EU Strategy Workshop Breakout Session, Isabelle Manneh

Introduction

The joint EU4Nutrition initiative aims to translate nutritional care science into EU policies and programmes.

It is supported by the Optimal Nutritional Care for All campaign, implemented in 19 countries.

The EU4Nutrition first strategy development workshop is a collaborative effort so that the final strategy reflects the collective input and perspectives of all relevant stakeholders and aims to create synergy, aligning goals, strategies, and tactics to maximize impact and avoid duplication of efforts.

The interactive break-out session aims to:

exchange good practices
discuss challenges and opportunities
ultimately resulting in first recommendations for a strategy towards the European Union that will inform key stakeholders, increase awareness and accelerate the implementation of optimal nutrition care for patients

Task

Please try to take the next 15-20 minutes to reflect and try to address the following questions:

What longer term, general trend do you see when looking at EU policies and the topic of malnutrition/nutritional care? What are trends that you notice at the level of the WHO, European Union and local governments?
What policy dossiers is your organisation working on that might align with better access to nutritional care for European citizens? Who is targeted, through what means? What are your (expected) achievements?
What would be desired outcomes of advocating for nutritional care in terms of EU policy? What would impact practice? What would be concrete asks?
What bottlenecks hamper the uptake of optimal nutritional care in EU policies? Which one seems most persistent or the hardest to tackle?
What are the strengths of the EU4Nutrition and ONCA campaign? The group comprises many EU-level NGOs and 20 teams in the member states, so how can we create synergy?
What would be key opportunities in the longer term? Opportunities that align with EU4Nuition and ONCA Campaign (future) strengths, might require a continued joint effort and will have a significant impact on patients/people at risk of malnutrition.
What potential stakeholders should be included? e.g. associations and advocacy groups, government agencies to be included in strategy development as well as future activities.
What can be promising structures, initiatives, programmes for nutrition care policy shaping activities e.g. existing policy frameworks, education, awareness
What potential resources could be found to support the EU4Nutrition initiative? What resources could support (significantly) scaling up our efforts to provide access to nutritional care to European citizens?

Process

Identify the relevant health policies: this includes relevant EU health policies and initiatives that could benefit from integrating nutrition care.
Identify current gaps in nutrition care within the identified health policies and initiatives, as well as the needs of the target population.
Analyze the evidence: this involves reviewing the available evidence on the effectiveness of nutrition care interventions, as well as the evidence on the costs and benefits of integrating nutrition care.
Develop recommendations for how nutrition care can be integrated into the identified health policies and initiatives.

Evaluation

One general trend observed when looking at EU policies and the topic of malnutrition/nutritional care is an increased focus on prevention and early intervention. There is a growing recognition that addressing malnutrition early on can help prevent a range of health problems and improve overall health outcomes.

At the level of the World Health Organization (WHO), there is a push for a more comprehensive approach to addressing malnutrition that takes into account the multiple factors, including poverty, food insecurity, and inadequate access to healthcare. The WHO has also emphasized the need to address malnutrition in all its forms, including both undernutrition and overweight/obesity.
In the European Union, there has been a growing emphasis on promoting healthy diets and lifestyles, with a focus on reducing the consumption of processed and high-calorie foods. This has been reflected in policies such as the EU School Fruit Scheme, which aims to promote healthy eating habits among children, and the EU Action Plan on Childhood Obesity, which aims to reduce the prevalence of overweight and obesity among children.
At the local government level, there has been a growing focus on community-based approaches to addressing malnutrition, including initiatives that promote access to healthy food options and encourage physical activity. Local governments have also been working to improve access to healthcare services and provide targeted support to vulnerable populations.

Advocating for nutritional care in EU policy can have several desired outcomes, including:

Increased awareness and recognition of the importance of nutrition in promoting health and preventing disease.
Development and implementation of evidence-based policies and programs that promote healthy diets and lifestyles.
Improved access to healthy and nutritious food for all populations, especially vulnerable groups such as low-income families and the elderly.
Increased funding for research and innovation in the field of nutrition and nutritional care.
Improved education and training for healthcare professionals on the importance of nutrition in patient care.

