelines tailored to their country's "eating habits and food systems".

EHN director Susanne Loegstrup told EUobserver that while there had been progress in tackling CVD, they questioned why there had so far been "so little appetite among our politicians" to implement policies on diet that had either been proven to be effective or have "great potential".

The evidence linking diet and CVD has only strengthened since EHN's last paper on the subject, published in 2011.

CVD is Europe's biggest killer, accounting for 45 percent of all deaths in the region and costing the EU economy more than €200bn per year, with around half of that burden attributed to diet.

Nearly four million Europeans die of CVD annually, while 85 million live with some form of the disease - many of whom have yet to reach retirement age.

The Brussels-based alliance of heart foundations and NGOs is urging a shift towards promoting a less animal-based and more plant-based diet.

This involves vegetables, fruit and berries "in abundance", whole-grain products, nuts and seeds, fish, pulses, low-fat dairy products, and non-tropical vegetable oils, while limiting red meat and processed meat.

Foods or drinks that are low in vitamins, minerals and dietary fibre should be avoided, as well as ones that are high in free sugars, saturated fat, trans fats or salt.

Rethinking CAP

There needs to be a "radical rethinking" of the "market-focused" EU Common Agricultural Policy (CAP), which the report claims has helped shape current dietary patterns.

It also objects to the existing approaches to restricting marketing of unhealthy foods to children as "inadequate" and says "decisive policy action is needed".

"We are flabbergasted that neither the European Parliament nor the EU member states are willing to introduce strict rules in the audiovisual media services directive to protect people, in particular children, from the advertising of foods high in fat, salt or sugar," said Loegstrup.

"It seems a no-brainer to address this driver of consumption at an EU level."

The report goes on to call for nutrition to be taken into account when negotiating trade and investment agreements, because they can "impact on the food environment" by influencing the price and availability of unhealthy foods, and may restrict governments' abilities to implement strong nutrition policies.

The intricacy of the food system - with long food chains, as well as economics and policy driving what food is produced, what's imported and how food is marketed - means influencing some global and external factors is "well beyond the reach of individual governments, let alone individuals," Loegstrup said.

"In a perfect world, people would buy and eat the food that is recommended in dietary guidelines, and markets would respond to consumer demand. But we do not live in a perfect world. Many other forces drive the food supply in today's complex food systems."

"However, there are different points along the food chain where policymakers can take action to improve diets. Such action has great potential … and may help address the associated financial burden," she added.

The paper calls for rapid and full implementation of a package of recommendations, to achieve its vision that "every European, irrespective of the place or socio-economic circumstances into which they are born, should be able to live free from avoidable, diet-related CVD".

Health-environment win-wins

Its recommendations also include: the creation of a global food convention to establish a regulatory framework on healthy diets; policies to tackle cardiovascular health inequalities; simplified, mandatory food labelling; and Europe-wide nutrition standards for food served or sold in schools, hospitals and other public institutions.

In pushing for the setting of mandatory maximum levels of industrially-produced trans fatty acids, the report cites a drop in cardiovascular death rates after legal limits were introduced in Denmark.

It also highlights the "overlap" between diets becoming healthier for populations and more environmentally sustainable - for example, reducing red meat consumption - and urges an integrated approach in what it calls "health-environment win-wins".

In recent years, there has been a better understanding of the need for government action to improve food environments, as well as to inform and educate about healthy diets.

But the report warns "much more progress is necessary", adding that if current trends continue, many European countries will miss the agreed global targets to halt the rise in obesity or diabetes, reduce salt intakes, increase breastfeeding or reduce physical inactivity by 2025.

"The good news is that much CVD can be prevented and dietary risk factors are avoidable. Policies and actions to reduce exposure to dietary risk factors can, and do, work," says EHN's report, which adds: "The case for investing in prevention is compelling."

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