Towards a better primary healthcare in europe: Shifts in public health nutrition policies

The interrelated challenges of suboptimal dietary habits and abnormal weight status have never been as high on the global and European public health agenda as nowadays [1]. Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), cancer, diabetes and respiratory disease, kill 41 million people each year, equivalent to 71% of all deaths and >80% of premature deaths globally [2]. Obesity prevalence is either rapidly increasing or stabilizing at very high levels in almost all European countries [3]. On the other side, the latest results from the ongoing Global Burden of Disease Study revealed that one in five deaths globally can be attributed to an unhealthy diet, with this proportion soaring when abnormal weight status and other measures of maternal and child malnutrition are included [4]. Similarly, it is estimated that among all behaviors, nutrition makes the largest contribution to CVD mortality and morbidity at the population level across Europe [5]. Countries in the World Health Organization (WHO) European Region are rather diverse in terms of income and development levels, as well as food culture and traditions. However, their dietary habits are commonly suboptimal, characterized by energy imbalance and excessive intake of saturated fats, trans fatty acids, added sugars and salt—largely due to increased consumption of highly processed, energy-dense manufactured foods and sugar-sweetened beverages—as well as inadequate consumption of vegetables, fruits and whole grains [6]. Regions of low socioeconomic status are the most severely affected, with major economic and welfare costs for the whole society [7]. Such observations spur the need for ambitious action by European governments.