Stichting European Nutrition for Health Alliance
ENHA
The European Nutrition for Health Alliance (ENHA) is a foundation, established to promote and implement nutritional risk screening and improve nutritional care for all European citizens.
ID: 349777191747-53
Lobbying Activity
Response to EU cardiovascular health plan
15 Sept 2025
European Nutrition for Health Alliance (ENHA) welcomes the European Commissions initiative to develop a Cardiovascular Health Strategy and urges that nutritional care services be explicitly integrated into its design. Malnutrition is both a consequence and a driver of poor outcomes in cardiovascular disease (CVD), especially in heart failure, where it is associated with higher mortality, rehospitalisation, and reduced quality of life [3]. Despite this, systematic nutritional screening and support remain the exception rather than the rule in European healthcare. Evidence shows that CVD is now predominantly a chronic-care burden. The Global Burden of Disease Study estimates that around 68% of all disability-adjusted life years (DALYs)a measure that combines years of life lost due to premature death with years lived with disabilityarise from conditions requiring long-term care, including cardiovascular disease [1]. At the same time, mortality from acute heart attacks has declined, while deaths from chronic conditions such as heart failure, hypertensive heart disease and arrhythmias have risen [2]. This shift underscores the need for a strategy focused not only on acute episodes but also on comprehensive, continuous care. Malnutrition is common in chronic CVD and has clear prognostic value. Large systematic reviews show that simple, low-cost indicessuch as the Geriatric Nutritional Risk Index (GNRI), the Controlling Nutritional Status score (CONUT), or the Prognostic Nutritional Index (PNI)predict survival and rehospitalisation independently of other risk factors [3]. These tools can be used in routine clinical practice to identify patients at risk and to guide interventions. Integrating nutritional care services into the EU CVD strategy will deliver multiple benefits. For patients, it means better symptom control (e.g. fatigue, frailty, cachexia), improved functional status, and higher quality of life. For health systems, it reduces avoidable hospitalisations and aligns care with the chronic nature of CVD. For policymakers, it offers a cost-effective way to strengthen sustainability and equity in ageing populations. We therefore recommend that the Strategy: Require opportunistic nutritional screening for all patients with CVD in hospitals and outpatient care. Establish EU-level standards for nutritional assessment and personalised interventions, ensuring continuity of care across hospital, rehabilitation, and community settings. Fund patient empowerment and nutrition literacy initiatives to support adherence and shared decision-making. Incorporate nutrition-related quality indicators (e.g. screening rates, malnutrition prevalence, readmission rates) into national CVD plans. Embedding nutrition in the Cardiovascular Health Strategy will align with Europes Beating Cancer Plan, the EU4Health programme, and other chronic disease initiatives, ensuring that every European living with cardiovascular disease has access to the nutritional care they need. To achieve this, the Strategy should also encourage the creation and support of multi-stakeholder alliancesbringing together policymakers, healthcare professionals, patient organisations, researchers, and industrysuch as ENHA, which can translate evidence into practice and sustain political momentum. References 1. GBD 2019 Acute & Chronic Care Collaborators. Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019. Nat Commun. 2025;16:4235. 2. King SJ, Wangdak Yuthok TY, et al. Heart Disease Mortality in the United States, 19702022. J Am Heart Assoc. 2025;14:e038644. 3. Lv S, Ru S. Malnutrition among patients with heart failure: a systematic review. PLoS ONE. 2021;16(10):e0259300.
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