To impact practice, it is important to advocate for concrete actions that can be taken at both the EU and member state levels. Some examples of concrete asks that can be made include:

Developing and implementing nutrition labeling policies that are easy for consumers to understand and use.
Encouraging the adoption of nutrition and health claims that are based on scientific evidence and are not misleading.
Promoting the use of nutrition screening and assessment tools in healthcare settings.
Developing and implementing guidelines for the prevention and management of malnutrition in different settings.
Providing financial incentives to promote the production and availability of healthy and nutritious food.

There are several bottlenecks that can hamper the uptake of optimal nutritional care in EU policies, including:

Limited resources and funding: limited resources and funding can make it difficult to implement evidence-based policies and programs that promote optimal nutritional care.
Fragmentation of policies and programs: the fragmentation of policies and programs can make it difficult to achieve a coordinated approach to promoting optimal nutritional care across different sectors and settings.
Food Industry influence: The influence of the food industry can make it difficult to implement policies and programs that are in the best interest of public health.
Lack of awareness and education: Lack of awareness and education among policymakers, healthcare professionals, and the general public can make it difficult to prioritize nutrition and to implement evidence-based policies and programs.

The EU4Nutrition and ONCA campaign have several strengths, including:

Collaborative approach: the campaign brings together a diverse range of stakeholders, including NGOs, health professionals, and policymakers, to work collaboratively towards a common goal of improving nutritional care in the EU.
Multi-level engagement: the campaign operates at both the EU and member state levels, which allows for a more coordinated and comprehensive approach to promoting optimal nutritional care.
Evidence-based approach: the campaign is grounded in scientific evidence and promotes evidence-based policies and programs to improve nutritional care in the EU.
Focus on vulnerable populations: the campaign places a strong emphasis on addressing the nutritional needs of vulnerable populations, such as children, older adults, and individuals with chronic illnesses.

To create synergy between the EU4Nutrition and ONCA campaign and the member states, there are several strategies that can be employed:

Communication and collaboration working closely with the member state teams to ensure that their efforts are aligned and complementary.
Capacity building at all levels, including providing training and support to member state teams
Advocacy and awareness-raising working with the member state teams to advocate for evidence-based policies and programs at the national level
Evaluation and monitoring of activities

There are several key opportunities in the longer term that align with the strengths of the EU4Nutrition and ONCA Campaign and have the potential to have a significant impact on patients/people at risk of malnutrition. These include:

Strengthening health systems: One key opportunity is to strengthen health systems to better integrate nutritional care and to promote a more patient-centered approach to care. This could involve improving training for healthcare professionals, increasing access to screening and assessment tools, and developing innovative care models that prioritize nutrition.
Promoting public-private partnerships: Another opportunity is to promote public-private partnerships that encourage the food industry to develop and promote healthier food products and to reduce the marketing of unhealthy products. This could involve incentives for industry to reformulate products, develop healthier options, and invest in nutrition research.
Increasing public awareness: A third opportunity is to increase public awareness of the importance of optimal nutritional care and to promote behavior change through targeted public health campaigns. This could involve working with the media, community organizations to disseminate evidence-based information and promote healthy behaviors.
Promoting policy coherence: A fourth opportunity is to promote policy coherence across different sectors, including health, agriculture, and trade, to ensure that policies and programs are aligned and support optimal nutritional care. This could involve developing cross-sectoral strategies, increasing collaboration between different ministries and agencies, and conducting policy reviews to identify areas for improvement.

To take advantage of these opportunities, it will be important for the EU4Nutrition and ONCA Campaign to continue to work collaboratively with stakeholders at the EU and member state levels, to advocate for evidence-based policies and programs, and to develop innovative approaches to promoting optimal nutritional care. By doing so, we can help to ensure that patients/people at risk of malnutrition receive the care and support they need to lead healthy and fulfilling lives.

