ENHA EU Manifesto: A Manifesto for Health Equity in the EU


Reducing the incidence of disease-related malnutrition

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Mette Holst Main contact Denmark

Head of Clinical Nutrition Research, Aalborg University Hospital, editor for this homepage and spokesperson for the collaboration between DSKE, ONCA-Denmark and ONCA.

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  • Henrik Højgaard Rasmussen

    Aalborg University Hospital
  • Jonathan Emil Andreasen

    Patient Association Representative
  • Anders Kroman Liin

    Secretariat FMF
  • Jørgen Wiis

    Copenhagen University Hospital
  • Pernille Hansted

    Danish Diet & Nutrition Association
  • Tatjana Hejgaard

    Danish Health Authority


The overall purpose of the Optimal Nutritional Care for All campaign of Denmark (ONCA Denmark) is that all patients and citizens in Denmark have the right and access to assessment of nutritional status and nutritional therapy, regardless of age, diagnosis and clinical problem, thus ensuring patient rights and equality in health care for all.

The Danish Campaign logo


ONCA-Denmark aims to reduce the incidence of disease-related malnutrition in Denmark, thereby reducing nutrition-related risk of complications, prolonged treatment, re-admissions, disease incidence and mortality. Clinical nutrition focusing on citizen and patient are essential to fight disease- age and physical condition related to malnutrition.

The Danish Malnutrition Awareness Week

Mandate for ONCA-Denmark


Optimal Nutrition Care for All (ONCA) is a pan-European multistakeholder initiative aimed at supporting professional communities, associations, and patient groups. Furthermore, ONCA-Denmark participates in advancing optimal nutritional practices for citizens, relatives, and patients suffering from disease-related malnutrition.

The ONCA campaign is facilitated by the European Nutrition for Health Alliance (ENHA)[1]. ENHA has appointed a steering committee to lead the initiative through strategic guidance and engagement with partners at a national level. The steering committee consists of representatives from ESPEN, EUGMS, HOPE, EFAD, EGAN og MNI.

ONCA-Denmark is the national formalized ONCA co-operation in Denmark consisting of relevant professional health societies, patient associations, and industry in Denmark.



The overall purpose of ONCA-Denmark is to contribute to patients’ and citizens’ equal rights and access to the detection of the risk of malnutrition and relevant nutritional treatment – regardless of age, diagnosis, and clinical problem. The aim is to secure equality in health services for all[2]. Finally, efforts must be taken to develop and introduce professional standards in the municipalities also including user rights in relation to nutrition.

ONCA-Denmark wishes to contribute to reducing the prevalence of clinical malnutrition in Denmark, thereby reducing nutrition-related risk of complications, prolonged treatment, re-admissions, increased morbidity, and mortality. In addition, it is an independent goal to help citizens, relatives, and patients gain influence on their own care.



ONCA-Denmark will strive to increase political awareness and prioritization, which is crucial for achieving measurable success and constantly improving the quality of nutritional efforts.

ONCA-Denmark will additionally work to establish a national strategy to create coherent services for all citizens and patients in Denmark at risk of malnutrition. This will be achieved through contributions that can motivate and help the implementation of the malnutrition guideline from The Danish Health Agency Malnutrition: Detection, treatment, and follow-up on citizens and patients at nutritional risk[3]. Specifically, ONCA-Denmark uses four parameters to measure the success of the national strategy:

  • Measure: Measurement and assessment of the nutrition effort allow for monitoring the quality and effect. Data collection gives us the opportunity to measure and assess resource consumption in relation to the effect of nutrition efforts. By showcasing and spreading good practice ONCA-Denmark wishes to encourage politicians and healthcare system leaders across sectors to optimize the nutritional status among Danish citizens and patients.
  • Educate: Good nutritional therapy begins with education. ONCA-Denmark wishes to inspire and engage students in healthcare and nutrition professionals’ educations, with state-of-the-art knowledge from academia and real-life examples. Thus, ONCA-Denmark aims to work towards clinical nutrition being an integral part of the education of health professionals and nutrition professionals.
  • Implement: ONCA-Denmark wishes to develop tools to achieve effective implementation of the malnutrition guideline from The Danish Health Authority Malnutrition: Detection, treatment, and follow-up of citizens and patients at nutritional risk and contribute to continuously updating evidence-based nutrition practice.
  • Influence: Communication is an integrated part of the ONCA initiative. By delivering our messages to the relevant stakeholders through relevant channels, ONCA-Denmark reinforces our impact.

ONCA-Denmark aims to be the common platform for professional associations, organizations, and patient associations.


Target group

To achieve its goals, ONCA-Denmark focuses primarily on health and nutrition professionals who work with nutrition in all treatment, nursing, and rehabilitation programs in hospitals, general practice, and the municipality, health centers, nursing homes, home care, and other care institutions. The cooperation must ensure the active involvement of citizens and patients, as well as dialogue between the actors in the collaboration.

ONCA-Denmark also aims to engage Danish politicians at all levels, officials, planners, and employees in municipal and regional services, private stakeholders within the field of nutrition, medical societies, and educational institutions of healthcare professionals.

“Detection, treatment, and follow-up on citizens and patients at nutritional risk”

The Danish Health Agency Malnutrition

Aims and goals of ONCA-Denmark

*The ONCA partnership is an interdisciplinary collaboration between The Danish Society for Clinical Nutrition (DAPEN), The Diet and Nutrition Association, The Danish Lung Association and the Medical Nutrition Industry association (MNI).

