Rethinking the EU cardiovascular health plan: Putting children at the heart of Europe’s health strategy

Every week in my clinic, I see what the data already tells us. Adolescents arriving with elevated blood pressure. Children showing early signs of metabolic dysfunction and excess weight gain. Teenagers whose diets consist largely of ultra-processed snacks and energy drinks. These are not isolated cases. They are becoming increasingly common, reflecting the food environment that has gradually taken shape around an entire generation, writes Dr Hena Ibrahim MD.

That reality makes it encouraging to see the European Union showing genuine ambition on public health. The Safe Hearts Plan and Europe’s Beating Cancer Plan demonstrate real political commitment, and that deserves recognition. But if these initiatives are to make a lasting difference for our children, they must confront the underlying causes of disease as they exist today. Ambition alone is not enough. Effective public health policy begins with an honest assessment of what is driving the burden of chronic disease among young people.

More than half of EU adults are already overweight, and around one in four children aged seven to nine is overweight, including around one in ten who are living with obesity. This is not a future risk. It is a public health crisis unfolding today. Children who develop obesity early often carry a lifelong burden of cardiovascular risk through hypertension, insulin resistance, and chronic inflammation. As a physician, I see the consequences of these trends every day. A heart health strategy that does not place childhood obesity at its centre is treating symptoms rather than causes.

Diet is not the only driver of childhood obesity. Physical inactivity, sedentary lifestyles, socioeconomic factors, and the broader environment all play important roles. But diet remains one of the most modifiable factors available to policymakers and one of the most significant contributors to long-term cardiometabolic health.
And the dietary drivers are not difficult to identify.

Ultra-processed foods high in added sugars, sodium, refined carbohydrates, and heavily processed ingredients have become a staple of many children's diets and are strongly associated with obesity and poorer metabolic health outcomes. Processed meats, which have been linked to increased risks of colorectal cancer and cardiovascular disease, remain widely consumed across Europe. At the same time, energy drinks loaded with sugar and caffeine are increasingly popular among adolescents and have been associated with elevated blood pressure, heart rhythm disturbances, and other cardiovascular concerns. These are not marginal issues. They are among the upstream drivers of the disease burden we are trying to reduce, yet they continue to receive less attention than they deserve in EU public health policy.

I do not underestimate the challenge. Ultra-processed foods are deeply embedded in modern life, from supermarket shelves to school cafeterias. But after years of working with families in both clinical and non-profit settings, I have seen that people respond when the right environment is created. Parents want to make healthy choices for their children, and schools want to provide nutritious meals. More often than not, the barriers are structural rather than personal.

That is why fiscal policy matters. The IMF and other international economic institutions have increasingly argued that taxation can be used to better align consumer prices with health harms, particularly for products associated with chronic disease risk. The EU already applies this principle to tobacco. There is a strong case for applying similar logic more consistently to products that are demonstrably contributing to obesity, cardiovascular disease, and poorer health outcomes across Europe.

Regulation must also keep pace with the evidence. Clear standards that discourage excessive sugar, sodium, and other dietary risk factors, applied consistently across product categories, would send an important signal to both manufacturers and consumers. The greater the risk, the stronger the regulatory response should be. That is not a radical idea. It is simply evidence-based policymaking.

The encouraging news is that progress is possible. We have seen it with tobacco and are beginning to see it with growing awareness of alcohol-related harms. The tools already exist. What is needed now is the willingness to apply them consistently.

That is why the upcoming vote on the European Parliament’s cardiovascular disease strategy matters so much. The decisions made will help shape Europe’s approach to heart health for years to come. The Safe Hearts Plan and Europe’s Beating Cancer Plan provide a strong foundation, but they will only succeed if they address the major drivers of disease. Obesity, metabolic health, healthy nutrition, and prevention-focused policies should be at the centre of that effort. From what I see in my clinic week after week, the stakes could not be higher.

Hena Ibrahim is a pediatrician based in Chicago. She graduated Cum Laude with a BA from Loyola University and received her MD from St. George’s University. She completed her residency at Cook County Hospital and is currently in private practice at Saint Anthony Hospital where she also served as Medical Director of Ambulatory Services. Dr. Ibrahim began her medical relief work in 2016, assisting Syrian refugees stranded along the Greece/Macedonia border. Since then, she has participated, led and established medical programs around the world. She served as interim executive director of MedGlobal from 2020-2021 and is an outspoken advocate for women & refugee health and gun violence.

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