To develop effective strategies and ensure the success of future activities, it is important to engage a wide range of stakeholders. Potential stakeholders that could be included in the development of strategies and future activities related to the promotion of optimal nutritional care in the EU include:

Non-governmental organizations (NGOs)
Professional associations representing healthcare professionals, nutritionists, and dietitians can provide expertise on the latest research and best practices in nutritional care, and can help to mobilize their members to advocate for evidence-based policies and programs.
Patient and consumer organizations
Government agencies at both the EU and member state levels play a critical role
Food Industry representatives that can provide insights into the challenges and opportunities
Academic institutions

There are several promising structures, initiatives, and programs that can help shape EU nutrition care policy and promote optimal nutritional care. Some examples include:

EU Nutrition and Health Claims Regulation: This regulation sets standards for nutrition and health claims on food labels and in advertising, and can help to promote consumer awareness of the nutritional content of food products.
EU School Fruit, Vegetables and Milk Scheme: This program provides free fruit, vegetables, and milk to schoolchildren in participating EU countries, with the aim of promoting healthy eating habits and improving nutrition among children
EU Platform on Diet, Physical Activity, and Health: This platform brings together stakeholders from across the EU to exchange information and best practices related to promoting healthy diets and physical activity.

By continuing to develop and implement evidence-based approaches to nutritional care, we can help to ensure that all EU citizens have access to the care and support they need to lead healthy and fulfilling lives.

here are several potential resources that could be found to support the EU4Nutrition initiative and to significantly scale up efforts to provide access to nutritional care to European citizens. Some examples include:

EU funding: the EU provides various funding opportunities for projects related to health and nutrition, such as the Horizon Europe research program and the European Social Fund.
Private sector partnerships
Philanthropic support: Philanthropic organizations and individuals can provide financial support to nutrition care initiatives through grants, donations, and partnerships.
Academic collaborations
Government support: Governments at the EU and member state levels can provide policy support, infrastructure, and other resources to support nutrition care initiatives, such as by funding nutrition education and training programs.

Teacher Page

Based on available research it is estimated that 10-20% of the 1.3 m cancer deaths in the EU (2020) can be attributed to malnutrition, rather than cancer itself. Yet, only 30%-60% of patients with cancer who were at risk of malnutrition receive nutritional support.
Today, over 30 million European citizens continue to be at risk of malnutrition, and the COVID pandemic has had a severe impact on cancer care with delayed diagnosis and (nutritional) treatment of cancer patients.
In February 2021, the European Commission adopted its ambitious €4 billion Europe’s Beating Cancer Plan covering prevention, early detection, diagnosis & treatment and quality of life.
Europe’s Beating Cancer Plan commits to giving everyone with cancer the same access to high-quality care.
Nutritional support that has become part of Europe’s Beating Cancer plan, within a workforce ‘Inter-specialty cancer training programme’ and secured commitment of the Commission’s cancer team to include support of cancer patients through screening for malnutrition, medical nutrition and treatment guidelines. However, the challenge of the plan lies in its implementation.
The European Parliament adopted on 16 February 2022 its own-initiative report on “Strengthening Europe in the fight against cancer – towards a comprehensive and coordinated strategy”. This report proposes a wide range of actions and measures for reducing the burden of cancer on society including: cancer prevention, equal access to cancer care across borders, and a European approach addressing medicine shortages.
European Commission's Health Policy Platform Annual Meeting May 5th, 2023 will include the presentation of the "Integrated Nutrition Cancer Care" Whitepaper.
The EU Health Policy Platform thematic network “Integrated Nutrition Cancer Care” led by the European Nutrition Health Alliance (ENHA) and various stakeholders, aims to make the case for why integrating Nutrition in National Cancer Care Plans and European Policies is crucial for patients.