Prioritizing Heart Health: A Call to Action for World Heart Day
With cardiovascular diseases (CVDs) now the leading cause of death globally, prioritizing their management and implementing preventative measures is critical to enhancing quality of life and longevity. This is a key goal of the World Heart Day campaign, which advocates for small lifestyle changes, including dietary adjustments, to better manage heart health and combat CVDs. Improving our diet by incorporating a variety of whole grains, ample fruits and vegetables, nuts, and legumes, while limiting excessive consumption of fats, salt, and sugars, is essential for CVD prevention. Alternatives to sugars, such as low- and no-calorie sweeteners, can play a significant role in sugar reduction and can be part of a healthy diet for optimal cardiometabolic health.
The Significance of CVDs
Over 50 million people in the EU are living with CVDs, with more than five million new cases diagnosed each year. This leads to millions of deaths from heart attacks or strokes, earning CVDs the title of “the EU’s biggest killer” (European Society of Cardiology). Additionally, CVDs are the leading cause of death worldwide (World Health Organization; World Heart Federation). The impact of CVDs on health, society, and the economy is profound, affecting quality of life, productivity, and increasing dependency on family and societal support.
World Heart Day, celebrated annually on September 29, serves as an important reminder of simple lifestyle adjustments that individuals can make to lead healthier lives.
The Need for Action
Addressing CVDs is a high priority on the EU agenda, with political groups across the spectrum recognizing it as a critical issue. Among other health priorities, the European Commission has committed to improving preventative health in its 2024-2029 political guidelines, with a specific focus on CVDs. The Hungarian Presidency of the Council’s concept paper emphasizes the importance of CVD prevention and advocates for an environment that supports physical activity, healthy nutrition, and mental well-being while combating significant risk factors such as tobacco and alcohol consumption. An upcoming European Action Plan will further address prevention, innovation, and treatment options.
A Healthy Diet: Key to Prevention
At least 80% of deaths from CVDs could be avoided through the adoption of healthier lifestyles (The Economist Impact). This includes quitting smoking, reducing alcohol consumption, combating unhealthy diets and obesity, and increasing physical activity (World Health Organization). In terms of food and nutrition, progress on reformulation frameworks aimed at reducing excess salt, saturated fat, and sugars in foods is vital.
A healthy diet that includes a variety of vegetables, fruits, legumes, nuts, and whole grains, while being low in salt, fat, and sugars, is essential for protecting cardiometabolic health. Limiting excessive intake of free sugars is globally recommended as part of a healthy diet, particularly for the prevention and management of cardiometabolic diseases such as CVDs and type 2 diabetes (World Health Organization).
The Role of Low/No-Calorie Sweeteners
“Low and no-calorie sweeteners (LNCS) can help individuals reduce sugar intake while enjoying a healthy and flavorful diet, particularly for those with or at risk of cardiometabolic diseases,” said Laurent Oger, Director General of the International Sweeteners Association (ISA). Given our innate appetite for sweetness, LNCS provide a useful strategy for managing cravings for sweet treats without the caloric burden and adverse effects of sugars. When used instead of their regular-calorie counterparts, foods and drinks sweetened with LNCS allow individuals to enjoy sweet flavors while reducing both sugar and calorie intake, enhancing dietary satisfaction and adherence to an overall healthy eating pattern.
Clinical research demonstrates that, when used to replace sugars, LNCS have a neutral or modestly beneficial effect on cardiometabolic risk factors, including glycemic control, blood pressure, lipid levels, liver enzymes, uric acid, body weight, and liver fat (McGlynn et al., 2022). The positive impact of LNCS on heart health markers such as liver fat, fat mass, and body weight is significant. By substituting sugars with LNCS, the caloric content of foods and drinks is lowered, along with their sugar content.
Systematic reviews and meta-analyses of randomized controlled trials consistently indicate that LNCS, when used in place of sugar, can support lower energy intake and aid in weight control over time (WHO, 2022; Laviada-Molina et al., 2020; Rogers and Appleton, 2021). The benefit, of course, hinges on the extent to which sugars and calories are replaced in the diet by LNCS.
As global and European rates of CVDs continue to rise, it is essential to expand and integrate tools into public health promotion strategies. In light of World Heart Day, prioritizing a healthy diet and nutrition should be central to the EU CVD Action Plan, ensuring that tools for sugar reduction, such as low and no-calorie sweeteners, are included in these discussions.
