ENHA EU Manifesto: A Manifesto for Health Equity in the EU
Nutrition and nutritional care are eminently (cost) effective interventions and should therefore be a key component and integral part of any EU health initiative that strives for disease prevention, effective treatment and improved patient outcomes.

By Olle Ljungqvist, Professor of Surgery, Nutrition & Metabolism, Örebro University, Sweden and Frank de Man, Executive director, European Nutrition for Health Alliance.

This OpEd was also published by Euractiv, on 24 sep 2020.

In her State of the Union on 16 September, European Commission president Ursula von der Leyen stated that ‘For me, it is crystal clear – we need to build a stronger European Health Union. And to start making this a reality, we must now draw the first lessons from the health crisis. We need to make our new EU4Health program future proof. This is why I had proposed to increase funding and I am grateful that this Parliament is ready to fight for more funding and remedy the cuts made by the European Council.’

“Needless to say, the EU health program budget is but a fraction in terms of funding, making it totally inadequate to answer the colossal health challenges we are facing at a European level”

MEP Sara Cerdas, MD (S&D), September 11

We strongly support a full-fledged and well funded EU4Health programme. However, we do believe the desired health benefits and patient outcomes of a stronger European Health Union can only be achieved by including nutrition and nutritional care in every health programme.

Malnutrition and undernutrition affect over 30 Million European citizens and place an unacceptable burden on European citizens and health care budgets. Ample scientific evidence shows that optimizing nutritional care is a very (cost-) effective measure in both disease prevention and treatment.

EU4Nutrition aims to secure optimal nutritional care for all EU citizens by integrating nutrition in all EU programs and EU recommendations for national health policies. It was launched by the European Nutrition for Health Alliance (ENHA) and partners and complements the national level Optimal Nutritional Care for All campaign, already implemented in 18 European countries.

Let us look at cancer, one of the key pillars of the EU4Health program is the Europe’s Beating Cancer Plan, as an example.

“Extensive scientific evidence shows that nutrition is one of the decisive elements for the prevention and good treatment of oncological diseases”

MEP Aldo Patriciello (EPP, Italy), Co-Chair of the Challenge Cancer Intergroup

But in reality, we do not act upon this scientific evidence. It is estimated that the deaths of 10-20% of patients with cancer can be attributed to malnutrition rather than to the malignancy itself. Thus, nutrition is an important aspect of multimodal cancer care. Yet, recent studies in European hospitals found that only 30%-60% of patients with cancer who were at risk of malnutrition actually received nutritional support.

This is why the European Cancer Patient Coalition (ECPC) and a wide range of European health stakeholders recently published a joint statement requesting to make cancer related complications and comorbidities an EU health priority, while emphasizing the importance of nutritional care. ‘Equitable access to nutrition and nutritional care as an integral part of comprehensive care for all cancer patients with a focus on ageing patients, is a key condition to reduce complications and comorbidity, maintaining optimal health and quality of life.’

Another example is the importance of nutrition in COVID. In their article in the Journal of Clinical Nutrition, June 2020, Rocco Barrazonni, chair of the European Society for Clinical Nutrition and Metabolism (ESPEN) and colleagues provide recommendations for effective nutritional management of COVID-19 patients.

In summary: ‘The COVID-19 pandemics is posing unprecedented challenges and threats to patients and healthcare systems worldwide…. ICU stay, poly-morbidity and older age are all commonly associated with high risk for malnutrition, representing a relevant risk factor per se for higher morbidity and mortality in chronic and acute disease. …. Prevention, diagnosis and treatment of malnutrition should therefore be routinely included in the management of COVID-19 patients.’


We call on anyone working on or deciding on EU health initiatives:

“If you are serious about health, you should be serious about nutrition.”

Frank de Man, Executive Director ENHA

The EU actively works on EU4Health, the Farm to Fork strategy, the Europe’s beating Cancer plan and the EU plan for health workers, initiatives that provide plenty of opportunity to include nutrition and nutritional care.

How? Watch our 1 October 2020 EU4Nutrition LIVE event now on demand.
A European-wide debate to secure optimal nutritional care for all European citizens, broadcasted live from Amsterdam Brussels and Madrid. With contributions from key opinion leaders in health care and MEPs such as Aldo Patriciello and Sara Cerdas.

Watch the EU4Nutrition LIVE event on demand

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