The Alliance Against Malnutrition consists of several leading organizations that share an interest in solving the problem of malnutrition in Denmark. Working together, ONCA-Denmark leverages the competencies and knowledge into action in an interdisciplinary environment.

1. The Danish Health Authority’s guideline must be implemented across the healthcare sector

In cooperation with authorities and organizations, ONCA-Denmark aims to work for a cross-sectoral implementation of the workflows in the primary and secondary sectors as described in the guideline from The Danish Health Authority’s disease-related malnutrition. Also, it is important that the implemented workflows are maintained at hospitals, in municipalities, and in general practices. Lastly, it is crucial to implement the workflows in the curriculums of the education of healthcare professionals and nutrition professionals.

  • A political decision must be taken to implement the guidelines of The National Health Authority.
  • A plan is necessary for implementing measures, as well as creating recommendations and guidelines for training relevant staff, citizens, and patients.
  • Better use of health data will monitor and document the results of the implementation of the malnutrition guideline over time in order to measure impact, including patient-reported outcome measures (PROMS) as well as clinical outcome measures (i.e. readmissions, infectious complications) and health costs.
  • Equal access to nutrition efforts across municipalities and regions must be elucidated.




2. All citizens and patients in Denmark have the right and access to an assessment of nutritional risk and nutrition therapy when needed

ONCA-Denmark works to ensure that nutritional risks are identified systematically, so that patients and citizens in the primary sector, e.g., in-home care and nursing homes, can receive timely intervention. Accordingly, a nutrition plan must be drawn up for all citizens and patients at nutritional risk with agreement on accurate goals and follow-up, as well as who is responsible for the follow-up upon transition between sectors.

  • It is essential to define a strategy for practitioners to detect nutritional risk, e.g., when referring patients to cancer package courses, health examinations of the elderly, and annual examinations and follow-ups with patients with chronic diseases, etc.
  • All patients must be assessed for nutritional risk on admission and during outpatient procedures.
  • A special effort must be implemented for patient groups with a high prevalence of malnutrition.
  • Accurate goals and follow-up criteria must be established that cut across sectors, just as the responsibility for follow-up during the transition between sectors must be defined by clear frameworks and guidelines.
  • Priority must be given to achieve equal access to nutrition efforts for citizens across municipalities and regions.


3. A strong interdisciplinary cooperation on clinical malnutrition

ONCA-Denmark is committed to establishing a strong partnership between relevant authorities and organizations with a particular focus on disease-related malnutrition.

  • The partnership must launch awareness-raising initiatives among decision-makers and authorities, including creating an increased focus on the health-economic benefits of treating malnutrition.
  • ONCA-Denmark must be a platform where citizens and patients (through their associations) can meet and interact with decision-makers, authorities, and other relevant stakeholders.
  • Politicians, authorities, municipalities, regions, and general practitioners must be aware of ONCA-Denmark and ONCA’s work.



A chair, a communications officer, and a secretary of state ONCA-Denmark. The board of the Danish Society for Clinical Nutrition and Metabolism (DAPEN), which is the national scientific clinical nutritional society of Denmark, appoints two representatives for the ONCA-Denmark board (chair and communications officer). The secretarial function is handled by the secretary of ONCA-Denmark that is appointed by the industry association MNI.

ONCA-Denmark has two to three physical annual meetings. Additionally, online meetings and meetings in the international ONCA team occur.

ONCA-Denmark’s terms of reference are updated continuously. All members of ONCA-Denmark are involved in the updating process.


The role of the parties

The Danish Society for Clinical Nutrition and Metabolism (DAPEN) / (Dansk Selskab for Klinisk Ernæring (DSKE))

The Danish Society for Clinical Nutrition and Metabolism (DAPEN) is a professional partner of ONCA-Denmark. DAPEN ensures professional sparring and is a link to other scientific societies.

 The Danish Lung Association (Lungeforeningen)

The Danish Lung Association is a professional partner of ONCA-Denmark. The Danish Lung Association, being a patient association of Danish patients with lung diseases, contributes with unique knowledge of what is important for the individual patient and their next of kin. The Danish Lung Association also functions as a link to other patient associations.

The Diet and Nutrition Association (Kost og Ernæringsforbundet)

The Diet and Nutrition Association is a professional partner of ONCA-Denmark. The Diet and Nutrition Association is a union and interest organization for nutrition professionals and contributes with knowledge about the education of nutrition professionals and the work of nutrition professionals.

 The Medical Nutrition Industry Association MNI (FMF – Food for Medical Purposes)

FMF is a professional partner of ONCA-Denmark. FMF is an industry association for manufacturers of food for special medical purposes in Denmark under the Danish Chamber of Commerce. FMF contributes with communicational and PR skills. Furthermore, FMF has a large network with various relevant stakeholders.

The Danish Health Authority

The Danish Health Authority has observer status in ONCA-Denmark. Participation is strictly professional and not of political nature.

The Danish ONCA logo


The logo for ONCA-Denmark may only be used by the parties based on ONCA-Denmark’s activities and to draw attention to the association’s purpose and existence in relevant cooperation. On withdrawal from the collaboration, one must no longer use the logo. Participants may not use the logo in their own signatures, or on websites other than ONCA-Denmark or those related to the association’s cooperation. The logo can be used in Danish or English as relevant.

[1] ENHAs homepage

[2] The Vienna Declaration (2022)

[3] Guidelines from The Danish Health Agency (2022)


The terms of reference of ONCA-Denmark are first written and approved on May 21st, 2019. The present update was approved by ONCA-Denmark on June 1st, 2023.

Download & Read the Report in Danish

Kommisorium for ONCA-Danmark

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